Blood Bank Rotation Exam 3

Universal donor for packed RBC is

O negative

Universal recipient for packed RBC is

AB positive

Universal Donor for FFP?

AB Pos/Neg

Universal Recipient for FFP?

O Pos/neg

Why doesn't the RH status of a unit of FFP or Cyro matter when transfusing an adult?

FFP and Cyro should be free of RBCs

If there are any present, they would be hemolyzed in the freezing process and cannot cause patient to form an Anti-D

Why is a crossmatch not necessary when issuing FFP, cyro or platelets

FFP, cryo, and platelets do not have red blood cells in them. RBC contain the antigens

What testing is performed on units of blood collected

ABO RH(including weak D if Rh negative)

Antibody Screen

RPR

All viral testing

Why do we retype units for ABO and Rh negative status that are received? What happens when there is an error?

To make sure the units are labeled correctly. An incorrect blood type labeling could cause a severe reaction (even death) in a patient . If an error was made, the unit must be returned to life serve.

If an error was made, the unit must be returned. Rh negative units are rechecked for the immediate spin D only in case a unit was inaccurately labeled Rh negative that is Rh positive (which could cause a patient to form an Anti-D).

There is no need to retype Rh positive units because if that unit was inaccurately labeled as Rh negative there would be no consequence for the patient.

What are the frequencies for A, B, O and AB in the united states?

O=44

A=40

B=11

AB=4

What is the frequency of RH positive and RH negative in the united states?

85% RH positive

15% RH Negative

What are the expiration dates of cryo, Frozen

1 Years

What are the expiration dates of FFP, Frozen

1 years

What are the expiration dates of Platelet, Single donor at RT

5 days rotating

What are the expiration date of RBC, AS1

42 days at 1-6c

What is the expiration date of Frozen RBC

10 years

What is the expiration date of FFP, thawed, extended

5 days, 4c

Pooled platelets

they are taken from six individual donors and then pooled into one bag for the patients. To do this the patient seal must be broken and the platelets are exposed to the possibility of contamination. For this reason pooled platelets would expire in 4 hours

What temprature do we store cryo?

-20 to -40c

What temperature do we store FFP

-20 to -40c

What temperature do we store Platelets

Room Temperature

20-40 and they need to be rotating

What temperature do we store RBC

1-6c

What temperature do we store thawed FFP

1-6C

What temperature do we store Thawed Cryo

Room Temperature

What does Leukoreduction do?

Removal of majority of WBC and prevent CMV transmission

What is the purpose of Irradiation?

Prevention of Graft vs Host disease

Irradiation is intended to prevent the donor transfused T-lymphocytes from multiplying in the patient by deactivating the lymphocytes of the donor. This is done primary for immunocompromised patient

When performing a type and cross match you find your antibody screen to be 2+ positive at AHG on surgiscreen II. What steps do you need to take to complete the crossmatch and find compatiable blood for your patient?

1. Antibody panel to identify the antibody

2. Antigen screen paitent and units- Paitent should be negative for antigen if this is an alloantibody

3. Crossmatch units through coombs (AHG)

Why do we do an immediate spin crossmatch (can be substituted with the electronic XM id two blood types on file- but can never be omitted!)?

To determine ABO compatibility/Incompatibility

AB thawed plasma are in __________ and should be saved for ____________

short quantity

Neonates

What are the steps you take when the ER wants uncrossed blood on trauma patient?

1. Get out 2 O neg RBCs tagged with "uncrossmatched" units. Mercy also sends out 2A thawed Plasma

2. AB thawed plasma are in short quantity and should be saved for neonates

3. ER tech brings uncross-matched form with blood band ID sticker

4. Write blood band ID number on the tags, sign out units and place them in a cooler under melting ice

5. Ask for a specimen ASAP

6. Set-up tubes or prepare Echo for the trauma

7. Once a specimen arrives, a type and cross match (uncomplicated) should only take 30 minutes

A patient has an Anti-K that is NOT showing today. Why do we need to antigen screen units for the patient? Do we have to take the units through Coombs?

The titer is below detectable but the paitent still has the Anti-K

We must give K negative units to prevent the Anti-K from getting stronger and causing a transfusion reaction

The unit must go through AHG (Coombs) to check for compatibility. Even though his antibody level is below detectable levels, it is still present so it is handled just the same as if the antibody screen was positive

Explain the difference in outdates on a unit when a sterile docking device is used and when the closure on the unit is "pierced"?

The sterile docking device allows a unit to maintain its original putdate. The sterile docking device uses a method that heats the seal where the unit is split to over 400c. This ensures that any bacteria present will be destroyed

When there is outdate when a unit is "pierced" or entered into 24 hours due to fact that the opening of the unit may cause ____________ to develop a and ______________

bacteria

contaminate the unit

When there is outdate when a unit is "pierced" or entered into 24 hours due to fact that the opening of the unit may cause bacteria to develop and contaminate the unit. The outdate can remain at _____________ for blood since it will be stored at _______ which slows ______________

24 hours

4c

Down the growth of bacteria

When is the outdate for platelets would be ________ since they are stored at _________, _________________

4 hours

Room Temperature

a temperature where bacteria thrive

ABSC not needed on TX Auto since patient will be receiving their own ___________________________; therefore, will not be exposed to . It must be added if patient received either _____________ or __________.

RBC

foreign antigens

Directed or Random donor units

At what phase IS in IAT testing

IgM antibodies typically react best at Room temperature.

37c, AHG

IgG antibodies typically react best at body temperature or when enhanced by AHG phase.

IS, 37c

At these phases in testing, patient plasma is still present. Rouleaux is not seen at AHG since prior to that phase, washing of the cells has occurred

At what phase (IS, 37 AHG) in IAT testing would the following most likely be seen

floor requests more than one unit at a time what do we do?

In the normal routine, only surgery can check out more than one unit of blood. Surgery can do so because they have a monitored refrigerator in their area. Sometimes ER or ICU will want to units, we simply have to ask them if they have two IVs going on the patient so that both units can be transfused at the same time.

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A.             Granulocyte Transfusion

most common cryopreservative for frozen platelet storage; how long can frozen platelet products be stored for?

DMSO; 2 years

Patients who are IgA deficient with antibodies to IgA would be susceptible to allergic reactions to blood products, what type of cellular component modification is known to be associated with this clinical situation?

washing red blood cells and platelets units

RBC is frozen with what cryoprotective agent? and what process must it undergo at the time it is transfused?

20-40% glycerol; it must undergo deglycerolization (washing)