Portland Community College | Portland, Oregon

This course focuses on basic principles and procedures related to general immunology and the structure, function, and classification of antigens and antibodies. The complement system and the principles involved in agglutination reactions are presented. ABO and Rh blood group systems are covered with emphasis on inheritance, principles of testing, terminology and problem recognition/resolution. Other commonly encountered blood group systems (other than ABO & Rh) are introduced with emphasis on genotype and phenotype. Introduces principles of antiglobulin testing.

Upon successful completion of the course students should be able to:

1. Apply basic blood bank knowledge to make appropriate and effective decisions.
2. Complete and interpret ABO and Rh blood typing procedures.
3. Recognize normal/abnormal test results and correlate these data with appropriate pathologic conditions to accurately advise health care providers.
4. Adapt immunohematology laboratory techniques and procedures when errors and discrepancies in results are obtained to effect resolution in a professional and timely manner.
5. Articulate the significance of blood groups outside of ABO and Rh.
6. Distinguish direct from indirect antiglobulin procedures.
7. Demonstrate and interpret direct antiglobulin testing procedures.

The class is presented by means of lecture/discussion, audio-visual presentations, handouts, demonstrations, web based instructional media and other educationally sound practices. Comprehensive lab work requires demonstration of competency to receive a satisfactory grade. A laboratory manual is 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. 

Assessment methods may include written and practical examinations, homework assignments and discussion activities. Student knowledge application, laboratory performance, problem solving skills, punctuality and attendance, participation, and communication skills is assessed in each laboratory exercise utilizing an evaluation rubric that includes cognitive, psychomotor and affective learning domains.  

Themes:

• Basic Immunology
  • Mechanisms of protection against disease including acquired immunity
  • Components and function of haptens and complete antigens
  • Cellular and humoral immunity and the roles of tissues and related cells that may be involved in immune responses
  • Differentiate and identify the various types of hypersensitivities and immunodeficiencies
  • The inflammatory process including cells and chemical mediators
  • Classification of immunoglobulins and properties and characteristics related to: type of L and H chain, subclasses, size and number of structural units, complement activation, placental transfer, seromucous secretion, primary function and relative concentration in serum
  • Differentiate primary and secondary (anamnestic) responses and antibody class(es) involved
  • The complement system
• Laboratory Testing
  • Agglutination reactions, their stages, and the factors affecting each stage
  • Problems that may be encountered such as: dosage effect, prozone phenomenon, and blocking antibodies
  • Reagents commonly employed in ABO and Rh testing procedures
  • Methodologies, interpretation, and sources of error for ABO forward and reverse typing, and Rh and weak D typing
  • AHG: principles, uses, and sources of error
• ABO and Rh Blood Group Systems
  • Inheritance of the ABO blood group system and related genotypes and phenotypes of the four major groups
  • The Secretor and H systems and their relationship to ABO antigens
  • The Bombay O type and expected ABO typing results
  • The Fisher-Race, Wiener, and current theories of inheritance
  • The weak D genotype and phenotype
  • Recognize and resolve problems encountered in routine ABO and Rh typing including the subgroups of A
• Blood Groups

  • Clinically significant non-ABO blood groups: their inheritance, genotypes, phenotypes, and antibody production and identification

  • Differentiate low-incident and high-incident antigens and their relation to antibody frequency when  selecting blood for transfusion

• Antihuman Globulin

  • Indirect vs. Direct antiglobulin methods

  • Antibody screening for clinically significant non-ABO blood group antibodies

Skills:

Knowledge and Application (Cognitive Skills):

• Cognitive processes
  • Explain immunohematology theory supporting test principles
  • Integrate knowledge and make informed judgments about immunohematology test results  in the clinical setting
  • Formulate a clear, answerable question
  • Predict expected results
  • Follow written protocols and verbal instructions
• Analysis skills
  • Collect and organize data in a systematic fashion
  • Present data in an appropriate form
  • Assess the validity of the data (including integrity and significance)
  • Recognize errors
  • Draw appropriate conclusions based on the results
• Safety skills
  • Recognize safety equipment and laboratory safety measures

·            Troubleshooting and problem solving

o     Recognize errors or discrepancies in results during lab procedures

• Select corrective actions for problem solving Communication skills
  • Discuss and present lab results or findings in the laboratory
• Interpersonal and citizenry skills
  • Work effectively in teams or groups so that the task, results, and analysis may be shared
  • Effectively manage time and tasks allowing concurrent and/or overlapping tasks to be done simultaneously, by individuals and/or within a group

Performance (Psychomotor Skills):

• Utilize safety measures and equipment
  • Utilize adequate personal protective equipment, sharp container, fume hood and other safety devices
• Proper collection and processing of peripheral blood samples for blood bank testing
• Use a serofuge in the performance of the tube methodology, including
  • Correctly balance the serofuge
  • Properly handle, clean, and store the serofuge
  • Apply correct speed and time settings for the appropriate procedure
  • Operate serofuge head correctly during cell washing procedures
• Use of a water bath in the performance of weak D typing
  • Select the correct temperature for the procedure
  • Properly handle, clean, and store the water bath
• Proper performance of ABO testing
  • Perform and interpret forward and reverse typing using the appropriate reagents and controls
  • Properly record results using appropriate notation
• Proper performance of Rh testing
  • Perform and interpret routine Rh typing using the appropriate equipment, reagents, and controls
  • Perform and interpret weak D testing using the appropriate equipment, reagents, and controls
  • Properly record results using appropriate notation
• ​​Proper performance of direct antiglobulin testing

  • Perform and interpret the direct antiglobulin test using the appropriate reagents and controls

  • Properly record results using the appropriate notation

• Proper performance of antibody testing

  • Perform and interpret the antibody screen test using the appropriate reagents and controls

  • Properly record results using appropriate notation

Professional (Affective) Skills:

• Demonstrate interest, enthusiasm, and willingness to learn as seen through active participation.
• Show initiative and motivation as demonstrated by independence in performing routine procedures, preparation before class, decreased need for supervision, willingness to go beyond the required assignments, and recognition of opportunities to improve quality and productivity of work.
• Adapt to stressful and/or new situations by maintaining composure and flexibility without compromising individual integrity.
• Exhibit teamwork through cooperation, courtesy, respect, and sensitivity towards others.
• Convey a professional attitude as shown by an appropriate level of confidence and a positive outlook toward work and other people.
• Demonstrate integrity as shown by the admission and documentation of errors, recognition of the potential danger of short cuts, and the maintenance of patient and co-worker confidentiality.
• Act responsibly and reliably as measured by punctuality, attendance, dependability, and quality of work.
• Respond favorably to supervision and feedback. 
• Persevere until task is completed satisfactorily.