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| 6902288301 | What is compatibility testing and its Purpose | pretransfusion testing To select blood components that will not cause harm to the recipient and will have acceptable survival when transfused Confirms ABO compatibility between the component and the recipient will detect the most clinically significant unexpected antibodies | 0 | |
| 6902288302 | components of compatibility testing | Proper specimen collection Reviewing patient transfusion history ABO, Rh, and antibody testing (screen/ID) Crossmatching Actual transfusion | 1 | |
| 6902288303 | 3 categories of compatibility testing | Preanalytical procedures Serological testing Postanalytical procedures | 2 | |
| 6902288304 | Pre-analytical phases | Patient identification Specimen collection Review of patient history | 3 | |
| 6902288305 | Patient Identification | Must confirm recipient's ID from bracelet ON the patient Full patient name and hospital number Name of physician | 4 | |
| 6902288306 | Identification should include | full patient name Medical record number Collection date and time Phlebotomist's initials Should be on both the request form and sample | 5 | |
| 6902288307 | Blood Specimen Tubes | pink- EDTA: plasma red top tubes - serum seperator |  | 6 |
| 6902288308 | Specimen Collection | Use EDTA or no additives Hemolysis - sample may be rejected True hemolysis is a result of complement activation | 7 | |
| 6902288309 | Sample labeling | should be done at the bedside pre-labeling is not recommended A record of individuals who collect and test specimens is documented "backtrack" in case of an error | 8 | |
| 6902288310 | IV line sample | infusion is stopped 5-10 minutes prior to blood drawing- preferred first 10 mL discarded- to prevent contamination of the samples or patient can be drawn below the line | 9 | |
| 6902288311 | Patient History | Prior unexpected antibodies Previous transfusion reactions | 10 | |
| 6902288312 | Serological Testing 3 tests | ABO/Rh Antibody detection/identification Crossmatch | 11 | |
| 6902288313 | ABO/Rh Typing | In the ABO typing forward and reverse MUST match In the Rh typing control must be negative Both of these will indicate what type of blood should be given | 12 | |
| 6902288314 | antibody screen | detects unexpected antibodies in recipient | 13 | |
| 6902288315 | If antibodies are detected | identification using panel cells Autocontrol IS 37° (LISS) AHG | 14 | |
| 6902288316 | If an antibody is present | negative units for the antigen must be given Proceed to the crossmatch | 15 | |
| 6902288317 | Purpose of Crossmatching | Prevent transfusion reactions Increase in vivo survival of red cells Double checks for ABO errors Another method of detecting antibodies | 16 | |
| 6902288318 | AABB and FDA | develop the standards for blood banking | 17 | |
| 6902288319 | Crossmatches | According to the AABB Standards: The crossmatch "shall use methods that demonstrate ABO incompatibility and clinically significant antibodies to red cell antigens and shall include an antiglobulin phase" | 18 | |
| 6902288320 | how to detect compatibility | Donor RBCs (washed) and Patient serum No agglutination ~ compatible Agglutination ~ incompatible |  | 19 |
| 6902288321 | The procedure | Donor cells are taken from segments that are attached to the unit itself Segments are a sampling of the blood and eliminate having to open the actual unit | 20 | |
| 6902288322 | if antibodies are NOT detected | Only immediate spin (IS) is performed using patient serum and donor blood suspension This fulfills the AABB standard for ABO incompatibility This is an INCOMPLETE CROSSMATCH | 21 | |
| 6902288323 | ABO/D Phenotyped determined No alloantobodies detected | No further tested needed immediate spin (IS) is performed or computer crossmatch if units are ordered | 22 | |
| 6902288324 | If antibodies ARE detected | Antigen negative units found and crossmatched All phases are tested: IS, 37°, AHG This is a COMPLETE (OR FULL) CROSSMATCH | 23 | |
| 6902288325 | ABO/D Phenotyped determined alloantobodies detected | Identify the antibody Perform a complete crossmatch IS and AHG of units that are antigen- negative for antibody | 24 | |
| 6902288326 | ABO/D Phenotyped determined Record of previous alloantibody | Rule out or identify additional antibodies Perform a complete crossmatch IS and AHG of units that are antigen- negative for antibody for prior and new alloantibody | 25 | |
| 6902288327 | Crossmatches will | Verify donor cell ABO compatibility Detect most antibodies against donor cells | 26 | |
| 6902288328 | Crossmatches will not | Guarantee normal survival of RBCs Prevent patient from developing an antibody Detect all antibodies Prevent delayed transfusion reactions Detect ABO/Rh errors | 27 | |
| 6902288329 | Incompatible crossmatches: AbY +, CMX- | Antibody screen- Positive Crossmatch- Negative Cause- Antibody directed against antigen on screening cell ResolutionID antibody, select antigen negative blood | 28 | |
| 6902288330 | Incompatible crossmatches: AbY -, CMX+ | Antibody screen- Negative Crossmatch- Positive Cause- Antibody directed against antigen on donor cell which may not be on screening cell OR donor unit may have IgG previously attached ResolutionID antibody- ID antibody, select antigen negative blood OR perform DAT on donor unit | 29 | |
| 6902288331 | Incompatible crossmatches: AbY +, CMX+ | Antibody screen- Positive Crossmatch- Positive Cause- Antibodies directed against both screening and donor cells ResolutionID antibody- Antibody ID, select antigen negative blood | 30 | |
| 6902288332 | Post-analytical phase | Labeling Form is attached to donor unit and only released for the recipient The unit is visually inspected for abnormalities, such as bacterial contamination, clots, etc | 31 | |
| 6902288333 | Bacterial contamination | This unit shows bacterial contamination and should NOT be given to the patient The plasma in the segments is fine, but the plasma in the unit shows heavy hemolysis from bacteria | 32 | |
| 6902288334 | Labeling consists of | patient's full name Patient's medical record number ABO/Rh of patient and unit donor number compatibility results tech ID | 33 | |
| 6902288335 | unused unit | Blood can be returned if it is not needed for transfusion Unit closure has to remain unopened Storage temperature must have remained in the required range (1° to 10°C for RBCs) If not at correct temp, unit must be returned within 30 minutes of issue | 34 | |
| 6902288336 | Issuing blood | Before release of a blood product Checklist Requisition form Comparing requisition form donor unit tag blood product label Name of persons issuing and picking up blood Date and time of release Expiration date | 35 | |
| 6902288337 | Once the specimen arrives | ABO/Rh typing antibody screening Crossmatch crossmatch additional units if more blood is needed | 36 | |
| 6902288338 | Emergency Release | In an emergency (ER or OR), there may not be enough time to test the recipient's sample In this case, blood is released only when signed by the physician The tag must indicate it is UNCROSSMATCHED blood Segments should be retained for crossmatching once patient has been drawn Every detail is documented (names, dates..) | 37 | |
| 6902288339 | If patient dies | testing should be complete enough to show that the death was unrelated to an incompatibility | 38 | |
| 6902288340 | What can be given in an emergency | Group O Rh-negative red cells or AB plasma Women < 55 years of age Children Or if in doubt Group O Rh-positive red cells Female > 55 years of age Males | 39 | |
| 6902288341 | Type O blood | Patient's Type: O 1st choice: O other choices: None | 40 | |
| 6902288342 | Massive transfusion | Approaches or exceeds 5 liters or 10-12 units within 24 hour period The original sample no longer represents the patient's condition Give ABO identical units If antibodies were originally ID's, continue to give antigen negative units | 41 | |
| 6902288343 | Appropriate units to give | ABO compatible should always be given first Group O individuals are "universal donors", they can donate to any blood group because they have no A or B antigens Group AB individuals are "universal recipients", they can receive blood from any group because they do not have A or B antibodies | 42 | |
| 6902288344 | Type A blood | Patient's Type: A 1st choice: A other choices: O | 43 | |
| 6902288345 | Type B blood | Patient's Type: B 1st choice: B other choices: O | 44 | |
| 6902288346 | Type AB blood | Patient's Type: AB 1st choice: AB other choices: A, B, O | 45 | |
| 6902288347 | Type & Screen | Used to conserve blood inventory Most surgical procedures use 1 unit of RBCs Units maybe on "hold" in the lab needed Only a type & screen are performed if blood is needed sample can be retrieved for crossmatching If antibodies are identified then antigen negative blood is reserved or crossmatched in advance of the surgery (variable by hospital policy, but typically no more than 72 hrs in advance) | 46 | |
| 6902288348 | Neonatal Transfusion | Babies <4 months old do not have antibodies O negative unit Less than 5 days old CMV negative Irradiated If clinically significant antibodies are detected usually maternal antigen negative units are given Pedipacks small aliquots of larger units prepared by the donor facility for infant transfusion | 47 | |
| 6902288349 | Autologous crossmatching | donation from the recipient for later use Special procedures/protocols unit is found and transfused to the recipient Pretransfusion testing procedures vary by site If an autologous unit has been collected, this unit MUST be transfused prior to allogenic unit FDA reportable offense if not followed | 48 | |
| 6902288350 | Other components to be given do not need to be crossmatched | Frozen plasma Cryoprecipitate Platelets pheresis Granulocyte concentrates Give ABO compatible units | 49 | |
| 6902288351 | Electronic or computer crossmatch | According to the AABB, the following must be fulfilled: Critical elements of the information system have been validated on-site. No clinically significant antibodies are detected in the current blood sample and there is no record of clinically significant antibodies in the past | 50 | |
| 6902288352 | Computer crossmatch | Patient's ABO group and Rh type has been tested twice and entered in the computer "second type" must be performed on separate sample collected at a separate time than the first The donor ABO/Rh have been confirmed entered in the computer donor unit identification number component name ABO/Rh type must be entered in the computer Computer system will alert the technologist to ABO & Rh discrepancies between information on the donor label and results of donor confirmatory testing | 51 |
