PART 1 - QMS ON IMMUNOHEMATOLOGY (BLOOD BANK)

Immunohematology

• the study of ANTIGENS associated with the cellular components of the blood

• the immunologic properties of different blood components, and their implications in blood transfusion

Laboratory

deals with the collection, storage, processing, and release of blood components for the purpose of transfusion

Accurate label

In quality assurance in blood banking, it is aimed to provide ____

TRUE

TRUE OR FALSE.

In transfusion service, it is important to monitor the source of error but also the number of times it repeated.

• To detect the problems

• Implement improvements

• Ensure accurate testings

• Improve workflow

• Benefit patients

Why do we need to monitor the errors?

FALSE

TRUE OR FALSE.

Quality Indicators are not always needed to be monitored in order to have accurate testings in Blood Bank.

Whole blood

Packed red blood cells

Platelet concentrate

Fresh Frozen Plasma

Cryoprecipitate

Factor VIII/XIII concentrate

Granulocyte concentrate

In Immunohematology, blood products processed:

Whole Blood

-Used to replace the loss of both RBC mass and plasma volume

-Example: rapidly bleeding patients

1-6 C (ref temperature)

Storage requirement for whole blood

35 days

Shelf-life of whole blood

CPDA-1

-the anticoagulant used for blood bags

35 days

shelf-life of CPDA-1

Whole blood

Rarely used in blood transfusion

Red Blood cells

also known as packed red cell

Red blood cells

• separated from plasma through centrifugation

• used for anemic patients or those with surgical and traumatic bleeding

Anemic patients

Surgical and Traumatic Bleeding

Patient with critical hemoglobin level

Red blood cells are usually used for _____

Critical hemoglobin level (6 grams per dL)

The time when the physician will request for a packed red cell unit from blood bank / immunohematology section

1-6 C

Storage requirement for red blood cells

35 days

storage life of red blood cells

Centrifugation

What process is used to separate the red blood cells from the plasma?

Whole blood

the source of red blood cells / packed RBC

TRUE

TRUE OR FALSE.

Whole blood and Red blood cells have the same storage requirement temperature and shelf life.

Platelet Concentrate

Used for patients with thrombocytopenia or impaired platelet function

Patient with thrombocytopenia

Impaired platelet function

Where platelet concentrate is used

Platelets

Needed for primary hemostasis

Primary Hemostasis

Platelets is needed for?

Random-donor PC

Single-donor PC

2 types of preparation platelet concentrate

Random-donor PC

• separation from plasma component of whole blood

• must be prepared within 4h of collection

Platelet-rich

Platelet-poor

2 types of plasma component

Platelet-rich plasma

It is obtained for transfusion, for platelet concetrate

4 hours

Random-donor PC must be prepared within _____ of collection

Single-donor

it is via Apheresis

apheresis

• Single-donor is obtained via ____

• uses a machine to obtain specific blood component from the patient and the RBC will go back to the patient

Hemorrhage

An escape of blood from a ruptured blood vessels especially when refused and is continuous bleeding

Hemostasis

Flowing or movement of blood

Thrombocytopenia

decreased platelets

20-24 C (Room Temperature) with agitation

Storage requirement for platelet concentrate

6.2 or greater

pH for platelet concentrate

FALSE

TRUE or FALSE.

pH of platelet concentrate can be lowered

5.5 × 10^10, 50-70 mL

Platelet count and volume for random donor

3 × 10^11, 200-400mL

Platelet count and volume for single donor

TRUE

TRUE or FALSE.

Platelet concentrates should always be agitated in a room tempt.

5 days

Shelf life of a platelet concentrate

TRUE

TRUE or FALSE.

Platelets should be agitated to ensure continuous oxygenation that can enter the storage container and that the excess carbon dioxide will be expelled

Fresh Frozen Plasma (FFP)

• prepared after removal of platelets for PC

• used for patients coagulation factor deficiencies

24 hours

How many hours does it take to thaw a FFP?

Once

How many times do you need to thaw a FFP sample?

6-8 hours

FFP must be prepared within ____depending on the anticoagulant used

-18 C

Storage requirement for FFP (freeze) for 1 year

1 year

Shelf life of a (freeze) FFP with a -18 C

-65 C

Storage requirement for FFP (freeze) for 7 years

7 years

Shelf life of a (freeze) FFP with a -65 C

Cryoprecipitate

• prepared from centrifugation of FFP

• Used for fibrinogen replacement

-18 C

Storage requirement for Cryoprecipitate in 1 year

1 year

Shelf life of cryoprecipitate with a -18 C

6 hours

shelf life of cryoprecipitate after thawing in a 20-24 C

20-24 C

Ideal temperature for cryoprecipitate

Factor VIII / Factor IX

• prepared through plasmapheresis

• used for patients with Hemophilia

Hemophilia

• a rare disorder

• the blood doesn’t clot normally, as it lacks sufficient blood clotting proteins or factors

Hemophilia A

Factor VIII deficiency

Hemophilia B

Factor IX deficiency

Granulocyte concentration

• prepared through granulocyte pheresis

• used for patients with severe neutropenia and serious bacterial or fungal infection

20-24C

Storage requirement for granulocyte concentrate

24 hours

shelf life of granulocyte concentrate

Blood Bank Refrigerator

• storage of full blood and red blood cell units

• control temperature: 1-6 C

1-6 C

Controlled temperature of a blood bank refrigerator

Blood bank Incubator with agitator

platelets are stored at 20-24 C with continuous gentle agitation to maintain the platelet function

Centrifuge

• used to separate blood components

• to enhance the antigen/antibody reactions during immunohemtologic testing

• example: blood typing, crossmatching, antibody screening

Apheresis machine

• separate and collect specific blood components

• example: platelet from a donor while returning the remaining blood components back to the donor circulation

Full name

Birthdate

Ward Number

Patient Identification

Bought from facilities that store blood products

Product Procurement

Not beyond anticoagulant’s expiration

Not mislabeled

When buying blood from facilities, blood should NOT be:

bags should be tested for blood groups and transfusion transmissible infections

When buying blood from facilities, blood SHOULD BE:

Unit Number/Donor Number

Collection Date

Expiration Date

Content of the label for bags before Blood Typing and Serologic testing

Blood Type

Label after Blood Typing