Portland Community College | Portland, Oregon

This course focuses on the most commonly encountered blood group systems (other than ABO and Rh) with emphasis on genotypes, phenotypes, and antibody detection. Blood bank test procedures, interpretation, and sources of error will be covered and include discrepancies from ABO subgroups. Donor selection criteria, anticoagulants, indications and contraindications for transfusing various blood components, transfusion reactions and investigation of reactions will be discussed. The course will also cover the principles and procedures involved in various serologic tests such as immunodiffusion, immunoelectrophoresis, immunofixation, immunofluorescence, and enzyme immunoassays. Serologic methods used in the diagnosis of viral hepatitis, Lyme disease, Syphilis, CMV, HIV, and Infectious Mononucleosis will be discussed.

Upon successful completion students should be able to:

1. Use an understanding of appropriate collection, identification, and processing of specimens; proper use of blood bank reagents; and accurate performance and interpretation of test results for ABO and Rh typing, antibody screen and identification, cross-match, antibody titer, acid elution, and rapid serology tests to make appropriate and effective on-the-job professional decisions.
2. Recognize normal and abnormal test results and correlate these data with appropriate pathologic conditions to accurately advise health care providers.
3. Adapt laboratory techniques and procedures in a corrective manner when errors and discrepancies in results are obtained to affect resolution in a professional and timely manner.

The material in this course will be presented in a traditional classroom (Campus program), or distance-learning format (Distance learning program). Both traditional and distance learning sections include required laboratory activities. Traditional classroom instruction consists of lecture, discussion, web-based instructional media (tutorials, animations, videos, etc.) and other educationally sound practices. Distance learning sections include similar educational practices and are primarily presented in a web-based format. Both campus and distance learning sections require periodic campus based laboratory exercises. In addition, the distance learning section may have hospital-based laboratory exercises. A laboratory manual will be provided. The laboratory exercises provide an opportunity for students to employ the testing principles and methodologies discussed and allow for discussion, application and correlation of the concepts presented. The student is expected to perform all laboratory procedures according to the criteria established by the department.

The instructor will outline the methods used to evaluate student progress and the criteria for assigning a grade at the beginning of the course. Assessment methods may include written and practical examinations and laboratory write-ups. Evaluation of problem solving skills, teamwork, attendance, laboratory performance and communication skills may also be included.

Course Themes

• Theme 1: Blood Groups
  • Recognizing and resolving problems encountered in routine ABO and Rh typing including the subgroups of A
  • Clinically significant non-ABO blood groups: their inheritance, genotypes, phenotypes, and antibody production and identification
  • Differentiating low-incident and high-incident antigens and their relation to antibody frequency
• Theme 2: Testing Methods, Principles, and Sources of Error
  • The antihuman globulin test, antibody screen, antibody identification, and cross-match
  • Blood bank reagents, their limitations and expected results
  • Pathophysiology and diagnostic testing for: Infectious Mononucleosis, Syphilis, CMV, HIV, viral hepatitis, and Lyme disease
• Theme 3: Hemolytic Disease of the Newborn
  • Common blood groups involved in Hemolytic Disease of the Newborn
  • The process of RBC sensitization
  • Isolation and identification of antibodies associated with HDN
  • Test results associated with ABO and Rh hemolytic disease
  • Criteria for exchange transfusions and the blood bank tests involved
  • Anti-Rh treatment and criteria for administration
• Theme 4: Component Therapy
  • Criteria used for acceptability of blood donors
  • Anticoagulants and preservatives used in blood collection for transfusion purposes and their outdating
  • General methods of production, tests involved, clinical indications for administration, and shelf life for components: whole blood, packed red cells, platelets, leukocyte-poor red cells, deglycerolized red cells, fresh frozen plasma, irradiated red cells (or platelets) and cryoprecipitate
  • Types of transfusion reactions, their clinical symptoms, and laboratory methods for investigation

 Laboratory Skills

• Proper collection and processing of peripheral blood samples for blood bank testing
• Use a serofuge in the performance of the tube methodology, including
  • Correctly balancing the serofuge
  • Proper handling, cleaning, and storage of the serofuge
  • Correct speed and time settings for the appropriate procedure
  • Correct use of the serofuge head during cell washing procedures
• Use of a water bath in the performance of antibody testing, including
  • Selecting the correct temperature for the procedure
  • Proper handling, cleaning, and storage of the water bath
• Proper performance of antibody testing, including
  • Perform and interpret the antibody screen test using the appropriate reagents and controls
  • Explain the principles involved in antibody screen testing and any discrepancies as well as sources of error
  • Troubleshooting and problem solving
  • Recording and interpreting results
• Proper performance of antibody identification testing, including
  • Perform and interpret the antibody identification panel using the appropriate equipment, reagents, and controls
  • Explain the principles involved in the antibody identification panel and any discrepancies as well as sources of error
  • Troubleshooting and problem solving
  • Proper recording of results and use of appropriate notation
• Troubleshooting and problem solving
  • Recognizing errors or discrepancies in results during lab procedures
  • Selecting corrective actions for problem solving

Cognitive Skills

• Cognitive processes, including
  • Formulating a clear, answerable question
  • Predicting expected results
  • Following written protocols and verbal instructions
• Analysis skills, including
  • Collecting and organizing data in a systematic fashion
  • Presenting data in an appropriate form
  • Assessing the validity of the data (including integrity and significance)
  • Recognizing errors and developing a corrective course of action
  • Drawing appropriate conclusions based on the results
• Communication skills, including
  • Discussing and presenting lab results or findings in the laboratory
• Interpersonal and citizenry skills, including
  • Working effectively in teams or groups so that the task, results, and analysis may be shared
  • Effectively managing time and tasks allowing concurrent and/or overlapping tasks to be done simultaneously, by individuals and/or within a group
  • Integrating knowledge and making informed judgments about blood bank test results in the clinical setting

Laboratory Safety

• Laboratory procedures, including
  • Reporting all spills and broken glassware to the instructor and receiving instructions for clean up
  • Minimizing or containing the production of aerosols and describing the hazards associated with aerosols
  • Washing hands prior to and following laboratories and at any time contamination is suspected
  • Using universal precautions with blood and other body fluids and following the requirements of the OSHA Bloodborne Pathogen Standard
  • Disinfecting lab benches and equipment prior to and at the conclusion of each lab session, using an appropriate disinfectant and allowing a suitable contact time
  • Identification and proper disposal of different types of waste
  • Good lab practice, including returning materials to proper locations, proper care and handling of equipment, and keeping the bench top clear of extraneous materials
• Protective procedures, including
  • Tying long hair back, wearing personal protective equipment (eye protection, coats, gloves, closed shoes), and using such equipment in appropriate situations
  • Always using appropriate pipetting devices and understanding that mouth pipetting is forbidden
  • Never eating or drinking in the laboratory
  • Never applying cosmetics, handling contact lenses, or placing objects (fingers, pencils, etc.) in the mouth or touching the face
• Emergency procedures, including
  • Locating and properly using emergency equipment (eye wash stations, first aid kits, fire extinguishers, chemical safety showers)
  • Reporting all injuries immediately to the instructor
  • Following proper steps in the event of an emergency