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CENTRAL TEXAS COLLEGE SYLLABUS FOR MLAB 2431

IMMUNOHEMATOLOGY

Semester Hours Credit: 4

INSTRUCTOR: OFFICE HOURS:

I. INTRODUCTION

A. This course is designed as a course in clinical immunohematology and immunology. Immunohematology is a study of blood antigens and antibodies, performance of routine blood banking procedures, including blood group and Rh typing, antibody screens, antibody identification, cross matching, elution, and absorption techniques. An introduction to the theory and application of basic immunology, including the immune response, principles of antigen-antibody reactions, and the principles of serological procedures will be included.

B. This course is designed to meet curriculum requirements for students in Medical Laboratory Technology, but may satisfy course requirements for other allied health disciplines.

C. This course is occupationally related and meets the curriculum requirements for

Medical Laboratory Technology programs.

D. Prerequisite(s): MLAB 1201- Introduction to Clinical Laboratory Science MLAB 1211- Urinalysis and Body Fluids MLAB 1415- Hematology

II. LEARNING OUTCOMES

Upon successful completion of this course, Immunohematology, the student will be able to:

A. Demonstrate the use of relevant terminology in immunohematology. B. Explain the structure and functions of the immune system. C. List the various methods employed in detection of antigen-antibody reactions. D. Describe various blood group systems (ABO/Rh/others). E. Relate disease manifestation and clinical correlation. F. Perform and evaluate the results of ABO, Rh, antibody screen, IAT, DAT, and

crossmatch testing. G. Describe hemolytic disease of the newborn. H. Describe collection, labeling, storage, and preparation of blood bank specimens. I. Describe immunologic and genetic theory. J. Compare principles of methods, including recognition and resolution of common

blood bank problems. K. Differentiate and resolve technical, instrumental, and physiologic causes of problems

or unexpected test results. L. Describe collection, handling, storage, and preparation of immunology specimens. M. Examine immunologic and physiologic theory of various immunology tests. N. Compare principles of methods in immunology. O. Relate disease manifestation and clinical correlation in immunology. P. Describe the following immunology tests: RPR, VDRL, FTA-Abs, Mono test,

Heterophile antibody, ASO, ANA, Hepatitis, Rubella, HIV, Cold Agglutinin, and CRP.

Q. Recognize and use safety procedures required in the clinical laboratory, including the handling and disposal of specimens, personal protective equipment, flammable materials, and sharps disposal.

R. Explain the importance of quality assurance in the clinical laboratory. Describe quality control and quality assurance measures taken in a transfusion service or donor center setting. Perform reagent QC requirements and interpret QC results.

S. Perform routine phlebotomy of Immunology and Immunohematology specimens. T. Exhibit attitudes consistent with professionalism and concern for high quality health

care by: 1. Performing analysis with care, adhering strictly to written procedure 2. Demonstrating flexibility by accepting and implementing approved changes

to procedures 3. Attending scheduled lecture and lab regularly and punctually 4. Completing assigned tasks with minimal guidance 5. Maintains confidentiality of patient results 6. Seeks activities which further assists learning 7. Admits mistakes and takes steps to correct them 8. Repeats procedures when test results are in doubt 9. Responds appropriately to authority 10. Takes pride in role in laboratory medicine 11. Complies with stated dress code for laboratory exercises

12. Participating in continuing education activities III. INSTRUCTIONAL MATERIALS

A. Required Texts: 1. Rudmann, Sally V. Textbook of Blood Banking and Transfusion Medicine.

2nd ed. Pennsylvania: Elsevier Saunders, 2005. (ISBN: 0-7216-0384-X) 2. Turgeon, Mary L. Immunology and Serology in Laboratory Medicine.

3rd ed. Missouri: C.V. Mosby Company, 2003. (ISBN: 0-323-02371-1)

B. Reference Texts: 1. American Association of Blood Banks. Technical Manual. 14th ed.

Maryland: American Association of Blood Banks, 2002. 2. Quinley, Eva D. Immunohematology: Principles and Practices. 2nd ed.

Pennsylvania: Lippencott, 1998. (ISBN: 0-397-55469-9) 3. Henry, John B. Clinical Diagnosis and Management by Laboratory Methods.

20th ed. Pennsylvania: W.B. Saunders Company, 2001. (ISBN: 0-7216-6030-

4) IV. COURSE REQUIREMENTS

A. To receive transferable credit for this course, you must earn a grade of "C" or better. B. You must keep up with the material on a day-to-day basis because the material is

technical. In order to understand the material, it must be learned in a sequential order. You are expected to read all assigned materials and to bring text books to class and laboratory.

C. A good set of notes will be important. The majority of exam material will be taken from your notes and handouts; the rest will be taken from the text. All written assignments given by the instructor are to be completed and handed in as required.

D. Students with a grade of "D" or less are expected to make an appointment with the instructor to discuss the reason for their low performance. Any material not understood by the student in lecture or lab can be discussed with the instructor privately. On the office door will be a list of office hours for conferences. Please try to make an appointment at your convenience.

E. Students are expected to attend all lectures/labs diligently and comply with college attendance rules as published in the Student Handbook.

V. EXAMINATIONS

A. Five lecture examinations, three laboratory examinations and a comprehensive final examination will be given. Examinations will include multiple choice, short answer, fill-in-the-blank, matching, and other test format styles as appropriate for the material covered. Lab exams will be both written and wet.

B. Make-up examinations will not be given unless approved by the instructor. If given, make-up examinations may be 50% essay.

C. Quizzes may be given at the discretion of the instructor. D. Procedures outlined in this syllabus may be modified by the instructor.

VI. SEMESTER GRADE COMPUTATION

A. Lecture Examinations: Lecture 1 100 points Lecture 2 100 points Lecture 3 100 points Lecture 4 100 points Lecture 5 100 points Comprehensive Final 200 points

TOTAL LECTURE POINTS 700 points

B. Laboratory Examinations:

Laboratory 1 100 points Laboratory 2 100 points

Laboratory 3 100 points Case studies, problems, article summaries,

quizzes, and laboratory assessment points 100 points

TOTAL LAB POINTS 400 points

C. Total Possible Points: 1100

990 - 1100 points = A 880 - 989 points = B 770 - 879 points = C 660 - 769 points = D < 660 points = F

VII. NOTES AND ADDITIONAL INSTRUCTIONS FROM COURSE INSTRUCTOR

A. Course Withdrawal: It is the student's responsibility to officially withdraw from a class if circumstances prevent attendance. Any student who desires to, or must, officially withdraw from a course after the first scheduled class meeting must file a Central Texas College Application for Withdrawal (CTC Form 59). The withdrawal form must be signed by the student.

CTC Form 59 will be accepted at any time prior to Friday of the 12th week of class during the 16-week fall and spring semesters. The deadline for sessions of other lengths is:

10-week session Friday of the 8th week 8-week session Friday of the 6th week 5-week session Friday of the 4th week

The equivalent date (75% of the semester) will be used for sessions of other

lengths. The specific last day to withdraw is published each semester in the Schedule Bulletin.

A student who officially withdraws will be awarded the grade of "W" provided the student's attendance and academic performance are satisfactory at the time of official withdrawal. Students must file a withdrawal application with the college before they may be considered for withdrawal.

A student may not withdraw from a class for which the instructor has previously issued the student a grade of "F" or "FN" for nonattendance.

B. Administrative Withdrawal: An administrative withdrawal may be initiated when the

student fails to meet College attendance requirements. The instructor will assign the appropriate grade on the CTC Form 59 for submission to the registrar.

C. Incomplete Grade: The College catalog states, “An incomplete grade may be given in those cases where the student has completed the majority of the course work but, because of personal illness, death in the immediate family, or military orders, the student is unable to complete the requirements for a course..." Prior approval from the instructor is required before the grade of "I" is recorded. A student who merely fails to show for the final examination will receive a zero for the final and an "F" for the course.

D. Cellular Phones and Beepers: Cellular phones and beepers will be turned off while

the student is in the classroom or laboratory.

E. American’s With Disabilities Act (ADA): Students requiring accommodations for disabilities are responsible for notifying the instructor. Reasonable accommodations will be granted in full compliance with federal and state law and Central Texas College policy.

F. Instructor Discretion: The instructor reserves the right of final decision in course

requirements.

G. Civility: Individuals are expected to be cognizant of what a constructive educational experience is and respectful of those participating in a learning environment. Failure to do so can result in disciplinary action up to and including expulsion.

VIII. COURSE OUTLINE

A. Lesson One: Immunology

1. Learning Outcomes: Upon successful completion of this lesson, the student will be able to: a. Define immunology and explain the function of immune system. b. Name and explain the characteristics of each of the five

immunoglobulin classes. c. Explain the phases of antibody response. d. Compare cell mediated immunity and humoral immunity. Explain

function of T & B cells. e. Compare and contrast primary and secondary immune response. f. Define basic immunology terms. g. Identify parts of antibody structure. h. Distinguish complement pathways. i. Describe the principles of agglutination and methods used in the

clinical laboratory. j. Describe the principles of precipitation and methods used in the

clinical laboratory. k. Correlate infectious disease with immunology tests used to diagnose

them. l. Perform syphilis and infectious mononucleosis testing.

m. At the conclusion of this lecture series, the learner will have achieved

the following: Achievement will be met when a minimum score of 70 percent is earned on the written examination covering the material.

2. Learning Activities: a. Classroom lecture/discussion b. Reading assignment: Turgeon as assigned c. Laboratory exercise d. Demonstration

3. Equipment and Materials: a. Test tubes and racks b. RPR test kit c. Mono spot test kit d. Serofuge e. Rotator

4. Audio-Visual Aids and Computer Technology:

a. Computer program: Immunology/Immunohematology Review b. VHS tape: Our Immune System

5. Lesson Outline:

a. Define immunology b. Describe agglutination c. Describe precipitation d. Correlate disease states to immunology tests

LECTURE EXAM 1

B. Lesson Two: Introduction to Immunohematology: Genetics and Immunology

1. Learning Outcomes: Upon successful completion of this lesson, the student will be able to: a. Define the following: gene, allele, locus, chromosome, homozygous,

heterozygous, dominant, recessive, co-dominant, genotype, phenotype, antigen, antibody, IgG, IgM, dosage, in-vivo, and in-vitro.

b. Explain dominant vs. recessive traits & explain co-dominance. c. Describe and identify four patterns of inheritance. d. Describe factors affecting antigen-antibody reactions. e. Calculate phenotypic frequencies and population genetics. f. Describe the principle of antiglobulin testing. g. Describe applications for antiglobulin testing. h. Define direct and indirect antiglobulin tests. i. Identify factors affecting antiglobulin testing. j. Grade agglutination patterns in test tube. j. At the conclusion of this lecture series, the learner will have achieved

the following: Achievement will be met when a minimum score of 70 percent is earned on the written examination covering the

material.

2. Learning Activities

a. Classroom lecture/discussion b. Reading assignment: Rudmann Chapters 1 & 2 c. Laboratory exercise in phenotype calculations d. Demonstration

3. Equipment and Materials:

a. VCR

4. Audio-Visual Aids: a. VHS tape: The Immune System: The Fighting Edge b. Computer program: Antiglobulin Test

5. Lesson Outline: a. Define medical terminology

b. Identify antibody structure and classes of greatest significance to blood banking

LAB EXAM #1 C. Lesson Three: ABO and H Blood Group Systems, Lewis, I & P Blood Group Systems

1. Learning Outcomes: Upon successful completion of this lesson, the student will be able to:

a. Briefly describe history of discovery of ABO blood groups. b. Define the following terms: forward type, reverse type, Landsteiner's

Rule, secretor, subgroup, discrepancy. c. Describe relationship between ABO antigens & antibodies for the

ABO blood group (Landsteiner's Rule). d. Identify the frequencies of ABO blood types. e. Explain the effect of age on demonstration of ABO type. f. Predict ABO phenotypes & genotypes of children from various ABO

parents. g. Explain ABO genetic theory of A, B, and H antigens and the

transferases responsible for each. h. Describe the differences between A1 and A2 phenotypes. i. Describe the Bombay phenotype. j. Interpret results of ABO typing and list red cell and serum associated

causes of ABO discrepancies. k. Explain what is meant by "secretor status," describe inheritance

patterns, and the affect on the ABO/H, and Lewis BGS l. Perform ABO grouping and evaluate the results of testing m. State BB specimen collection, labeling, storage, and preparation.

n. Accomplish the following in regard to Lewis, P, and I/i blood group systems:

(1) List major antigens and their frequencies (2) State clinical correlation between blood group and related

disease state (3) Describe the major characteristics including inheritance

patterns o. At the conclusion of this lecture series, the learner will have achieved


material.

2. Learning Activities: a. Classroom lecture/discussion b. Reading assignment: Rudmann Chapter 3 and 4 c. Laboratory exercise d. Demonstration

3. Equipment and Materials: a. Test tubes and racks b. ABO typing sera and reverse group cells c. Viewer d. Serofuge e. Saline

4. Audio-Visual Aids: None

5. Lesson Outline:

a. Identify ABO blood group antibodies b. Interpret ABO typing c. Describe specimen collection and storage

D. Lesson Four: Rh Blood Group System

1. Learning Outcomes: Upon successful completion of this lesson, the student will be able to: a. Describe the Rh blood group antigens. b. Compare the Fisher-Race and Wiener nomenclature. c. Describe weak D. d. List three characteristics of Rh antibodies. e. Perform routine Rh and weak D testing and interpret results. f. Identify and resolve problems encountered in Rh testing. g. Describe Rh system genetic theory and history of discovery of the

D antigen. h. Determine the appropriate use of Rh control material based on

reagent type. i. At the conclusion of this lecture series, the learner will have achieved

the following: Achievement will be met when a minimum score of 70 percent is earned on the written examination covering the material

2. Learning Activities: a. Classroom lecture/discussion b. Reading assignment: Rudmann Chapter 5 c. Laboratory exercise – Rh and weak D testing, Rh BGS antigen

typing d. Demonstration

3. Equipment and Materials: a. Test tubes and racks b. Saline c. Rh system antisera, AHG, check cells d. Serofuge e. Heating blocks

4. Audio-Visual Aids:

a. VHS tape: Rh Blood System b. VHS tape: Automated Blood Typing Analyzer

5. Lesson Outline:

a. Describe Rh antigens b. Perform Rh testing c. Identify Rh antibodies

LECTURE EXAM #2

E. Lesson Five: Other Blood Group Systems

1. Learning Outcomes: Upon successful completion of this lesson, the student will be able to: a. Accomplish the following in regard to other blood group systems:

(1) List major antigens and their frequencies (2) State clinical correlation between blood group and related

disease state (3) Describe the major characteristics

(a) MNSs (b) Kell, Duffy, and Kidd systems (c) Lutheran and Xg

c. Distinguish between antibodies that show enhanced reactivity after treatment with enzymes and those that exhibit decreased reactivity

d. Relate immunogenicity to antigens. e. At the conclusion of this lecture series, the learner will have achieved

the following: Achievement will be met when a minimum score of

70 percent is earned on the written examination covering the material

2. Learning Activities: a. Classroom lecture/discussion b. Reading assignment: Rudmann Chapter 6 c. Laboratory exercise

3. Equipment and Materials: a. Reagent cells b. Reagent antisera


5. Lesson Outline:

a. Describe blood group antigens b. Identify antibodies to blood group antigens

F. Lesson Six: Donor Unit Processing and Blood Products

1. Learning Outcomes: Upon successful completion of this lesson, the

student will be able to: a. List and describe the regulating authorities in donor centers. b. Describe factors affecting the available blood supply.

c. List and describe donor screening procedures and requirements. d. Outline blood collection procedures. e. Define possible donor reactions and solutions. f. Describe donor unit component preparation and processing. g. Describe the various types of anticoagulants/preservatives used in

blood donation and the expiration dates associated with each. h. List the various components that can be made from a unit of blood:

(1) Red blood cells (Irradiated, Whole Blood) (2) Leukocyte poor RBCs (3) Washed RBCs (4) Frozen, deglycerolized RBCs (5) Platelet concentrates (LP, random, pheresis) (6) Fresh, frozen plasma (7) Cryoprecipitate (8) Granulocyte concentrate

i. Describe method of storage for each component. j. Describe the use of each component. k. State donor record requirements. l. Describe pretransfusion testing of donor units. m. Describe the requirements for a blood unit label. n. List the changes that occur during storage of a red cell product.

o. Describe shipping requirements for the various components. p. Define the terms: hemapheresis, autologous, and directed donation

q. Describe the criteria used for selection for donors. r. Outline the procedures for donor/patient care during the collection

and processing of pheresis and autologous units. s. Identify reasons for therapeutic phlebotomy t. At the conclusion of this lecture series, the learner will have achieved


2. Learning Activities: a. Classroom lecture/discussion b. Reading assignment: Rudmann Chapters 8, 9, and 10 c. Laboratory exercise


a. Donor unit collection set b. Donor questionnaire

4. Audio-Visual Aids: None 5. Lesson Outline:

a. List donor requirements b. Identify anticoagulants in blood donation c. Identify components made from a unit of blood

d. Describe the storage of components LECTURE EXAM #3

G. Lesson Seven: PRETRANSFUSION TESTING: Compatibility Testing and the

Antibody Screen

1. Learning Outcomes: Upon successful completion of this lesson, the student will be able to: a. Explain use of antibody screen. b. Recognize common problems encountered with IAT and how to

resolve them. c. Perform and interpret antibody screen testing. d. Define unexpected antibody and clinically significant antibody. e. Describe purpose of an auto control. f. Perform and interpret specific antigen typing using IAT. g. Describe collection of patient and donor samples for testing. h. Outline the procedure for testing donor and patient samples. i. Select appropriate donor units in routine transfusion, in

emergencies, and special circumstances. j. Compare the different crossmatch procedures.

k. Resolve crossmatch incompatibilities. l. List phases and temperatures used in crossmatching procedures. m. Perform crossmatch testing and interpret compatibility results. n. Describe methods used in the administration of blood components

using devices and blood filters.. o. At the conclusion of this lecture series, the learner will have achieved


2. Learning Activities: a. Classroom lecture/discussion b. Reading assignment: Rudmann Chapter 11 c. Laboratory exercise d. Demonstration

3. Equipment and Materials: a. Test tubes and racks b. BB reagent cells and sera c. Saline d. Serofuge e. Heating blocks


a. VHS tape: Antibody Detection b. Computer program: Antiglobulin Test

c. VHS tape: New Directions in Blood Transfusions

5. Lesson Outline: a. Describe antiglobulin testing b. Perform antibody screen testing c. Perform IAT testing d. Describe collection of donor samples e. Select appropriate donor units f. Perform crossmatch testing

g. Resolve crossmatch incompatibilities

H. Lesson Eight: Antibody Identification and ABO Discrepancies

1. Learning Outcomes: Upon successful completion of this lesson, the student will be able to: a. Define the following terms: adsorption, antigram, dosage, eluate,

neutralization, unexpected or alloantibody. b. Describe the specimen, purpose, and limitations of antibody

identification. c. List and discuss the characteristics of reagents used in antibody

identification. d. Outline the procedures used for antibody identification.

e. Interpret the results of antibody panel studies and suggest rule-out and confirmation procedures.

f. Read an antigram. g. Perform antibody panel studies and interpret results. h. Describe components appropriate for transfusion when

alloantibodies or ABO discrepancies are present. i. Perform enzyme treatment of reagent RBCs and perform testing. j. Recognize abnormal results of ABO typing & resolve commonly

occurring discrepancies such as clerical, subgroups, recently transfused patient, weak/missing or unexpected antigens or antibodies.

k. Resolve case studies given patient history and test results with an ABO discrepancy

l. At the conclusion of this lecture series, the learner will have achieved the following: Achievement will be met when a minimum score of 70 percent is earned on the written examination covering the material.

2. Learning Activities: a. Classroom lecture/discussion b. Reading assignment: Rudmann Chapter 12 and 13 c. Laboratory exercise d. Demonstration


a. Test tubes and racks b. BB reagent cells and sera c. Saline d. Serofuge e. Heating blocks f. Ficin, panel cells


a. VHS tape: Identification-Solving Antibody Problems

5. Lesson Outline: a. Describe antibody testing b. Interpret antibody testing c. Perform antibody panel studies d. Perform enzyme treatment and testing

I. Lesson Nine: Transfusion Practice and Component Therapy

1. Learning Outcomes: Upon successful completion of this lesson, the student will be able to: a. List the indications and contraindications for blood component

therapies and the goals of transfusion. b. Outline the composition of the blood components: RBC

components, platelets, FFP, and cryo. c. Describe the purpose and method of gamma irradiation. d. Describe component therapy in patient with complications such as

DIC, liver disease, and hemophilia. e. At the conclusion of this lecture series, the learner will have achieved


2. Learning Activities:

a. Classroom lecture/discussion b. Reading assignment: Rudmann Chapter 14 c. Laboratory exercise

3. Equipment and Materials


5. Lesson Outline:

a. Describe component therapy b. Describe massive transfusion J. Lesson Ten: Transfusion Reactions


student will be able to: a. Define transfusion reaction. b. Explain the risks associated with transfusion. c. Explain the difference between immediate and delayed hemolytic

transfusion reactions. d. Explain the criteria used to evaluate whether or not a transfusion

reaction has occurred. e. List the steps to be followed when a transfusion reaction is

suspected. f. At the conclusion of this lecture series, the learner will have achieved


2. Learning Activities: a. Classroom lecture/discussion b. Reading assignment: Rudmann Chapter 15 c. Laboratory exercise d. Demonstration

3. Equipment and Materials


5. Lesson Outline: a. Describe transfusion reaction

b. List criteria used to evaluate a transfusion reaction LECTURE EXAM #4

K. Lesson Eleven: Hemolytic Disease of the Newborn/Rh Immune Globulin

1. Learning Outcomes: Upon successful completion of this lesson, the student will be able to: a. Describe the basic process of HDN and the factors required for its

development. b. List three types of HDN based on antibody specificity. c. Define hydrops fetalis, kernicterus, and icterus. d. Explain the various tests and procedures employed to diagnose,

monitor and treat HDN. e. Describe the utilization of the antibody titer in the OB population.

f. Given mother and baby information, choose appropriate red cells for transfusion.

g. Describe how Rh Immune Globulin works. h. Describe the procedures used to screen for fetal bleeds and

calculate the number of vials of RhIG is needed. i. List the various blood group antibodies that can cause HDN. j. Perform cord blood testing. k. Perform fetal bleed screening test. l. At the conclusion of this lecture series, the learner will have achieved



a. Classroom lecture/discussion b. Reading assignment: Rudmann Chapter 16 c. Laboratory exercise d. Demonstration


a. Test tubes and racks b. BB reagent cells and sera c. Fetal hemoglobin test kit d. Saline e. Serofuge

f. Heating blocks


5. Lesson Outline:

a. Describe HDN b. Describe Rh immune globulin c. Perform cord blood testing d. Perform fetal bleed screening test

L. Lesson Twelve: Transfusion of Select Patient Populations

1. Learning Outcomes: Upon successful completion of this lesson, the student will be able to: a. Define massive transfusion and describe complications of this

procedure. b. Describe the purpose of apheresis and therapeutic phlebotomy. c. Describe transfusion therapy in the burn patient.d. Describe transfusion therapy for the patient with liver disease or

transplant. e. Describe transfusion practice for the neonate. f. Define exchange transfusion and ECMO. g. At the conclusion of this lecture series, the learner will have achieved



a. Classroom lecture/discussion b. Reading assignment: Rudmann Chapter 17 c. Laboratory exercise d. Demonstration


a. Test tubes and racks b. BB reagent cells and sera c. Heating blocks d. Saline e. Serofuge


5. Lesson Outline:

a. Describe massive transfusion b. Describe the purpose of apheresis and therapeutic phlebotomy c. Describe transfusion of the liver patient d. Describe transfusion of the neonatal patient.

M. Lesson Thirteen: Direct Antiglobulin Test/Autoimmune Hemolytic Anemia


student will be able to: a. Describe the possible causes of a positive DAT.

b. Outline the procedure for evaluating a positive DAT result. c. Define immune hemolysis. d. Classify different manifestations of immune hemolysis according

to the serological findings and the antibody specificities. e. Describe various mechanisms of drug-induced RBC sensitization. f. Describe causes of and serological work up for AIHA. g. Define the principles of elution procedures. h. Perform DAT testing and interpret results. i. At the conclusion of this lecture series, the learner will have achieved


material


3. Equipment and Materials: a. Test tubes and racks b. BB reagent cells and sera c. Saline d. Serofuge e. Heating blocks

4. Audio-Visual Aids

5. Lesson Outline:

a. Describe a positive DAT b. Describe elution procedures c. Perform DAT testing d. Describe the 4 types of autoimmune hemolytic anemias

N. Lesson Fourteen: Record Keeping Procedures in Transfusion Service

1. Learning Outcomes: Upon successful completion of this lesson, the student will be able to: a. Define patient confidentiality and the application of HIPAA

guidelines. b. Describe record retention requirements in the transfusion service.

c. Describe the purpose and maintenance of procedure manuals. d. Describe the “Deviation from SOP” documentation. e. Describe the implementation of a computer system into a

transfusion service and the required validation. f. At the conclusion of this lecture series, the learner will have achieved


material


3. Equipment and Materials: a. Test tubes and racks b. BB reagent cells and sera c. Saline d. Serofuge e. Heating blocks f. Patient cards/records

4. Audio-Visual Aids - None

5. Lesson Outline:

a. Describe records retention in a blood bank b. Describe proper documentation procedures c. Describe transfusion service computer system requirements

LECTURE EXAM #5 LAB EXAM 3 COMPREHENSIVE FINAL EXAMINATION TO BE GIVEN DURING FINAL WEEK SEE SEMESTER SCHEDULE FOR TIME AND DATE

LABORATORY OBJECTIVES MLAB 2431

Lab Lesson One: Professionalism, Laboratory Safety, and Introduction to Immunology

Upon successful completion of this lesson, the student will be able to: 1. Identify safety features in student laboratory. 2. Exhibit sense of professionalism by:

a. Performing analysis with care, adhering strictly to written procedures b. Demonstrating flexibility by accepting and implementing approved

changes to procedures c. Attending scheduled lab sessions regularly and punctually d. Completing assigned tasks with minimal guidance e. Maintaining confidentiality of patient results f. Admitting mistakes and taking steps to correct them g. Repeating procedures when test results are in doubt h. Responding appropriately to authority

i. Complying with stated dress code for laboratory exercises 3. Demonstrate correct specimen handling. 4. Perform clerical error correction procedure 5. Demonstrate correct patient identification, specimen labeling and sample

processing 6. Indicate proper reagent handling and storage 7. Recognize contaminated/unsatisfactory reagents 8. Perform Quality Assurance on Laboratory storage units

Lab Lesson Two: Immunology Testing A. Upon successful completion of this lesson, the student will be able to:

1. Differentiate immunology agglutination tests and techniques. 2. Perform and interpret RPR testing. 3. Perform and interpret RF testing. 4. Recognize VDRL test results.

B. Upon successful completion of this lesson, the student will be able to:

1. Differentiate immunology precipitation tests and techniques. 2. Perform and interpret Monospot testing. 3. Perform and interpret precipitation testing. 4. Recognize RID/Ouchterlony test results.

C. Upon successful completion of this lesson, the student will be able to: 1. Differentiate the electrophoresis, immunoassay, and other misc. immunology tests

and techniques. 2. Perform and interpret CRP testing. 3. Perform and interpret ASO testing. 4. Recognize Strepzyme test results.

Lab Lesson Three: Blood Bank Reagents, Equipment, and Quality Assurance; Upon successful completion of this lesson, the student will be able to:

1. Demonstrate proper cell washing techniques. 2. Apply appropriate incubation times and temperatures. 3. Describe proper specimen handling. 4. Perform phlebotomy. 5. Prepare appropriate strength cell suspensions. 5. Describe functions and quality assurance of laboratory equipment: serofuge,

microscope, cell washers, incubators, refrigerators, thermometers Lab Lesson Four: ABO Blood Group Testing

Upon successful completion of this lesson, the student will be able to: 1. Demonstrate basic blood banking techniques in:

a. Preparing proper RBC suspensions b. Reading agglutination using viewer

c. Centrifuging test specimens d. Resuspending cell buttons

2. Perform, record and interpret ABO forward and reverse testing 3. Recognize ABO testing reagents

Lab Lesson Five: Rh Blood Group Testing

Upon successful completion of this lesson, the student will be able to: 1. Perform, record and interpret Rh testing 2. Perform weak D testing 3. Recognize Rh and IAT testing reagents

Lab Lesson Six: Antibody Screen Testing

Upon successful completion of this lesson, the student will be able to: 1. Demonstrate proper cell washing techniques. 2. Apply appropriate incubation times and temperatures. 3. Perform IAT using screening cells. 4. Record and interpret antibody screen results. 5. Describe proper specimen handling.

Lab Lesson Seven: Type & Screen Testing

Upon successful completion of this lesson, the student will be able to: 1. Demonstrate proper cell washing techniques. 2. Apply appropriate incubation times and temperatures. 3. Perform IAT using screening cells. 4. Record and interpret antibody screen results. 5. Describe proper specimen handling. 6. Perform Autologous Control testing. 7. Perform phlebotomy to obtain appropriate T&S specimen.

Lab Lesson Eight: Special Blood Bank Reagents/techniques;

Antigen Type Testing/Automation in BB/IAT vs. DAT

Upon successful completion of this lesson, the student will be able to: 1. Demonstrate proper cell washing techniques. 2. Apply appropriate incubation times and temperatures. 3. Describe proper specimen handling. 4. Perform antigen testing of RBCs. 5. Differentiate IAT from DAT testing. 6. Perform phlebotomy to obtain appropriate T&S specimen. 7. Perform patient antigen testing using rare antiseras, QC rare antiseras, and

interpret all results. 1. Recognize application of automation in the Blood Bank. 9. Describe content and uses for following types of reagents: AHG (mono vs. poly

specific), potentiators (albumin, LISS, PEG), reagent red cells (A1, A2, B, screening cells, panel cells, check cells), Fetal Bleed Screens, enzymes, adult Ai@ cells, W.A.R.M., RESt, chloriquine

10. Define following terms: lectin, avidity, titer, adsorption vs. absorption 11. Correlate use of special blood banking procedures with routine test results: 4 0 C

and room temperature incubations, Mini-cold panel, prewarming technique Lab Lesson Eight: Cordblood /DAT Testing

Upon successful completion of this lesson, the student will be able to: 1. Describe proper cord blood specimen and handling. 2. Recognize problems these specimens present. 3. Perform cord blood ABO testing. 4. Perform DAT testing and evaluate these results in relation to HDN. 5. Perform and interpret fetal bleed screen testing and quality control.

Lab Lesson Nine: Crossmatch Testing

Upon successful completion of this lesson, the student will be able to: 1. Perform, record, and interpret crossmatch testing. 2. Describe and demonstrate proper specimen and handling. 3. Describe and demonstrate proper donor unit segment handling and storage. 4. Determine reasons for immediate spin and IAT crossmatching. 5. Identify problems related to the crossmatch test.

Lab Lesson Ten: Antibody Panel Testing

Upon successful completion of this lesson, the student will be able to: 1. Test for and identify alloantibodies in patient serums. 2. Interpret antibody panel studies. 3. Determine if further testing is indicated. 4. Perform enzyme treated panel testing. 5. Perform, record, and interpret auto control testing.

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