Blood Compatibility Testing Overview
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Questions and Answers

What is the maximum age of a patient sample that can be used for pre-transfusion testing?

  • 2 days old
  • 5 days old
  • 3 days old (correct)
  • 7 days old

Which of the following tests is NOT performed during donor testing at the collecting facility?

  • ABO testing
  • Blood type confirmation (correct)
  • Ab Screen
  • Rh testing

In patient sample testing, what must be checked aside from current results?

  • Previous records (correct)
  • Blood pressure records
  • Dietary restrictions
  • Weight history

Which type of sample is preferred for donor testing?

<p>Plasma from integral tubing (A)</p> Signup and view all the answers

What is required during donor testing for Rh-negative units?

<p>Confirm Rh only (B)</p> Signup and view all the answers

What is the primary purpose of conducting a type and screen before a surgical procedure?

<p>To conserve blood inventory (D)</p> Signup and view all the answers

Which blood type must be given for intrauterine transfusions?

<p>O, Rh negative (C)</p> Signup and view all the answers

What is the main requirement for autologous transfusions?

<p>Collecting institution must have specific protocols (A)</p> Signup and view all the answers

Which of the following components does NOT require crossmatching due to prior screening for antibodies?

<p>Fresh Frozen Plasma (A), Platelet Concentrate (B), Granulocyte Concentrates (C)</p> Signup and view all the answers

What must be done if antibodies are identified during blood typing?

<p>Antigen negative blood is reserved or crossmatched (C)</p> Signup and view all the answers

What is the primary purpose of an antibody screen?

<p>To detect unexpected antibodies in patient serum (B)</p> Signup and view all the answers

What action should be taken if unexpected antibodies are detected in a patient's serum?

<p>Identify the antibodies using identification panel cells (B)</p> Signup and view all the answers

Which of the following statements regarding the minor crossmatch is true?

<p>It is no longer necessary because donated units are screened for antibodies (B)</p> Signup and view all the answers

What does agglutination during a major crossmatch indicate?

<p>Incompatibility between donor cells and recipient serum (D)</p> Signup and view all the answers

When calculating the number of units screened, which formula is used?

<h1>units screened = # units needed / frequency of antigen-negative units (C)</h1> Signup and view all the answers

Which type of crossmatch is routinely performed in laboratories?

<p>Major crossmatch (A)</p> Signup and view all the answers

What must be demonstrated in a major crossmatch?

<p>ABO incompatibility and presence of unexpected antibodies (B)</p> Signup and view all the answers

What is the correct definition of a major crossmatch?

<p>Donor red cells crossmatched with recipient serum (A)</p> Signup and view all the answers

What is the primary purpose of compatibility testing?

<p>To ensure safe blood transfusions for the recipient (D)</p> Signup and view all the answers

Which of the following is NOT a component of compatibility testing?

<p>Assessment of recipient's past medical procedures (A)</p> Signup and view all the answers

In compatibility testing, what must be confirmed regarding the recipient?

<p>The recipient's correct identification (A)</p> Signup and view all the answers

What are the three categories into which compatibility testing can be divided?

<p>Pre-analytical, Serological, and Post-analytical (D)</p> Signup and view all the answers

What is the significance of antibody screening in compatibility testing?

<p>To identify potential unexpected antibodies (A)</p> Signup and view all the answers

If a patient does not have a wristband for identification, what is a necessary step?

<p>Attach another form of positive identification (B)</p> Signup and view all the answers

What does the crossmatching procedure confirm?

<p>ABO compatibility and presence of unexpected antibodies (D)</p> Signup and view all the answers

Which phase is NOT part of the pre-analytical procedures in compatibility testing?

<p>ABO blood typing (C)</p> Signup and view all the answers

What is the definition of a massive transfusion?

<p>A transfusion approaching or exceeding 5 liters within 24 hours (D)</p> Signup and view all the answers

When ABO-specific blood is unavailable, what should be given to patients with blood type A?

<p>Blood type A or O only (A)</p> Signup and view all the answers

Which scenario is acceptable for Rh-positive blood transfusion?

<p>To Rh-positive elderly females (D)</p> Signup and view all the answers

What is the priority in donor selection for ABO identical units?

<p>ABO identical units should always be given first (D)</p> Signup and view all the answers

What must donor blood be phenotyped for?

<p>To lack antigens corresponding to circulating antibodies (D)</p> Signup and view all the answers

When should Rh-negative blood be conserved?

<p>When there are adequate supplies of Rh-positive units (C)</p> Signup and view all the answers

What is the first choice for blood type B patients when ABO-specific options are limited?

<p>Type AB or O blood (C)</p> Signup and view all the answers

What is necessary for Rh-negative male patients receiving Rh-positive blood?

<p>There must be no demonstration of anti-D in the sera (A)</p> Signup and view all the answers

What key information must be included on the labeling form of a blood unit?

<p>Patient’s full name and ID number (B)</p> Signup and view all the answers

Which temperature range is required for the proper storage of RBCs?

<p>1° to 10°C (B)</p> Signup and view all the answers

In an emergency release situation, which blood type is typically released when there is not enough time for testing?

<p>O negative (D)</p> Signup and view all the answers

What action must be taken if a blood unit is not needed for transfusion?

<p>It can be returned to the blood bank (A)</p> Signup and view all the answers

What must be done with the segments from released blood units during an emergency?

<p>They should be retained for crossmatching (D)</p> Signup and view all the answers

Which document must be checked when issuing blood to ensure proper protocol?

<p>Requisition form (B)</p> Signup and view all the answers

What should be documented in detail during an emergency release of blood?

<p>Names, dates, and other details (A)</p> Signup and view all the answers

If a blood unit needs to be returned due to incorrect storage temperature, what is the maximum time frame for this to occur?

<p>30 minutes (A)</p> Signup and view all the answers

Flashcards

Compatibility Testing

Tests performed before blood transfusion to ensure blood components are safe for the recipient and have acceptable survival.

Pre-Transfusion Testing

Another name for compatibility testing, aimed at identifying suitable blood components for transfusion.

ABO and Rh Compatibility

Ensuring the blood types of the donor and recipient are compatible to prevent harmful reactions.

Antibody Screening

A test identifying unexpected antibodies in the recipient's blood that could react with donor blood.

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Crossmatching

A test mixing donor and recipient blood to check for agglutination (clumping), indicating potential incompatibility.

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Patient Identification

Crucial step in compatibility testing; verifying the patient's identity using a wristband or other suitable method.

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Specimen Collection

The process of obtaining blood samples from the patient for compatibility testing.

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Review of Patient History

Assessing the patient's previous transfusion history, allergies, and medical conditions relevant to blood transfusions.

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Antibody Identification

Determines the specific type of unexpected antibody found in a patient's blood.

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Major Crossmatch

Tests patient serum against donor red blood cells to check for compatibility.

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Transfusion Reaction

Harmful reaction that occurs when incompatible blood is transfused.

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ABO Incompatibility

Blood types A, B, AB, and O are not compatible with each other.

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Minor Crossmatch

Tests donor serum against patient red blood cells (less critical now).

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Blood Transfusion Safety

Ensuring the blood given to a patient is compatible to avoid severe reactions.

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What are the donor blood testing requirements?

Donor blood must be tested for ABO and Rh type, as well as various infections like HIV, Hepatitis B and C, and syphilis.

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Why is donor blood collected from integral tubing?

Collecting blood from the integral tubing ensures a continuous chain of custody and minimizes the risk of contamination or sample mix-up.

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What is important about the patient blood sample?

The patient sample should be non-hemolysed (red blood cells not broken down), collected within 3 days, and be plasma or serum. It is used for compatibility testing.

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What is significant about the patient's antibody screen?

The antibody screen must detect clinically significant antibodies that could cause complications in the transfusion.

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What are the pre-transfusion testing requirements for the transfusing facility?

The transfusing facility should confirm the ABO blood type and the Rh type on negative units. Weak D testing is not required.

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Emergency Release

Blood released quickly to treat a life-threatening situation, often before full testing is complete.

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O Rh(D)-negative Blood

The 'universal donor' blood type, safe for most people in emergency situations.

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O Rh(D)-positive Blood

Used as a substitute for O-negative if it's unavailable, but restricted to males or postmenopausal women.

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Massive Transfusion

Giving a large amount of blood - usually exceeding the patient's total blood volume within 24 hours.

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Original Sample

The first blood sample taken from the patient, used for initial testing.

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ABO-specific Blood

Blood matching the patient's ABO blood group (A, B, AB, or O) for the first transfusion.

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Rh-negative Blood Use

Conserve Rh-negative blood for Rh-negative patients. It can be given to Rh-positive patients in an emergency.

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Rh-positive Blood Restrictions

Not given to Rh-negative women of childbearing age, to prevent sensitization.

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Post-Analytical Phase

The final step in blood bank testing, involving labeling, inspecting, and issuing the blood unit for transfusion.

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Blood Unit Labeling

Attaching a label containing crucial information like patient's name, ID number, blood type, compatibility results, and donor information to the blood unit.

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Issuing Blood

The process of releasing a blood unit to the nurse or physician for transfusion.

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Blood Unit Checks

Verification steps performed before issuing blood, involving checking the requisition form, donor unit tag, and blood product label for consistency.

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Unused Blood Unit

A blood unit that is not needed for transfusion.

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Emergency Blood Release

Releasing blood for transfusion without complete compatibility testing due to urgency.

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Emergency Release Documentation

Thorough documentation of all details related to emergency blood release, including names, dates, and the reason for the emergency release.

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Post-Emergency Release Testing

Performing compatibility testing on the released blood unit after it is given to the patient, including antibody screening and crossmatching.

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Type & Screen

A blood test performed to determine a patient's blood type and check for unexpected antibodies. It conserves blood inventory by only crossmatching blood if a need arises.

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Autologous Transfusion

A blood transfusion where the patient donates their own blood for later use during surgery. This is done to minimize the risk of complications from incompatible blood.

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Intrauterine Transfusions

Blood transfusions given to a fetus before birth, often when the fetus has a blood disorder or Rh incompatibility with the mother.

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Other Blood Components

Blood components like fresh frozen plasma, platelet concentrate, and cryoprecipitate do not require crossmatching because they have been thoroughly screened for antibodies. ABO compatibility is important.

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Emergency Transfusion

In emergencies, O-negative blood can be given without full crossmatching. Blood products like platelets and plasma can also be transfused urgently.

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Study Notes

Compatibility Testing Overview

  • Compatibility testing is crucial for blood transfusions to prevent harm.
  • It ensures the recipient and the blood component are compatible.
  • The process involves several stages, including identifying the patient's blood type, reviewing medical history, and cross-matching.

Pre-analytical Phases

  • Patient Identification: Verify the patient's identity using wristbands. This includes name, hospital number, and physician's details.
  • Unknown Patients: Positive identification is required for patients without wristbands (e.g., identification form attached to the patient).
  • Specimen Collection: Use appropriate tubes (e.g., lavender top - EDTA, red top - no additives). Issues like hemolysis (red blood cell breakdown), require rejection. If blood is drawn from an IV line, initial 10 mL must be discarded.
  • Review of Patient History: Review the patient's past transfusion history and other relevant medical details to help in the selection of the correct blood.
  • Sample Identification: The sample should include complete patient details (name, hospital number, location, physician name, date of collection and phlebotomist's initials.
  • Specimen Tubes: Lavender-top tubes contain EDTA (a blood anticoagulant). Red-top tubes collect serum (liquid portion of the blood without cells).

Serological Testing

  • ABO/Rh(D) Typing: Ensures compatibility of blood type and Rh factor, with forward and reverse reactions to confirm blood type.

  • Antibody Screening/Identification: Identifies unexpected antibodies in the patient's serum; If antibodies are found, specific blood needs to be identified, for example using a panel of blood cells (testing cells) to determine the type(s) of antibodies present. The results from these tests are then used to determine the correct type of blood for transfusion.

  • Crossmatching: Matches donor and recipient blood to identify possible incompatibility.

  • Cross Matching Types:

    • Major crossmatch: This type matches the recipient's serum against donor red blood cells is performed to identify potential incompatibility and is necessary for all transfusions.
    • Minor crossmatch: Matching the donor's serum against the recipient's red blood cells, was historically performed; however, since 1976 this is often not performed.

  • Crossmatch Methods:

    • Immediate Spin Technique (IST): This method detects IgM antibodies.
    • Conventional AHG (antihuman globulin) crossmatch: Detects IgG antibodies.

Post-analytical Phase

  • Labeling: Label the blood unit with recipient and donor information, including blood type, location, and physician details.
  • Inspection: Visually inspect the donor blood unit for abnormalities such as clots, discoloration, or contamination or other obvious issues, then prepare the unit for release to the recipient.

Issuing Blood

  • Verify the requisition form, donor tag and the unit label.
  • Check the date of expiration for the blood unit.
  • Ensure the correct blood unit is selected.
  • Release the blood to the recipient's care taker under the appropriate circumstances.

What if the Unit is Unused?

  • If blood is not needed for a transfusion, it can be returned to the blood bank.
  • The unit should remain unopened.
  • It should be stored at the correct temperature (e.g., 1-6°C for whole blood).
  • Return the unit within 30 minutes of issue if temperature is incorrect.

Special Circumstances

  • Emergencies: In emergencies, blood may be released without complete crossmatching and patient testing if signed for by a physician. A special tag must indicate it's not crossmatched.

Other Components

  • Some components, like fresh frozen plasma, platelet concentrates, and cryoprecipitate, don't require the same testing as whole blood before transfusion due to specific screening procedures.
  • ABO compatibility is still required for these components.

Neonatal Transfusions

  • Neonates (under 4 months) need specific considerations with regards to cross matching, for example exchange transfusion and top up transfusions. Tests such as antibodies with maternal serum might also need to be taken into account.

Massive Transfusion

  • Massive transfusion procedures should take into account the original sample may no longer reflect the patient's current condition.
  • ABO identical units are provided.
  • If antibodies were detected initially, then antigen negative blood is used for the massive transfusion.

Type & Screen

  • Type and screen testing is done to reduce blood inventory.
  • Usually, a crossmatch is not necessary to release the blood, if the blood is needed.

Autologous Crossmatching

  • Autologous blood refers to a patient donating blood for later use.
  • It often involves specific protocols, and may require different tests, in particular, the blood transfusion services.

Intrauterine Transfusions

  • For intrauterine transfusions, specific types of blood are used according to the mother and father's blood groups(Rh negative blood may be used).

Worksheet + Case Study

  • Students should complete worksheets and case studies to use and apply learning.

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Related Documents

Compatibility Testing PDF

Description

Explore the critical components of blood compatibility testing, which is essential for safe blood transfusions. This quiz covers the procedures involved, including patient identification, specimen collection, and reviewing medical history. Understanding these processes will help ensure the safety and efficacy of blood transfusions.

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