Measures of Central Tendency: Mean, Median and Mode
Investigation in mismatch blood transfusion.pptx
1. Lab Investigation in Transfusion
reaction and mismatch blood
transfusion
Dr sandeep singh
2. SLO
At the end of session students must be able to:
Define transfusion reaction
Describe initial measures after transfusion reaction
occurs
Preliminary tests for investigation
Other additional tests
3. NEED FOR BLOOD transfusion
Blood transfusion is needed:
when if the person is too much of blood loss, such as
the following :Injury or major surgery
An illness that causes bleeding such as a Bleeding ulcer,
piles, hemetemesis
An illness that destroys blood cells, such as Haemolytic
Anemia or Thrombocytopenia.
If there is an illness in which bone marrow doesn't make
enough blood, such as Aplastic anemia, you may needed
transfusion.
4. Transfusion reaction
Reaction of the body to a transfusion of blood that is
not compatible with its own blood.
An adverse reaction can range from fever and hives, to
renal failure, shock and death
5.
6. Initial measures
Stop the transfusion and disconnect the entire
infusion set from the needle/catheter.
Using a new infusion set, keep the IV line open with a
drip of normal saline.
Check the
label on blood bag,
cross matching report,
and identify the patient to confirm that the patient
received the correct unit of blood or component.
7. Initial measures
The patient's physician should be informed
immediately for evaluation of the patient and to
determine appropriate clinical care.
Notify the blood bank and fill the form of transfusion
reaction report.
8.
9. Initial measures
Return all transfused packs to Blood Bank full or
empty
Return giving set and attached solutions.
Send post transfusion blood samples(opposite arm)-
10 ml in plain and 2 ml in EDTA
First voided urine should be sent for the laboratory for
the analysis of free hemoglobin.
Return transfusion sheet with full details of suspected
reaction and transfusion reaction report.
10. Sample criteria
Verify the patient's identity using at least two unique
identifiers.
Date and time of sample collection.
Ensure all section in the form are completed in a
legible and detailed manner.
Completed all the information in the 'specimen
collection' information.
Ensure both the nursing and facility of blood bank
clerical checks have been completed and this
documented on the form. This will prevent delays in
testing.
11. Sample rejection
Specimen receives unlabeled/improperly labeled or
overloaded with more than one name.
Key identifiers information is missing, incorrect or
discrepant on the sample and/or requisition.
Specimen not received in the laboratory within 8
hours of collection.
Unacceptable tube received.
Specimens which are haemolysed.
Insufficient of sample.
12. After initial measures, there are three basic
preliminary test are done. They are:
Clerical check
Visual check
Serology check
13. Clerical error
Check identity of patient, label on donor blood bag
and all relevant paper to ensure that there was no
clerical error.
Most common errors:
Misidentification of patient
Mixup of samples in the lab
14. Visual check
Compare the color of plasma of patient’s pre and post-
transfusion blood sample.
Pink red discoloration of Post transfusion sample- free
hemoglobin d/t hemolysis
Yellow or brown discoloration in patient's sample drawn
4-10 hrs after the transfusion – presence of bilirubin
15.
16. Visual check
Check the color of transfused bag:
Purple colored and presence of clot in blood bag but no
change in color of blood in tubing - Bacterial
contamination
Change in color both in tubing and bag – hemolysed
blood
Check the color of post voided urine:
Redish color – acute hemolysis
17. Serology check
Repeat ABO , Rh (D) testing in the
patient’s pre-and post-transfusion blood samples
blood from bag and segment of tubing ( attached to the
bag)
Perform DAT/DCT on patient’s post transfusion
sample
DCT Negative – No incompatibility
DCT positive – do test on pre-transfusion sample
If negative indicates incompatibility
18. Repeat the cross match with pre and post transfusion sample of the patient
against the sample of blood bag by a saline , albumin and IAT techniques.
Antibody screening in patients’s pre-and post transfusion samples and in
the blood from the bag or segment of the tube