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AustinCommunityCollege  6)'Fd66)'Fd66)'t"Fd664 (Times NewRomanTTP h:FTFA MinutesFirst Pages%Xf$ hN p x (#%'0*,.8135@8:<H?AXX7?tXdd7  @  FULLTIMEFACULTYASSOCIATION  @+Minutes    + 2 ,'  ?tXXXs%Xf$ hN p x (#%'0*,.8135@8:<H?AX J(# Minutes   6)' xd6('2(T$ NU!   ^>8ACC AddressACC Return AddressAustinCommunityCollegeP.O.Box140526Austin,Texas78714dC,EqualEqual Opportunity Statement@.. ACCisanequalopportunityinstitution. N24 labels4 line labels ,  , ,       \RA'\ X X '  &6. Crossmatchlab6(Carolyn Ragland 0 .  ~Crossmatch; Task; To perform complete crossmatch procedure. ; Aim; To perform with 100% accuracy a patient's ABO and Rh type, donor typing, antibody screen, and crossmatch procedure. ; Introduction; Blood bank personnel are responsible for providing serologically compatible blood within an appropriate time frame.R& 8BibliogrphyBibliography0....fp2Doc InitInitialize Document Style3S 7    I. 1. A. a.(1)(a) i) a)S456($0 ($0 0 (($0 0 0   A_ekqwDocumentDocument StyleI.1.A.a.(1)(a)i)a)jo4Tech InitInitialize Technical StyleS 9  1 .1 .1 .1 .1 .1 .1 .1 S CuyTechnicalTechnical Document Style11.11.1.11.1.1.11.1.1.1.11.1.1.1.1.11.1.1.1.1.1.11.1.1.1.1.1.1.1x?;u2PleadingHeader for numbered pleading paper ; z <(  ?tXXXXX6)'*d66)'*d6dd1dd2dd3dd4dd5dd6dd7dd8dd910111213141516171819202122232425262728  .+('2(T$ NU!   <VV@2:QuickFormat1OX  cb   OX  cb   ('2(T$ NU!   .4` dTable_AOU1, 2, 3,Level 1Level 2Level 3Level 4Level 54#:v2Quick 1.G  .0 G   B-%  CRight ParRight-Aligned Paragraph NumbersI.A.1.a.(1)(a)i)a)3|n'\  `Roman PSXn\  Ps: XP0D4`n PSRD4PkCP/D4A`ArialTT[D4PkCP0D4`lTT||ID4PkC|P64 (Times NewRomanTTxx/4 pTCxp'6X'A`"Sans Serif PSTTXn6XPT} XP.4` Serif PSTTeJ4 PCP( U$  (9 Z 6Times New Roman Regular<\  `(Roman 10cpiXx\  @ X@<*f9 `(*Roman 10cpiItalicXx*f9 h XHa1a, b, c,Level 1Level 2Level 3Level 4Level 5TABLE A6#=4Quick a. 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D  ?2OX>XXiX޺OX>XXOX>cb     ?2,iX޺XOX>iX޺XiX޺cb     '6X'A`"Sans Serif PS(9 Z(Times New Roman ,rAZ"Arial Regular incomp NU!   _HHB  X,hfL0X~ \ X0 IP9Exercise6 @) Crossmatch  5 L Textbook: _Quinley_,Chapter11   Skills: 0 ` 20points`$`$  Objectives:   m  c( 93a"e3"  e32   1  .3  0    List4procedureswhichmustbeincludedinperformingthecrossmatchtest.e3݌z E$$ Ќ  "e3"  e32   2  .3  0    Describethetypeofindividualswhoshouldcollectsamplesforcompatibilitytesting.e3݌f 1 $$ Ќ  "e3"  e32   3  .3  0    Statetheprincipleofthemajorcrossmatch.e3!݌R $$ Ќ  "e3"  e32   4  .3  0    Listthecomponentsplacedinthetubeforthemajorcrossmatchprocedure.e3݌> $$ Ќ  "e3"  e32   5  .3  0    List2thingsthatacompatiblecrossmatchwillensure.e3)݌* $$ Ќ  "e3"  e32   6  .3  0    List6limitationsofthecrossmatchprocedure.e3)݌ $$ Ќ  "e3"  e32   7  .3  0    Listthe3requirements,asstatedby_AABB_ԀStandards,whichmustbeincludedinthecrossmatchtest.e3! ݌ $$ Ќ  "e3"  e3G 2   8  .3  0    Statethemaximumageofsampleswhichmaybeusedforthecrossmatch.e3G t ݌$$ Ќ  "e3"  e3V 2   9  .3  0    Statetheprimaryimportanceoftheimmediatespincrossmatch.e3V ݌$$ Ќ  "e3 "  e3] 2   10  .3  0    Statethepurposeofthe37Cincubationandantihumanglobulintestincompatibilitytesting.e3] ݌$$ Ќ  "e3 "  e3 2   11  .3  0    Describetheimportanceofperforminganantibodyscreeninpretransfusiontesting.e3 ݌}$$ Ќ  "e3 "  e32   12  .3  0    Statetheprincipleoftheminorcrossmatchtest.e3݌i$$ Ќ  "e3 "  e32   13  .3  0    Discusstheimportancecompleteconcentrationwhenperformingthecrossmatchprocedure.e3݌U$$ Ќ  "e3 "  e32   14  .3  0    Discussthecriteriaforselectionofbloodoftheappropriatetype,especiallywhenapatientsABO/D vA typeisunavailableormustbechanged.e3݌b-$$ Ќ  "e3"  e3-2   15  .3  0    GivenanABOtypelisttheappropriatealternatives,intheproperorder,whenthetypemustbechanged.e3-Z݌N$$ Ќ  "e3"  e3_2   16  .3  0    StatetheserologicalreasonsthatgroupABpositivepatientistheuniversalrecipientandgroupO : negativeistheuniversaldonor.e3_݌&$$ Ќ  "e3"  e32   17  .3  0    Statetheuniversaldonorforplasmaproductsanddefendyourchoice.e3݌$$ Ќ  "e3"  e32   18  .3  0    Performtwo2unitcrossmatcheswith100%accuracy.e3݌$$ Ќ  "e3"  e32   19  .3  0    Statetherequirementsforacrossmatchtobeinterpretedas compatible.e3݌$$ Ќ  "e3"  e32   20  .3  0    Listthe5tests/stepswhichmustbeperformedwhenanytubesintheantibodyscreenand/orcrossmatch  givepositivereactions.e3݌ $$ Ќ  "e3"  e3D2   21  .3  0    Statethetestwhichmustbeperformedwhentheantibodyscreenisnegativeand1donoris !y incompatible.e3Dq݌"e $$ Ќ  Discussion  r$= " Bloodbankpersonnelareresponsibleforprovidingserologicallycompatiblebloodwithinanappropriatetime J&"$ frame.Acrossmatch(compatibilitytest)isperformedforpatientswhoneedreplacementoftheirblood 6'#% volumeduetoanemiaoractive,massivebleeding. "(#& Compatibilitytestingincludesanumberofbloodbankproceduresperformedbeforeatransfusiontoensure )%( theproperselectionofbloodforthepatient.Theseproceduresshouldincludethefollowing: *&) 1.0  Areviewofbloodbankrecordsforprevioustestingofthetransfusioncandidate.PreviousABO,Dand ,(+ antibodydetectiontestresultsshouldbecomparedwithcurrentinterpretationsandanydiscrepancies -u),  resolved..a*-$$ IP9 I I  2.0  DeterminationofABOandDgroupsandexaminationforunexpectedantibodiesoneachrecipient 5  samplereceived.!$$ 3.0  SelectionofABOandDcompatibledonorunitsthathavebeentestedinaccordancewithStandardsand  foundacceptablefortransfusion.$$ 4.0  _Crossmatching_Ԁtestsbetweenpatientserumanddonorredcellsforevidenceofserologic   incompatibility. t$$ Scientificandtechnicaladvancesinbloodgroupimmunologyhavemadethetransfusionofbloodarelatively  L  safeprocedure,butseriousadverseeffectsoftransfusionstillresultbecauseofhumanerror.Onlyindividuals m 8  whounderstandtheimportanceofbloodbankprotocolsandadheretothemshouldbeallowedtocollect Y$  patientsamplesorperformtests.Failuretoconcentratecompletelyanduseofcarelesstechniquesin E  performinglaboratorytestsdirectlyendangerthelifeofthepatient. 1  Thepurposeof_crossmatching_Ԁistopreventthetransfusionofincompatiblecells.Testingoftherecipient's    (patient)serumwithdonorcells ( major_crossmatch_) isrequiredbecauseitisthebestavailablewayto  detectantibodiesinthepatientserumthatmightdamagetransfusedredcellsandcausehemolytictransfusion  reactions.  Whenperformedproperly,acompatible_crossmatch_Ԁ will : t H:v  H:vz%G1  .0    verify,inmostinstances,thatdonor'sredcellsareABOcompatiblewiththepatient;H:vz%%GیL$$ Ќ  2.0  detectmostantibodiesintherecipient'sserumdirectedagainstantigensonthedonorredcells.m8$$ The_crossmatch_Ԁhasmanylimitations.Acompatible_crossmatch_Ԁ willnot : E 1.0  guaranteenormalsurvivaloftransfused_RBCs_;$$ 2.0  preventimmunizationoftherecipient; $$ 3.0  detectallunexpectedredbloodcellantibodiesintherecipientserum;$$ 4.0  preventdelayedhemolysisduetoananamnesticantibodyresponsetoantigensagainstwhichthepatient  haspreviousbutundetectableimmunization; $$ 5.0  detectallABOgroupingerrorseitherindonororrecipient;! $$ 6.0  detectmostDgroupingerrorsinthedonororrecipient."p!$$  Principle  }$H # StandardsrequiresthattestsforserologicincompatibilityemploymethodsthatdemonstrateABO U& "% incompatibility,detectclinicallysignificantantibodiesactiveat37$C,andincludetheantiglobulintests.The A' #& patientspecimenmustbelessthan72hoursoldforcompatibilitytestingsothatitrepresentsthecurrent -(#' immunologicstatusofthepatient. )$( The major _crossmatch_Ԁinvolvestestingthepatient'sserumwithdonorcellstodeterminewhetherthepatient *&* hasanantibodywhichmaycauseahemolytictransfusionreactionordecreasedcellsurvivalofdonorcells. +'+ OfgreatestimportanceisdetectionofABOincompatibilities.ABOproblemsquicklybecomeapparentwhen ,(,  themixtureofpatient'sserumanddonorcellsisexaminedaftercentrifugation(immediatespin_crossmatch_). -)- Unexpectedcoldreactingantibodiesmayalsobecomeapparentatthisstep,butonceidentifiedassuch,they 5 areusuallyconsideredinsignificant. !  Thecrossmatchisincubatedat37$Ctodetectclinicallysignificantagglutinatingorhemolyzingantibodies.  Afterincubationandwashing,antiglobulinserum(Coomb'sserum)isemployedtodetectantibodiesthathave  attachedtocellswithoutcausingagglutination(sensitization).  Additionalsolutionssuchasalbumin,polymerizedalbuminorlowionicsaltsolutions(_LISS_)arefrequently  t employedtoincreasethesensitivityofthecrossmatchortoreducetheincubationtime.Byloweringtheionic  ` strengthorincreasingthedielectricconstantofthetestmedium,thesesolutionsincreaseantibodyuptakeand  L  enhancethestrengthoftheantigenantibodyreaction. m 8  Anantibodyscreenisperformedalongwiththemajorcrossmatch.Theantibodyscreenisimportantin E  detectingweakantibodieswhichmayonlyreactwiththehomozygousscreencellsortodetectantibodies 1  directedagainstantigenspresentonthereagentscreencellsbut not presentonthedonorcells.   The minorcrossmatch involvestestingthepatientscellswithdonorplasmatodeterminewhetherthereis  anantibodyinthedonor'splasmadirectedagainstanantigenonthepatient'scells.Sincealldonorsare  routinelyscreenedatthecollectionfacilityfor_irregular_Ԁantibodiesthisprocedureisnolongerroutinely  performed.Theremayberareinstanceswhenthisproceduremayneedtobeperformedsobefamiliarwith  it. t Itcannotbestressedenoughthatcompleteconcentrationandgoodtechniquemustbeusedinbloodbank L procedures. Incorrectidentificationofspecimensormaterialsorincorrectrecordingofresultsor m8 interpretationscausefalsepositives,falsenegativesandtotaldisaster!  Y$  SelectionofBloodforTransfusion  - WheneverpossiblethebloodselectedforcrossmatchshouldbeofthesameABOandDgroupasthatofthe  recipient.However,thereareinstanceswhenitisacceptableorevenadvisabletotransfuseredbloodcells  ofadifferentABOgroup,providedthattheyarecompatible.Forexample:  1.0  Whengroupandtypespecificbloodisunavailable,asintransfusinggroupAbloodtoanABrecipient.! $$ 2.0  Apatient,suchasanAorB,ismassivelybleedinganddepletingthetypespecificstock,thereisalarge "l! numberofgroupOunitsavailable,transfusewithgroupO.#X"$$ 3.0  ForABOand/orRhhemolyticdiseaseofthenewborn.y$D #$$ DpositiveindividualsmayreceiveDnegativeblood,althoughDnegativeunitsshouldbereservedforD Q&"% negativepatients.Butacommonsenseapproachtobloodusageshouldbemaintained.IfyouhaveanA ='#& positive"suregive",andyouhave2unitsofAnegativeexpiringsoon,itisabetteruseofthebloodresources )(#' togivethe2Dnegativetopreventtheirexpiration.Youwouldnotmakethisdecisiononyourown,but )$( wouldconferwithyourcoworkersorsupervisor. *%) DnegativerecipientsshouldalwaysreceiveDnegativebloodunlessalifethreateningsituationarose.The +'+ doctorwouldneedtosignareleaseformagreeingtothetransfusionofDpositivebloodtothisindividual. ,(,  .h*. _ ChoiceofBloodWhenGroupSpecificBloodisUnavailable  5 Whenbloodoftherecipient'sABOgroupisunavailable,transfusionwithanalternategroup,asshown,is   acceptablebutmustbe administeredasredbloodcells. NotethatforABindividualstheSecondChoicelists  groupOasthenextlogicalchoice.GroupBbloodisrelativelyuncommon,youwouldnotwishtodeprive  groupBpatientsoftypespecificblood,soitmakesmoresensetochoosegroupO,whichisusuallyin  abundantsupply.    *TUJddd Xdd Xdd XH$H$,dd ,dd ,dd +  ) P  P )PatientABOGroup 6,!  "B 6FirstChoice 6,!  "B 6SecondChoice ;1&  "  B ;A 'i4 " 'O 'i4 " 'None 'i4 " 'B ' " 'O ' " 'None ' " 'AB 'i4 " 'A 'i4 " 'OorB 'i4 " 'A2BwithantiA1 '" 'A2 '" 'OorB '" 'O 'i4" 'None 'i4" 'None"i4"  "GroupABpositiveisconsideredtobetheuniversal recipient for redcell transfusion.Duetotheirlackof ]( ABOantibodiestheywillbecompatiblewithallredbloodcelltypes.Forthetransfusionofredbloodcells I groupOnegativeistheuniversal donor sinceitlacksallABOandDantigens.Inanemergencysituation 5 groupOnegativeredbloodcellswouldbeissueduntilapatientsamplecouldbetested. !  For plasma componentsgroupOistheuniversal recipient ,sincetheyhaveallABOantibodiespresentall " plasmaproductswillbecompatible.GroupABistheuniversal donor forplasmaproductssincetheylack # allABOantibodies. $ Itiscriticalthatyouhaveabasicunderstandingofuniversaldonorsandrecipients.Inanemergencysituation t& youmayneedtoutilizetheseconceptstotransfusemassivelybleedingpatientsandyoumustknowwhatyour  `' optionsaretoprovidethesafestproductsforthesituationathand.Youmustalsohaveasoundunderstanding !L( anduseacommonsenseapproachanytimeyoumustprovidebloodofadifferenttypetoapatient. m"8)  +p'3   ?2OX>XXOXOX>XXOX>cb     Reagents?2KSOX>XOX>OX>XOX>cb      5 1.0  Seepage19$$ 2.0  Donorsegments%$$   ?2OX>XXOX>OX>XXOX>cb     Procedure?2QMOX>XOX>OX>XOX>cb        1.0  Foreachpatientsetup27tubesasfollows.Patient'sfullnameandhospitalnumberonserumandcell   suspensiontubes.Labelothertubeswiththepatient'sinitialsandthereagent/donorcelltobeplaced   inthetube.OWXOX>AWOW  $$ *CDdddd dd dd TUH$H$, ,9 ,X , ,9 ,X , ,  , ,, ,  , ,  ,E +  1'c. c.  1 'c. 3 'donor2cells 'c. 3 'O 'c. 3 'O 'c. 3 'O 'c. 3 'O 'c. 3 ' 'c. 3 ' 'c. 3 ' 'c. 3 ' 'c. 3 ' 'c. 3 ' 'c. 3 ' 'c. 3 ' :0c. 3 : ' 3 'donor1cells ' 3 'O ' 3 'O ' 3 'O ' 3 'O ' 3 ' ' 3 ' ' !3 ' ' "3 ' ' #3 ' ' $3 ' ' %3 ' ' &3 ' :0 '3 : 'j (3 'Retype 'j )3 'O 'j *3 'O 'j +3 'O 'j ,3 'O 'j -3 ' 'j .3 ' 'j /3 ' 'j 03 ' 'j 13 ' 'j 23 ' 'j 33 ' 'j 43 ' :0j 53  :clot '? 63 'patientcellO '? 73 'O ? 8 AntiA ' 93 'O ? : AntiB ' ;3 'ЀO ? < Anti_A,B_Ԁ ' =3 'O ? > AntiD ' ?3 'O ? @ patientserum ' A3 'Acells ? B O ' C3 'Bcells ? D O ' E3 'S1 ? F O ' G3 'S2O '? H3 'S3O '? I3 '_Xm_Ԁ1O '? J3 '_Xm_Ԁ2O(? K3  ($$U$AX>XAW2.0  Placeone(1)dropofallantiserumsintheappropriatelylabeledtubes (includingrepeatpatient,donor  L 1,anddonor2) . M$$ 3.0  Placethree(3)dropspatientseruminallappropriatelylabeledtubes(ReverseType,S1,S2,S3,_Xm_Ԁ1 O and_Xm_Ԁ2). NOTE:VISUALLYINSPECTEACHTUBETOENSUREEACHTUBEHAS P SERUM/ANTISERUMINIT Q$$ 4.0  PerformforwardandreversetypingonpatientspecimenaccordingtoABOandDlabprocedureand dS recordresults. DONOTADDSCREENCELLSTOSERUMATTHISTIME! PT$$ NOTE:Alwaysplacetubesinthe_serofuge_Ԁintheorderthatyouwillreadthem,_ie_,antiAinslot1,antiBin a,V slot2,etc.Thiswillsaveyoutimeandhelppreventclericalerrors. MW 5.0  Basedupontheoutcomeselectone(1)segmentfromeachoftwo(2)donorunitsoftheappropriate %Y TypeandDandpreparetheircellsuspensions.Z$$ 6.0  Visuallyinspecttubestomakesureallserumsareinthetubes.  \$$ 7.0  Addone(1)dropofreagentscreencellstotheappropriatelylabeledtubes."^$$ 8.0  Addone(1)droppatientcells fromtheclottube toallrepeatforwardtypingtubes.$h `$$ 9.0  Placeone(1)dropofeachrespectivedonorcellstotheirappropriatelylabeledforwardtypingtubesand y&D"b crossmatchtubes.e'0#c$$ Ѐ10.0  Centrifugethescreencellsandtwo(2)crossmatchtubesfor15seconds.Readforagglutinationand/or =)%e hemolysis. Recordreactionsimmediately.)*%f$$  11.0  Addtwo(2)dropsofalbumin toalltubesandplacein37$Cwaterbathfor20minutes.NOTE: Five  ,'h tubesshouldbein_waterbath_.,(i$$   -)j 12.0  Centrifugeforwardtypingtubesforpatientanddonors.Readandrecordreactionsimmediately(the 5  repeattypingofthepatientwillberecordeddirectlyabovetheinitialtyping). TheDandDctrltubes ! ofDnegativepatientsanddonorsshouldbeimmediatelyplacedinthe_waterbath_Ԁafterreading.   NOTE:IfpatientanddonorstypeasABpositive,anegativecontroltubemustbeperformed.$$ 13.0  Afterthe20minuteincubation,centrifugethecrossmatchandantibodyscreenfor20seconds.Read  foragglutinationand/orhemolysis. Recordreactionsnow.  $$ 14.0  Washthetubesthree(3)timeswithsaline,decantingcompletelybetweenwashesandblottingthetubes  l afterthelastwash.( BesuretowashDandDctrltubesofDnegativepatients/donorsatthesame  X  time ).} H $$ 15.0  Addtwo(2)dropsofCoombsserum(AHG)toeachtube.Mixwellandspinfor15seconds.Readfor Y$  agglutinationmacroscopicallyandmicroscopically. Recordreactions. E $$ 16.0  Toalltubesshowinganegativereaction,addone(1)dropCoombscontrolcells(checkcells).Mixwell !  andcentrifugefor15seconds.A1-2+reaction must beobtainedorthetestmustberepeated.Record   reactions.$$ Ї  InterpretationofResults  5 A.0  Ifalltubeshaveremainednegativethroughoutthecrossmatchprocedure,andthecheckcellshave   checked,theantibodyscreenis negativeandtheunitsareinterpretedas compatible, recordas   componyoursheet. $$ B.0  Antibodyscreenispositive,unitsmaybecompatibleorincompatible( recordas incompon   sheet ): |$$ 0  1.0`$$Apanelstudymustbedoneandtheantibodyspecificityidentified. X `$`$ 0  2.0`$$Theunitsmustbetestedfortheantigentowhichtheantibodyisdirected(antigentyped). y D  Example:Ifthepatienthasananti-E,theunitsmustbetestedwithanti-Etypingserum.)e0 `$`$ 0  3.0`$$Ifanyunitisantigenpositive,eventhoughitappearscrossmatchcompatible,itmustbereleased Q  (returnedtoregularstock,nottobeusedforthispatient).= `$`$ 0  4.0`$$Additionalreplacementunitsmustbetestedwithantiserumuntilantigennegativeunitsare )  found.Theseantigennegativeunitsmustbecrossmatchedwiththepatientbeforebeing   consideredcompatible.`$`$ 0  5.0`$$Testthepatientfortheantigentoverifythathe/sheisantigennegative.`$`$ C.0  Antibodyscreenisnegative,butoneormoreunitsappearincompatibleperformaDATontheunit:$$ 0  1.0`$$IftheDATispositive,returntheunittothebloodprovider.h`$`$ 0  2.0`$$Ifnegative,thenapanelstudymustbeperformedtodeterminethespecificityoftheantibody.T`$`$ V=  0   `   V=tRa  .0$$  Ifanantibodyisidentified,allunitsmustbetested0@blood,a0@ T$ T$ @ withtheappropriateantiserum.V=ttRیa,$$ Ќ     `   b.0  Incompatibleunitsaswellasantigenpositiveunits0@blood,a0@ T$ T$0@. T$. T$ @ mustbereleasedandantigen @"  M negativeunitsmustbe @& foundandcrossmatchwiththepatient.9$$ 0   `   c.0$$Typethepatientfortheantigentoverifyhe/sheisnegativefortheantigen.%$$ Othermorecomplexproblemsmayarisewhendoingacrossmatch,suchasalltubesinthecrossmatch  proceduregivingpositivereactions.Thisisusuallyduetononspecificwarmautoantibodiesormultiple  antibodyspecificitiespresentinthepatientsample.Extensivetestingwouldneedtobeperformedto   resolvetheproblem. !  Ifotherproblemsoccurotherthanthoselisted,consultyourreferencebookswhichshouldbepresentin #d" thelaboratory. $P #  ]&("%  Homework  5 Nextweek,alongwiththestudyquestions,youmustturninacondensedprocedurewrittenononeindex M card.Thisistobewritteninasimplifiedmannertoaidyouinperformingthisprocedure. 9 __@;; OrganizationalFlowChartforPerformingthe 5 @,,$_Crossmatch_ԀProcedure  `   Preparecellsuspension,useserumtubeasbalancetube    While_RBCs_Ԁandserumtubesarespinning, labelALLtubes      t Addpatientserumandreagentserum toALLtubes   `   P Addpatientcellstoforward,andreagentcellstoreversetypingtubes q <   ](  Spinforward/reversetubes,recordpatientinformationfromclottubeontoresultsheet I   5  Read,recordforward/reversereactions,interpret,obtainappropriatedonorunitsfrombloodbank !      Preparedonorcellsuspensions,whilethesearespinningdropreagentscreencellin_approprirate_Ԁtubeas  wellaspatientcellsfromclottubeintoretypetubes    Dropdonorcellsintoappropriate forwardAND_crossmatch _Ԁtubes   x  SpinscreensAND_crossmatch _Ԁtubes,readandrecord. d  ADDALBUMINTOSCREENAND_CROSSMATCH_ԀTUBESAND T PLACEIN37$CWATERBATH.  u@  a, Spin,readandrecordpatientrepeatanddonorforwardtypes,incubateDandDctrltubesifpatient/donors M areDnegative. 9  % AfterincubationspinandrecordSCand_XM_Ԁtubes    Wash_3Xs_Ԁ_(incuding_ԀDand_Dtrl_ԀifD=),add_AHG,_Ԁreadmacroandmicro,record     Addcheckcells,spin,readandrecord !  "x  Ifnoagglutinationincheckcelltubes, STARTOVER #d!  .x*-    9 XT8| pX~J90$Name_________________________________ !  Exercise6 @) Crossmatch Y$ @'StudyQuestions    ! ! c( 99c"e3"  e3Ɇ2   1  .3  0    Compatibilitytestingincludesanumberofbloodbankproceduresperformedpriortotransfusion.List   andbrieflydescribethese4procedures.(2points)e3Ɇ݌ $$ Ќ  "e3"  e3K2   2  .3  0    Describethetypeofindividualwhoshouldbeallowedtodrawpatientsamplesorperformbloodbank  tests.(1point)e3Kx݌$$ Ќ  "e3"  e32   3  .3  0    Whatistheprimarypurposeofthecrossmatchprocedure?(0.5)e3Ή݌a,$$ Ќ  OX>XXAX>"e3"  e3̊2   4  .3  0    Statetheprimaryimportanceoftheimmediatespincrossmatch.#AX>XXOX>#e3̊݌$ "$$ Ќ  "e3"  e32   5  .3  0    Listtwo(2)thingsacompatiblecrossmatchwillindicate.(2points)e3'݌)P%'$$ Ќ    /*- "e3"  e3"2   6  .3  0    Thecrossmatchprocedurehasmanylimitations.Listsix(6)thingsthatacompatiblecrossmatch 5 can/maynotdo.(3points)e3"O݌!$$ Ќ  "e3"  e32   7  .3  0    OX>XXAX>Statetheprincipleofthemajorcrossmatch.#AX>XXOX> #Ԁ(1point)e3݌1 $$ Ќ  "e3"  e3͏2   8  .3  0    Therearethree(3)importantphasesofthecrossmatchdescribedinthetestprinciple.Identifywhat \  antibodyclass wouldbedetectedateachphase.(3points)e3͏݌}H$$ Ќ  *bXYJdd 9 9X X 9 9X X    , ,     E ECDH$H$b, dd ,Sdd ,A dd +  EE  6,!t"B 6CrossmatchPhase 6,!t"B 6AntibodyClassDetected 2(&t"  B 2a. )   )   ) b. t    t!   t" c. ) #   ) $  ) %  "e3"  e3ڔ2   9  .3  0    Define minorcrossmatch.Whyisthisprocedurenolongeraroutinepartofthecrossmatchprocedure?e3ڔ݌#'$$ Ќ  0  (2points) $($$   -.)3 "e3 "  e3n2   10  .3  0    Statetheconsequenceswhichmayoccurifcompleteconcentrationandgoodtechniquesarenot @" utilized 5  whileperformingbloodbankprocedures.(1point)e3n݌!$$ Ќ  "e3 "  e32   11  .3  0    Listthree(3)instancesinwhichitmaybenecessarytotransfusebloodofanothertypetothe @ " patient.(1.5  L  points)e3-݌m 8 $$ Ќ  "e3 "  e3g2   12  .3  0    Foreachofthefollowingbloodgroupsfillinthefirstandsecondchoiceswhenanalternate @! bloodgroup  mustbetransfused.(2.5points)e3g݌p$$ Ќ  B XT8D<pXT8DpDB  *]^J'dd dd Sdd SA dd A XYH$H$,dd ,dd ,dd +  }H}H  BloodGroup -#!"B -FirstChoice -#!"B -SecondChoice ;1&"  B ;A2BwithantiAOX>XhAX>1#AX>XhOX># a,"   a,   a, AB "       O a, "   a,!   a," A #"   $   % B a ,&"   a ,'  a ,(  "e3 "  e32   13  .3  0    StatethereasonthatthesecondchoiceforanABindividualisgroupOinsteadofgroupB.(1point)e3݌i"4)$$ Ќ  "e3 "  e32   14  .3  0    Statethefollowing:(2points)e3D݌'".$$ Ќ  0  Universalredbloodcelldonor:($0$$ 0  Universalredbloodcellrecipient:*&2$$ 0  Universalplasmadonor:,X(4$$ 0  Universalplasmarecipient:e.0*6$$  Q/+7 "e3"  e392   15  .3  0    Theantibodyscreenisnegativebuta2+reactionisnotedononeofthecrossmatchtubesatthe0@" AHG 5 phase.Whatadditionaltestmustbeperformed,andstatetheappropriatecourseofactionforpositive ! andnegativeresults.(1.5points)e39f݌ $$ Ќ  "e3"  e372   16  .3  0    Outlinetheproceduretofollowwhenaunitappearscompatible,buttheantibodyscreenis @^! positive.(2.5 E  points)e37d݌1 $$ Ќ  "e3"  e32   17  .3  0    AgroupAposindividualismassivelybleedingandrapidlydepletingyoureAposstock.Youhave20 A    0pos,20Bposand10ABpos.Stateyouralternatechoiceandreasonforselection.(2points)e3˥݌-$$ Ќ  "e3"  e3Y2   18  .3  0    Whatadditionaltest(s)mustbeperformedwhenapatienttypeisABpositive?Why?(1point)e3Y݌#X"$$ Ќ  "e3"  e32   19  .3  0    Whatisthemaximumamountoftimeaspecimenmaybeusedforpretransfusiontesting.(0.5)e3݌*&*$$ Ќ    -|)- "e3"  e3Ω2   20  .3  0    DrawapictureanddescribetheprincipleoftheIndirect_Antiglobulin_Ԁtest.Thiswillalsobearequired 5  activityforExam3(2points)e3Ω݌!$$ Ќ  "e3"  e3m2   21  .3  0    DrawapictureanddescribetheprincipleoftheDirect_Antiglobulin_Ԁtest.Thiswillalsobearequired  activityforExam3(2_points)e3m݌$$ Ќ  @._