Donor Screening and Component Preparation Flashcards
(102 cards)
1
Q
What is the definition of a BB lab and what is it comprised of?
A
- Collection
- Storage
- Processing
- Distribution
2
Q
A blood bank functions as a unit part of what larger organizations?
A
Hospital OR Community Blood Centre
3
Q
A blood bank is divided into these distinct areas?
A
- Component preparation
- Donor processing
- Product labelling
- Main Lab
- Reference Lab
4
Q
Describe a blood bank without collection facilities?
A
Depend on outside sources for blood supplies and recive their products on component form.
5
Q
Describe a blood bank with collection facilities?
A
Collect thier own units of cold blood can use resources effeciently by seperating them into a variety of components.
6
Q
The following are part of Donor Centre Operations EXCEPT?
- Component prep and storage
- Donor processing
- Product labelling
- Routine testing
- 1 - 3 are correct
- all of the above
A
- 1 - 3 are correct
7
Q
Before a unit can be added to the general inventory, ytesting must be done to dertermine suitability for transfusion. This is the responsibility of?
A
Donor processing
8
Q
Seperate tubes of blood are collected form the donor at the time of donation for testing. Nucleic acid amplification testing (NAT) is used to detect what?
A
- HIV - 1
- HCV
9
Q
When can labelling of blood products ooccur?
A
Only after careful review of all test results shows the unit to be suitable for transfusion
10
Q
What suitability criteria must be met before a product can be labelled?
- No descrpancies in ABO & Rh testing
- Abscence of detectable Abs in plasma containing components
- Nonreactive viral marker tests and nonreactive syphilis test
- All of the above
A
- All of the above
11
Q
When a blood product is shipped to a blood bank, they are required to reconfirm ABO Rh label of each RBC component? (T/F)
A
True
- Must confirm ABO
- Rh - negative must also be reconfirmed
12
Q
What is the primary mission of the main laboratory sections (transfusion services)?
A
- Patient care
- Testing to determine compatibility between patient needing transfusion and unit of blood to be transfused.
13
Q
How many identifiers are required for patient samples used for blood bank testing?
A
Minimum of 2
14
Q
What patient identifier is required?
- DOB
- Medical record number
- Patient’s full name
- All of the above
A
- Patient’s full name
15
Q
The followin are acceptable patient identifiers EXCEPT?
- DOB
- Medical record number
- Patient’s full name
- Patient location (room #)
A
16
Q
Many hospitals use a blood bank identification number added to the hospital patient identification bracelet.
True / False
A
FALSE
A blood bank bracelet is seperate to the hospital bracelet and contains a unique BB number linked to that sample collection
17
Q
Each speciment request form from the blood bank must be carefully examined for?
- Proper spelling of patient’s name
- Correct ID #s
- Correct date of collection
- ID Phelobotomist
- All of the above
A
All of the above
18
Q
Once a patient sample has been judged acceptable, the testing requested by the physician can be performed. These tests ared requested as a group and may include? (5)
A
- Type & screen
- Type & XM
- Prenatal eval
- Postpartum eval.
- Cord blood studies
19
Q
What components do not require pre-transfusion testing?
A
PLTS or FFP
20
Q
When can blood products be issued?
A
After all pre-transfusion testing has been completed, then it can be released for transfusion.
21
Q
What is an exception to when blood products can be issued?
A
All serological discrepancies must be resolved before issuing blood EXCEPT in extreme emergency.
22
Q
What must the individual who will issue the blood product do before issuing the blood?
A
- Inspect unit for any abnormal appearance
- verify all transfusion forms and labels complete
- properly identify transfusion recepient
23
Q
What modifications may need to be done before the issuance of blood products?
How do these modifications affect the product?
A
- Thawed in a waterbath (FFP @ 37oC)
- Individual PLT concentrates pooled into single bag for ease of transfusion
- Packed RBCs may need irradiated
Shorted the shelp life and will need to be recorded on the product label and in the computer system.
24
Q
What section of the blood bank is intergral to Transfusion services?
A
Reference laboratory
25
What statement can you use to best describe the reference lab and what they do?
Problem-solving part of transfusion services
26
What is the goal of the reference lab?
To ensure discrepancies are resolved in an accurate and time-effcient manner
27
What discrepancies are resolved by the reference lab? (7)
* ABO
* Rh
* Abs ID
* Positive DAT
* Warm AutoAbs
* Cold AutoAbs
* Transfusion Reactions
28
At minimu what is required (included in) of an investigation of a suspected HTR? (4)
* ABO
* Rh
* DAT
* Visual Hemolysis check using post-transfusion sample
29
The Regulating agency for the BB Lab is?
FDA
30
The accrediting organization for BB Lab is?
AABB (American Association of Blood Banks)
31
What agencies are involved in Donor selection and donor unit processing?
Center for Biologics Evaluation and Research (CBER)
College of American Patholigists (CAP)
32
The Armed Services Blood Program is a joint military forces operation consiting of ____ blood banks and ____ FDA Licensed Donor centres.
* 81
* 22
33
Manages the Blood program for the DoD
Uder the authority and control of the SECDEF via the Asst. SECDEF Health Affairs
Under operational control of the Joint Chief of Staff (JCS)
Armed Services Blood Program Office (ASBPO)
34
ASWBPL stands for?
Armed Services Whole Blood Processing Laboratories
35
The Scope and responsibilty of the ASBP is to?
Provide quality blood products for service members, veterans and their families.
36
The ASBP has many components that work together to? (5)
* Collect
* Process
* Store
* Distribute
* Transfuse Blood Worldwide
37
What blood was sent into combat zones and why?
Type O negative
Universal Donor
38
Military Treatment Facilities (hospitals), Labs and BBs are responsible for communicaiting their blood requirements to?
MTFs Blood Supply Units
39
MTFs provide two major reports for blood products, what are they?
* Blood reports (BLDREP)
* Blood Shipment Report (BLDSHIPREP)
40
How are the major reports for blood products, submitted to the BSU via?
* SIPRNET
* NIPRNET
41
What is comminicated in a BLDREP? (5)
* Current Blood (what we have)
* Disposition of blood in last 24hrs
* Amount of blood products req. in next 12-48 hrs (what we need)
* Amount Expiring in the next 7 days (what we will lose)
* Esimated products req. inthe next 7 days (what we need)
42
What is communicated in a BLDSHIPREP?
* Provides info on the reciver of Blood Products
* Arrival Schedule of shipped blood products
* Type of shipment (land, air, etc.)
* Shippers address and POC
43
What Statement best describes a Directed Donor?
* One who donates blood for use by others.
* One who donates blood for his/her own use.
* A unit collected and directed toward a specific patient
* All of the above
* A unit collected and directed toward a specific patient
44
What color tag is used to differentiate a directed donor unit from an autologous unit?
Yellow/Salmon
45
For a directed donor, if the unit is for a blood relative what must be done to the blood unit and why?
Irridiated to prevent graft-versus host disease (T cekks fron donor attack patient cells and tissues)
46
What color tag is used to differentiate an autologous unit from an directed donor unit?
Green
47
What is the minimum age for an allogenic donor?
17
48
What is the required Weight for Whole Blood Collection?
At what weight is the amount of blood reduced?
10.5 mL/kg
110 lbs (amount of blood and anticoagulant must be proportionately reduced.)
49
What is the acceptable time interval for allogenic and pheresis donors?
* 8 Weeks or 56 days - Whole blood donors
* 48 Hours - Pheresis donors (Plts, Plasma, granulocytes) before donating whole blood
50
When is a prepoperative collection performed?
5 - 6 weeks prior to surgery unless RBCs are to be frozen
51
For a preoperative collection, when should the last blood collection occur? Why?
* No sooner than 3 days (72hrs) before the scheduled surgery
* To allow volume repletion
52
This process involved the removal of whole blood from a patient with infusions of cytaloid or colloid before surgical blood loss.
Stored at room temp and shed blood may be reinfused into patient within 8 hours
Acute Normovolemic Hemodilution (ANH)
53
Acute Normovolemic Hemodilution (ANH) - Collection from an open system such as central venous line may be stored for up to ______ at room temp and ______ in a refridgerator.
8 Hours at room temp
24 hours monitored fridge
54
Involves collecting blood from the surgical site (drainage tube).
Colllect and reinfuse blood lost during surgery.
Can be stored for up to 6 hours at room temp or 1- 6 oC for 24 hours.
Intraoperative Collection
55
Collected from a drainage tube placed at the surgical site.
Reinfused (with or w/o processing) via a microaggregate filter to screen out debris wirthin 6 hours otherwise discarded.
Postoperative collection
56
What is the maximum amount of blood from a Postoperative collection that can be reinfused?
why?
1,400 mL
Blood is dilute, partially hemolysed, and defibrinated.
57
What is Apheresis?
procedure to collect specific blood components while returning unwanted oponents to patient/donor
58
Describe Plateletpheresis?
Which donors are defered and for how long?
* Plateletpheresis - collection of PLT concentrates
* Taking feldene / aspirin - 48hr deferral
* Plavix / ticlid - 14 days
59
Describe Plasmapheresis?
Collecting plasma further made into plasma derivatives also used to collect FFP
60
Describe Leukapheresis?
Only effective method collecting GRANULOCYTES
\*\*\* Donors are given drugs or sedimented agents (hydroxyethystarch and corticosteroids) to collect large volumes of WBCs
61
Describe double RBC Pheresis?
How long are they deferred?
* Collection of double units of RBCs
* 16 weeks (successful completion / 300mL red cells lost)
62
Describe Stem Cell Pheresis?
* Collect Hematopoietic progenitor Cells (HPCs) aka Peripheral Blood Stem Cells (PBSCs)
* Allogenic / autologous
* Selective collection of mononuclear cells - found in upper (buffy layer) layer.
* Proceudure takes 4 - 6 hours
Main purpose is to increase circulating tem cells in peripheral circulations USED TO TREAT CANCERS (leukemia, Breast cancer, Thalasemia, Sickle cell)
63
Describe Membrane technology methodology?
Uses centrifugal force to seperate blood into components based on their differences in density.
64
What are the two menthods of Membrane Technology?
Intermittent Flow Centrifugation - Blood is processed in cycles or batches
Continuous Flow Centrifugation - Blood witdthdrawal, processing, and reinfusion are done simultaneously in an ongoing manner.
65
Identify the factors that can be removed by PLASMAPHERESIS?
What type of donors are these collected from?
* Factor VIII concentrates
* Factor IX concentrates
* Factor XIII concentrates
* Intravenous Immune Globulin (IVG)
* Hepatits Immune Globulin (HIG)
* Rh-immune Globulin (RhoGam)
Immune plasma fron donors with increased concentrations of plasma immune globulins who were exposed to hepatitis B, CMV, Varicella zoster
66
What are some adverse effects of Apheresis?
* Citrate toxicity
* Vascular Access Complications
* Vasovagal reactions
* Hypovolemia
* Allergic reactions
* Hemolysis
* Air embolus
* Depletion of clotting factors
* Circulatory and respiratory distress
* transfusion transmitted disease
* Lymphocyte loss
67
How far around should the area for puncture be cleaned in Asecptic Technique and for how long?
4 cm in all directions from the site for min of 30s
68
All of the following are severe donor reactions on their except?
* Fall in systolic pressure to 60 m Hg
* Cerebral ischemia
* Marked hyperventilation
* Epilepsey
* Fall in systolic pressure to 60 m Hg
* This is moderate unless combined with the other symptoms
69
What is a hematoma?
Collection of blood under the skin due to needle going through vein with subsequent leakage of blood.
70
RBCs are preserved in bags made from?
Poly Vinly Chloride (PVC)
71
What percentage of RBCs that have been transfused need to stay viable?
What is the FDA requirement for free Hgb?
75% for 24 hours (FDA Requirement)
\<1% of total Hgb
72
All of the following Anticoagulant-preservative solutions have a maximum storage time of **21 days @ 1 - 6 oC** for **Whole Blood and Packed RBCs *_EXCEPT_***?
* ACD (acid citrate-dextrose)
* CPD (citrate phosphate-dextrose)
* CP2D (citrate phosphat-double-dextrose)
* CPDA-1 (citrate-phosphate-dextrose-adenine)
* CPDA-1 (citrate-phosphate-dextrose-adenine)
* **35 days storage @ 1 - 6 oC**
73
What are Addative Solutions?
How long do these extend the shelf life of pRBCs and why?
These are added to RBCs after plasma removal with or w/o PLTS.
**42 days** by addind nurtients
74
How do these addative solutions affect RBC concentrate?
Produces an RBC concentrate of lower viscosity that is easier to infuse
75
Addatives allow the harvesting of more plasma and PLTS from the Whole Blood Unit.
True / False
True
76
What are the 3 types of addative solutions licenced in the united states?
* Adsol (AS - 1)
* Nutricel (AS - 3)
* Optisol (AS - 5)
77
Addative solutions are contained within a satelite bag and is added to the RBCs. All of the addative solutions contain Saline, Adenine, and Glucose. What addatives contain **MANNITOL** to protect from **_storage related hemolysis_**?
Which contains citrate and phosphate?
* AS-1 (Adsol) and AS-5 (Optisol)
* AS-3 (Nutricel)
78
What is the most common test used for the detection of Hepatitis B Surface Antigen (HBsAg)?
* ELISA
* if reactive must be repeated to confirm (both tests MUST be positive)
* if negative no further testing needed
79
What Hepatisis B antibody is is tested for?
What disease is this implicated in?
Why is this test done?
Antibody to Hep. B CORZYME
Hep. C disease
To prevent post-transfusion of Hep. B
80
Ab for Hep. C is tested for by?
NAT can detect small amounts of core viral proteins such as HCV Core Antigen. What test is used to confirm?
* Enzyme ImmunoAssay (EIA)
* RadioImmuneBlot Assay (RIBA)
81
All donor units must be screened for HIV 1 / 2 by what FDA approved test?
What tests are used to confirm?
EIA method - Same as Hep B if positive MUST be repeated.
Confirm with Western Blot and Immunoflourescence
82
Apart from Hep B and C, HIV 1/2 what oth viruses are donor blood screened for?
* WNV and Abs for WNV
* Ab Human T-cell Lymphotic Virus Type 1 & 2 (anti-HTLV-I/II)
* Syphilis
83
What is the confirmatory tests for syphilis?
FTA-ABS / flourescent trepanomal Ab absorbtion test w/ indirect immunoflourescence to detect the spirochete Trepanoma Pallidum - microbe causing syphilis
84
A unit of allogenic / autologous blood must be labelled in accordance with what standards?
The ISBT number is how many alphanumeric characters long?
AABB standards, FDA regulations, ISBT Code 128
14 characters
85
The Unique Identifier, ABO, Rh type, component labels and expiration date must be checked with a SECOND PERSON.
True / False
True
86
RBCs are frozen with?
Glycerol
87
How long can frozen RBCs be stored for?
10 years
88
The resulting deglycerolized product is free of leukocytes, plts, and plasma due to?
The washing process
89
Frozen RBCs - which substance is penentrating and non-penetrating?
Penetrating - Glycerol: crosses cell memebrane cytoplasm
Non-penetrating - Hyroxyethyl Starch (HES): large molecules form a shell around the cell to prevent waterloss and dehydration. Used to freeze Hematopoitic progenitor cells
90
What are the two methods of freezing RBCs?
* High Glycerol Method
* Low Glycerol method
91
What is the volume of the high vs low glycerol method?
What is the freezing process and temp for each?
* High - 40% Vol.
* slow uncontrolled
* **-80oC**
* **MOST WIDELY USED PROCEDURE**
* Low - 20% Vol.
* Rapid, controlled
* **-120oC**
* **LIQUID NITROGEN USED IN THIS METHOD**
92
In the high glycerol method RBCs are frozen within how many days of collection when preservative is CPD or CPDA-1, and up to ____ days of collection with preserved in AS-1,3, 5?
How long does it take to thaw high glycerol RBCs?
* 6 days
* up to 42 days
Thawing takes 30 mins @ 37oC
93
What is the only FDA approved solution for the rejuvination of RBCs in the US?
Rejuvisol
94
RBCs can be rejuvinated up to how long after expiration?
How is the rejuvination process accomplished?
3 days and then glycerolized and frozen
Incubate at 37oC for 1 hour with 50 mL of rejuvisol
95
Glycerol must be removed to what level?
\<1%
96
Rejuvinated RBCs must be transfused within how long?
24 hours
97
Transported non-frozen blood is kept at what temperature?
What are the other requirements for transport?
1 - 10 degrees celcius
up to 30 units packed in a cardboard/styrofoam box
covered with 14 lbs or more of cubed WET ICE
temp maintained for 48 hours
any unita above 10 degree C quarantined
98
Using dry ice transport - arrival temp is ?
How many?
- 18 degrees C
up to 15 FFP/PF24 or 30 units of cryoprecipitate
cover with 20 - 30 lbs of dry ice
99
The Arrival Temp of Frozen Blood is?
- 40 degrees C
up to 12 units of frozen RBCs packed in shipping container
100
Frozen blood should be recieved w/i how many hours accrording to ASWBPL?
How many months shelf life left should frozen blood products have left after arrival at ASWBPL?
What form is checked for ASWBPL shipping and receiving of frozen blood?
24 hours
6 months
DD 573
101
Blood components out of storage are suitable for reissue if?
Appropriate temp has been maintained (at 1 - 10 degrees C)
MUST NEVER BE STORED AT PATIENT CARE unless in a CONTROLLED ENVIRONMENT
102
What units are unsutable for reissue once issued? How long to infuse?
Spiked units for transfusion. must be infused w/i 4 hours or discarded.
