CLS 306 - Pretransfusion Testing

Flashcards covering pretransfusion testing, compatibility testing, and related procedures.

Pretransfusion Testing

Also known as Compatibility Testing.

Purpose of Pretransfusion/Compatibility Testing

To select the safest blood/blood components for transfusion, meet recipient needs, provide acceptable donor RBC survival, and eliminate destruction of recipient cells.

Why Transfuse a Patient?

To improve the patient's blood oxygen-carrying capacity to sustain vital organs.

Hemoglobin-Oxygen Dissociation Curve

Shows the red cells' affinity to oxygen or its ability to release oxygen to the vital organs.

MD/Clinician Role in Transfusion

Initiates the transfusion order.

Nurse's (RN) Role in Transfusion

Creates the Blood Bank requisition for the transfusion.

"Type & Cross" Order

Refers to the blood typing of the patient and the crossmatch.

3 Processing Phases of Compatibility Testing

Pre-Serologic Procedures, Serologic Testing Procedures, Post-Serologic Procedures.

Pre-Serologic Procedures Details

Specimen collection & Patient ID, Specimen ID verification, Specimen Meets Requirements / Specimen Age, Review of patient's records.

Serologic Testing Procedures Details

ABO / Rh typing & ABS of patient specimen, Ab ID if ABS is positive, ABO confirmation of RBC unit & Rh0(D) confirmation, Crossmatching of blood.

Post-Serologic Procedures Details

Proper release of test results, labeling of RBC/blood component, release/distribution of RBC/blood component, transport/storage, re-release/re-distribution.

Step 1: Collection of Specimens/Types

Patient ID verification, Use both patient RBCs and Serum/Plasma for testing, Usually use a BB pink top tube (K2 EDTA - dried form), Alternate Specimens.

Patient Sample Label Requirements

Medical Record Number, Patient's Name, Initials of the person drawing the specimen, Date & Time of Collection

Specimen Criteria - Patient

Non-hemolyzed, Free from IV contaminants, ≤ 3 days old, Retain this sample for 7 days following transfusion.

Specimen Criteria - Donor

Non-hemolyzed, must take pigtail/segment hermetically sealed and attached to unit, retain 2 pigtails/segments for 7 days.

Compatibility Testing for Recipient

Check the BB patient history file, Perform ABO & Rh typing, Perform Ab Screen (ABS), Perform Crossmatch (Xmat).

ABO Confirmation on Donor Unit

Every RBC/WB incoming unit must be ABO confirmed.

Rh0(D) confirmation

Only required on all Rh negative RBC/WB units.

Patient Compatibility Testing Procedure, AKA, Type and Cross

ABO typing is critical & must be performed correctly, Rh typing is critical, ABS is critical, Xmat is critical.

2 Methods to Perform a Crossmatch (Xmat)

Physical/Manual & Electronic

Major Crossmatch

Donor's cells + Patient's serum.

Minor Crossmatch

Donor's serum + Patient's cells.

Why Major Crossmatch is Called Major

Donor cells react with antibodies in patient's plasma and are destructed.

Why Minor Crossmatch is Called Minor

Donor's plasma gets diluted in patient's plasma, so less chance of hemolytic reaction.

MINOR CROSS MATCH TEST:

mixing the donor's plasma with patient's RBCs.

Immediate Spin X-Match

Perform only immediate spin phase if ABO/Rh type previously performed and R & R Abscreen is negative.

Xmat - Limitations - Will

Verifies donor cell ABO compatibility and detects most antibodies against donor cells.

Xmat - Electronic

BB computer software matches the recipient data to each random donor unit(s) data.

Transfusion Record Form (TRF)

Patient's full name, Medical Record Number (MRN), DOB, Hosp location, Patient's ABO & Rh, Unit #, Unit ABO & Rh, Unit expiration date, Unit product code.

Each Xmat unit(s) is…

Checked AGAIN (by the CLS) just prior to distribution.