5. Pretransfusion testing Flashcards
6 crucial steps for safe transfusion
- ID of patient and donor with appropriate sample collection
- Testing of donor sample
- Testing of patient sample and patient history review
- Selection of appropriate units
- Crossmatch
- Re-identification of patient before infusion
circle of safe transfusion
Patient wristband → BB sample → crossmatched units → transfusion request record → patient wristband
sample condition requirements (5)
- labelled correctly (2 identifiers); date; phlebotomist’s ID
- sufficient quantity
- minimal hemolysis
- appropriate site (not above IV)
- indelible ink used
records kept indefinitely
any difficulty in typing
clinically significant Abs
I, II and III screening cells are type — and have at least one cell…
O
homozygous for all clinically significant Abs
selection of appropriate units
- type-specific preferred
- use short-dated
- conserve O for O patients
preferred form of XM
EXM
You can stop XM after negative IS or EXM if…
negative ABS
no hx of significant Ab
serves as final check for ABO/Rh compatibility
XM
major XM
pt plasma + donor cells
minor XM
donor plasma + pt cells
often to blame for XM incompatibility
autoAB
potential reasons for XM incompatibility (5)
- autoAb
- alloAb
- error in unit selection/typing
- excessive protein in pt serum
- contaminants in test system
in emergencies, O= is given to….
females
males < 12 yo
in emergencies, O+ is given to…
males > 12 yo