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The clinical rotation for Blood Bank at
HCMC consists of 6 weeks (3 weeks in the first half of the internship,
3 weeks in last half) of practical laboratory experience supplemented
with unknowns, clinical case studies, and self-instructional units. One
additional day is spent at a Blood Center. Near the end of the clinical
internship, additional case studies are presented as part of a year-end
review.
Prior to the internship at HCMC, it is expected that the student will
have mastered each of the items listed in the following Blood Bank Pre-clinical
Competencies. These competencies consist of basic blood bank procedures
and theory that are to be learned during the summer program at the university.
NOTE: Each student is required to write out answers for all of the
objectives. If the objective involves the performance of some activity,
describe what you did in your college courses in order to meet that objective.
These answers must be turned in to the HCMC program director on the first
day of orientation. They will be evaluated for completeness by the HCMC
education techs.
Each student is also expected to review the Blood Bank Pre-clinical Competencies
immediately prior to the first week of their internship in the Blood Bank
section. Complete knowledge of these competencies will allow the student
to move through the clinical rotation with greater ease and fewer additional
assignments and test samples.
Bev Osekowsky, MT (ASCP)
Reviewed 1/07
BLOOD BANK PRE-CLINICAL COMPETENCIES
Upon entering the nine months of clinical
study the student will be able to:
I. BASIC IMMUNOLOGY
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A. Define antigen and antibody
as they pertain to blood banking.
B. List the 5 classes of immunoglobulins and note which classes are
encountered in the Blood Bank.
C. Compare and contrast the different immunoglobulins. Include such
considerations as basic units (number and composition), ability to
cross the placenta, optimal temperature reactivity, number of binding
sites and concentration in normal serum.
D. State two indications that an antigen-antibody reaction has occurred
in blood bank testing.
E. Describe and be able to draw pictures of the two stages of agglutination
reaction (include factors and/or conditions affecting each stage).
F. Describe and compare the characteristics of a primary response
to those of a secondary response.
G. Discuss why either serum or plasma may be used in most blood bank
testing. |
II. TECHNIQUES
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A. Prepare a 2%-5% RBC suspension
for testing.
B. Perform routine ABO/Rh typing using the tube technique.
C. Read and grade positive reactions (macroscopic and microscopic)
according to their observed strength (using proper optical aids) as
outlined in the AABB Technical Manual.
D. Perform direct antiglobulin tests.
E. Perform antibody screens. |
III. ABO
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A. Explain why the ABO blood group is the
most important system encountered in the Blood Bank.
B. Define cell typing (forward grouping or front type).
C. Define serum typing (reverse grouping or back type).
D. Explain why ABO antibodies are found in most serums regardless
of previous RBC immunization.
E. For each of the following, list the ABO testing discrepancies
that would be observed and explain how to resolve each discrepancy:
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1. Reverse (serum) typing
is weak or absent.
2. Patient is A2 with anti-A1.
3. A group A patient has been transfused with group O packed
red blood cells.
4. Patient has acquired B phenomenon. |
F. Define phenotype.
G. Define genotype. |
IV. Rh
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A. State the two currently accepted theories
of inheritance in the Rh system.
B.List the 5 most common antigens which comprise the Rh system using
the Wiener and Fisher-Race nomenclature. Note which antigen constitutes
Rh positive or Rh negative status.
C. Describe the weak D variant and discuss testing methods for identification.
(Include discussion of when such testing is necessary).
D. Discuss the significance of a positive direct antiglobulin test
on cells being tested for weak D.
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V. ANTIBODY DETECTION
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A. Discuss and draw a picture
of the principles of the antiglobulin test.
B. Draw the steps in the direct antiglobulin test (DAT) and state
two (2)applications of the DAT.
C. State two components of polyspecific antihuman globulin reagents.
D. List two monospecific antihuman globulin reagents.
E. Draw the steps in the indirect antiglobulin test (IAT) and state
two (2) applications of the IAT.
F. Define allo antibody.
G. Define auto antibody.
H. Define dosage and give examples of antibodies noted to exhibit
this phenomenon.
I. Using the crossing-out technique, interpret the attached antibody
panel. Show your work and explain the process you followed.
J. State the purpose of an eluate. |
VI. CROSSMATCHING
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A. List the main
steps of the major crossmatch.
B. List acceptable ABO/Rh types (for both red cell products and plasma
products) that patients can receive if that patient's type is not
available.
C. Explain the significance of a compatibility test. |
AABB Technical Manual, Current edition
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