Group 6 - Immunohematology _Blood Banking

PHILIPPINE ASSOCIATION OF SCHOOLS OF MEDICAL TECHNOLOGY AND PUBLIC HEALTH Prototype Course SyllabusCourse Title: Immunohematology and Transfusion Medicine (Blood Banking) Course Description: Immunohematology (Blood Banking) deals with the study of immunologic principles applied in blood group specific antigens and antibodies and its application in transfusion medicine. It also deals with mechanisms of blood typing and crossmatching, antihuman globulin testing, detection and identification of antibodies, screening of donors for blood donation, bleeding techniques, preparation of blood components and blood products, their storage and disposal with emphasis on quality systems. Course Credit: 3 units (2 units lecture, 1 unit laboratory) Contact Hours: 2 hours lecture, 3 hours laboratory per week (36 hours lecture and 54 hours laboratory per semester) Prerequisites: Biochemistry, Human Anatomy and Physiology, Medical Technology Laws and Bioethics st Placement: Fourth Year, 1 Semester Terminal Competencies: At the end of this course, the student is able to: 1. explain the principles and procedures in Immunohematology, collection, processing, preservation, storage, distribution of blood, its component and derivatives. 2. accurately perform the techniques of blood grouping and compatibility testing and other methods of Immunohematology. 3. explain the concepts in the operation and organization of the Blood Bank. 4. demonstrate quality assurance in the performance of Immunohematology tests. 5. acquire a deep sense of responsibility and ethical attitudes towards Blood Banking practice References: th 1. AABB Committee. Standards of Blood Banks and Transfusion Services 24 ed. USA: American Association of Blood Banks, 2006. th 2. AABB Committee. Standards of Immunohematology Reference Laboratories 5 ed. USA: American Association of Blood Banks, 2007. nd 3. Blaney K.D. and P.R. Howard. Concepts of Immunohematology 2 ed. USA: Mosby, 2008. th 4. Brecher, Mark. Technical Manual of the American Association of Blood Banks 15 ed. USA: American Association of Blood Banks, 2005. 5. Department of Health (DOH). Manual of Standards for Blood Banks and Blood Centers in the Philippines. Manila: DOH, 1996. th 6. Harmening, Denise. Modern Blood Banking and Transfusion Practices 5 ed. Thailand: Book Promotion & Service Co., Ltd., 2005. nd 7. Hilyer, Christopher et. al. Blood Banking and Transfusion Medicine: Basic Principles and Practice 2 ed. USA: Churchill Livingstone, 2006. PASMETH, Inc. Copyright © 2008 All Rights Reserved. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. Hilyer, Christopher et. al. Blood Banking and Transfusion Medicine. Singapore: Elsevier PTE LTD, 2003. th Klein H.G. and D.J. Anstee. Mollison’s Blood Transfusion in Clinical Medicine 11 ed. USA: Wiley-Blackwell, 2005. Marques, Marisa. Quick Guide to Transfusion Medicine. USA: AACC Press, 2007. nd McClatchey, Kenneth. Clinical Laboratory Medicine 2 ed. USA: Lippincott Williams and Wilkins, 2002. nd McCullough J. Transfusion Medicine 2 ed. USA: Churchill Livingstone, 2004. st Mcpherson Richard A. and Matthew R. Pincus. Henry’s Clinical Diagnosis and Management by Laboratory Methods 21 ed. Philadelphia: Elsevier Inc., 2007. nd Murphy M.F., D. Weatherall and Pamphilon D.H. Practical Transfusion Medicine 2 ed. USA: Wiley-Blackwell, 2005. nd Reid M.E. and C. Lomas-Francis. The Blood Group Antigens FactsBook 2 ed. USA: Academic Press, 2003. Rudmann, Sally. Textbook of Blood Banking and Transfusion. USA: Elsevier, 2005. th Sacher, Ronald and Richard McPherson. Widmann’s Clinical Interpretation of Laboratory Tests 11 ed. Thailand: F.A. Davis, 2000. Electronic References: 1. http://www.aabb.org 2. http://www.bbguy.org 3. http://www.bloodbook.com/banking.html 4. http://www.bloodline.net/transfusion/index 5. http://www-medlib.med.utah.edu/WebPath/TUTORIAL/BLDBANK.html PASMETH, Inc. Copyright © 2008 All Rights Reserved. Learning Objectives / Intermediate Competencies At the end of this unit, the student is able to: 1. Trace the development of Immunohematology and blood transfusion practice as well as future trends in blood banking 2. Correlate the structure of the red cell membrane with the occurrence of blood group antigens and its impact in blood storage 3. Recall the basic concepts of Genetics Content I. Introduction Lecture: 1. History of Immunohematology and Blood Transfusion practice and future trends 2. The Red Cell Membrane 2.1. Structure of the red cell membrane 2.2. Blood group antigens on the red cell membrane 2.3. Other properties of the red cell membrane 3. Basic Principles in Genetics Laboratory: 1. Blood Banking Laboratory Equipment Study 2. Collection of blood and specimen preparation for blood banking tests 3. Genetics of Blood Group Systems 4. Genetic Mating of Blood Groups II. Fundamentals of Immunology Lecture: 1. The antigen 2. The antibodies 3. The Complement system 4. Characteristics of Antigen-Antibody reactions 5. Detection of red cell antigen-antibody reactions Laboratory: 1. Antigen-Antibody Reactions 2. Laboratory Safety 3. Laboratory Waste Management T.A . Teaching Strategies Lecture Film Showing Integrated Method Lecture/ PowerPoint Presentation Laboratory - Study of equipment used in a blood bank facility - Lab seatwork on genetics of blood group systems Skills Values Evaluation/Assessme nt Unit test Performance Evaluation Checklist Quizzes Periodical Examinations Class Participation 2 hrs Technological Skills (Uses technological equipment accurately, properly and in timely manner Obedience -follows established procedures properly -follows protocols as defined in policy and procedure manual. 3 hrs At the end of this unit, the student is able to: 1. Describe the characteristics/functions/structure/si gnificance of 1.1 antigens 1.2 antibodies 1.3 Complement System 2. Characterize the immune response according to antigen-antibody reactions, host factors, suppression and primary and secondary responses 2.1 discuss factors affecting agglutination reactions 3. Compare traditional and nontraditional laboratory techniques for detecting antigen-antibody reactions At the end of this unit, the student is able to: 1. Explain the properties of antihuman globulin 2. Describe the preparation of antiglobulin reagents 2 hrs Lecture/ Multimedia Presentation Discussion Case study - Lab seatwork on antigenantibody reactions 3 hrs Technological Skills (Uses technological equipment accurately, properly and in timely manner Honesty, Compassion Accuracy Unit test Practical Examination Class Participation Quizzes III. The Antihuman Globulin Test Lecture: 1. Principles and properties 2. Preparation of antiglobulin reagent 3. Types of antiglobulin reagents 4. Methods 3 hrs Lecture/ Multimedia Presentation Discussion Case study Actual Laboratory Work - DAT - IAT Analytical and problem solving skills Responsibility Accountability Hard work Commitment Faithfulness Unit test Performance Practical exam Evaluation Checklist Quizzes PASMETH, Inc. Copyright © 2008 All Rights Reserved. 3. 4. 5. Differentiate the different types of antiglobulin reagents Discuss the significance of antiglobulin test Explain the errors in antiglobulin tests and their resolutions 5. 6. 4.1. Direct (DAT) 4.2. Indirect (IAT) Application of antiglobulin tests Errors in antiglobulin tests 6 hrs Periodical Examinations Class Participation At the end of this unit, the student must be able to: 1. Describe the reciprocal relationship between ABO antigens and antibodies for blood types O, A, B and AB 2. Identify the frequencies of the four major blood types in the Filipino populations as compared to other races 3. Predict the ABO phenotypes and genotypes of offspring from various ABO matings 4. Explain the formation of H, A and B antigens on the red cells from precursor substance to Laboratory: immunodominant sugars 1. Slide or Direct Method of ABO Typing 5. Describe and illustrate the formation 2. Tube Method (Forward) Method of ABO Typing of H, A and B red cell antigens and 3. Reverse ABO Typing soluble substances 4. Determination of Secretor Properties 6. Explain the basis of the methods 5. Laboratory Safety used for the determination of the 6. Laboratory Waste Management blood type and secretor status 7. Identify the subgroups of ABO systems 8. Relate the importance of subgroups/variants in blood transfusions 9. Differentiate the methods used in subgrouping/detection of variants 10. Interpret the results from an ABO typing and resolve any discrepancies if present At the end of this unit, the student must V. The Rh Blood Group System be able to: Lecture: 1. Discuss the principles of the Rh-Hr 1. Discovery Laboratory: 1. The Antiglobulin Test 1.1. Direct Antiglobulin Tests 1.2. Indirect Antiglobulin Test 2. Laboratory Safety 3. Laboratory Waste Management IV. The ABO and H Blood Group Systems Lecture: 1. Discovery/Laws/Properties/Characteristics/Inheritan ce 2. ABO Typing Techniques 3.1. Slide (Direct) Method 3.2. Tube (Direct) Method 3.3. Reverse Typing 3.4. Secretor Studies 3.5. Emerging Technologies 3. ABO Subgroups and Variants Description Importance in Blood Transfusion Methods 4. ABO Discrepancies and their resolutions 6 hrs Deductive/ Inductive Method Case Study on ABO discrepancies Report-Back Session Lecture/ Discussion Case Analysis on subgroup like Ax, Bx, Oh and Post Conference Actual Laboratory Work - Forward Typing (Slide Method) - Forward Typing (Tube Method) - Reverse Typing - Secretor Studies Technical Skills Motor/Mobility skills Respect for Life Cooperation Commitment Compassion Love of fellowmen (Donor/Patient/C o-workers) Unit test Performance Practical exam Evaluation Checklist Quizzes Periodical Examinations Class Participation 9 hrs 5 hrs Class Discussion/ Analysis of Actual Laboratory Work Technical Skills Motor/Mobility Prudence Honesty Honesty Unit test Performance Practical exam PASMETH, Inc. Copyright © 2008 All Rights Reserved. 2. 3. 4. 5. 6. 7. 8. 9. system Explain the nomenclature of the RhHr System Discuss the discovery/characteristics/inheritance of the Rh-Hr System Illustrate the biochemical structure of Rh Compare and contrast the genetic pathways for the inheritance of Rh antigens and the discrepancies resulting to problems in the said pathway Discuss the significance of the weak D variants and other miscellaneous Rh antigens Differentiate the Rh antibodies Describe the techniques in Rh grouping Discuss the discrepancies related to Rh-Hr blood grouping and their resolutions 2. 3. 4. 5. 6. 7. 8. Nomenclature 1.1 Weiner 1.2 Fisher-Race 1.3 Rosenfield 1.4 ISBT Characteristics Inheritance Rh antibodies Rh variants Techniques in Rh Grouping 7.1 Slide Method 7.2 Tube Method 7.3 Emerging Technologies 7.4 Errors in Rh Grouping Discrepancies and resolutions in Rh typing 6 hrs experiences and reported cases Report Back Session Case Analysis on Rh Discrepancies - Rh typing (slide method) - Rh typing (tube method) - Test for Weak D skills Compassion Responsibility Evaluation Checklist Quizzes Periodical Examinations Class Participation Laboratory: 1. Slide Method of Rh Typing 2. Tube Method of Rh Typing 3. Test for Weak D 4. Laboratory Safety 5. Laboratory Waste Management VI. Other Blood Group Systems and Blood Group Collections Lecture: 1. Historical Perspectives/ Significance/Characteristics/Reactions/Antigens/Phe notypes 1.1. Kidd 1.2. Duffy 1.3. Kell 1.4. P 1.5. Lutheran 1.6. MNSs 1.7. I/i 1.8. Lewis 1.9. Others Blood Group Systems 1.10. Other Blood Group Collections/High Incidence Antigens At the end of this unit, the student must be able to: 1. Trace the discovery of the other blood group systems and blood group collections 2. Explain the basis of the ISBT nomenclature for the blood group systems and blood group collections 3. Characterize the phenotypes, antigens and antibodies of other blood group systems and blood group collections 4. Discuss the frequencies of the antigens and antibodies of the other blood group systems and blood group collections 5. Explain the importance of the other blood group systems and blood collections to blood transfusions At the end of this unit, the student is able to: 1. Identify diseases associated with transfusion practices 2. Discuss the diseases associated with 3 hrs Integrated Method, Lecture/ Discussion, Reporting/Repo rt-Back Session “Multi-skilling” facilitate acquisition of knowledge from others Prudence Integrity Respect Cooperation Commitment Compassion Love of fellowmen (Donor/Patient/C o-workers) Prudence Honesty Unit test Performance Evaluation Checklist Quizzes Periodical Examinations Class Participation VII. Blood Group Associated Diseases Lecture: 1. Hemolytic Diseases of the Fetus and the Newborn (HDFN) 1.1. Definition 2 hrs Role Play on Laboratory Investigation of transfusion reaction Hemolytic Disease of the Newborn Workup Time Management skills Technical skills patience, responsibility, logical thinking, honesty, awareness Unit test Performance Evaluation Checklist Quizzes PASMETH, Inc. Copyright © 2008 All Rights Reserved. blood banking practice Explain the laboratory investigation of various blood group associated diseases 4. Enumerate measures for the prevention and treatment of blood group associated diseases where applicable At the end of this unit, the student must be able to: 1. Define compatibility testing 2. Discuss the purposes, principles and methods of compatibility testing 3. Differentiate major from minor crossmatch 4. Perform properly the various methods of crossmatching 5. Explain the new methodologies employed in compatibility testing 6. Describe the ways of detecting and identifying antigens and antibodies of the other blood group systems and blood group collections 7. Identify the various factors that affect compatibility tests 8. Explain the procedures to resolve incompatible crossmatches 3. 2. 3. 1.2. Causes 1.3. Laboratory Investigation 1.4. Prevention and Treatment Autoimmune Hemolytic Anemia Others 3 hrs 4 hrs Case Study on selection of crossmatching method. Case Analysis Actual Laboratory Work - Major Crossmatch - Minor Crossmatch - Antibody Screening - Antibody Identification Motor/Mobility skills Periodical Examinations Class Participation Laboratory: 1. Laboratory Investigation of HDN VIII. Compatibility Testing Lecture: 1. Definition of compatibility testing 2. Purposes of Compatibility Testing 3. Types of Crossmatch 3.1. Major Crossmatch 3.2. Minor Crossmatch 4. Principles and Methods 4.1. Broad Spectrum Compatibility Test 4.2. Abbreviated Crossmatch 4.3. Computerized Crossmatch 4.4. Other emerging technologies 5. Antibody Screening and Identification 5.1. Purpose 5.2. Principle 5.3. Procedures/Techniques 6. Factors that Affect Compatibility Tests 7. Resolution of Incompatible Crossmatches 7.1. Use of auto controls 7.2. Utilization of Cell Panels 7.3. Emerging Technologies Laboratory: 1. Antibody Screening and Identification 2. Crossmatching 3. Elution of Antibodies 4. Laboratory Safety 5. Laboratory Waste Management IX. Blood Bank Organization Lecture: 1. Voluntary blood donation 2. Criteria for the selection of blood donors 3. Blood collection / Phlebotomy 4. Blood processing 5. Preservation and storage of blood 6. Issuance and transport of blood 7. Quality Assurance Technical Skills Motor/Mobility skills Honesty Compassion Responsibility Accuracy Unit test Performance Practical exam Evaluation Checklist Quizzes Periodical Examinations Class Participation 6 hrs At the end of this unit, the student is able to: 1. Discuss the legal bases of blood donation in the Philippines 2. Explain the principles of blood donation 3. Discuss the criteria in the selection and deferral of blood donors 4. Enumerate the equipment / materials for blood collection 5. Explain the process of donor 2 hrs Lecture/ Discussion Reinforcement Activity on Informed Consent Proxy Consent Role Play Alternative Classroom Learning Experience (ACLE) Immersion in Blood Letting/Donati on “Multi-skilling” facilitate acquisition of knowledge from others Prudence Integrity Respect Unit test Performance Practical exam Evaluation Checklist Quizzes Periodical Examinations Class Participation PASMETH, Inc. Copyright © 2008 All Rights Reserved. 6. phlebotomy, preservation, storage, issuance and transport of blood Apply the principles of quality assurance in blood banking Laboratory: 1. Blood Donation 2. Laboratory Safety 6 hrs At the end of this unit, the student is able to: 1. Define component therapy 2. Discuss the purpose and methods of blood component therapy 3. Explain blood component preparations 4. Explain blood product preparations 5. Discuss special categories of blood transfusion 6. Discuss the hazards of massive blood transfusion X. Blood Component Preparation and Therapy Lecture: 1. Indications of blood transfusion 2. Methods of blood transfusion 3. Blood component and blood products preparation 4. Apheresis 5. Special categories of blood transfusion Laboratory: 1. Blood Component Preparation 2. Laboratory Safety 3. Laboratory Waste Management XI. Transfusion Reactions Lecture: 1. Classification of transfusion reactions 1.1. Immediate 1.1.1. Immunologic 1.1.2. Nonimmunologic 1.2. Delayed 1.2.1. Immunologic 1.2.2. Nonimmunologic 2. Signs and symptoms of transfusion reactions 3. Investigation of transfusion reactions 4 hrs 6 hrs Integrated Method Reporting/ Discussion Reinforcement Activity: Students to report on “Primitive” Method of Blood Transfusion. Actual blood component preparation ACLE immersion “Multi-skilling” facilitate acquisition of knowledge from others awareness, appreciation, logical thinking, enthusiasm, perseverance Unit test Performance Practical exam Evaluation Checklist Quizzes Periodical Examinations Class Participation At the end of this unit, the student must be able to: 1. Define transfusion reactions 2. Explain the causes of the different transfusion reactions 3. Categorize the different types of transfusion reactions 4. Recognize the signs and symptoms of transfusion reactions 5. Illustrate the scheme of investigation of transfusion reactions 2 hrs Lecture/ Discussion Case studies on Incompatible Blood Transfusion Panel Discussion on Hemolytic (Immune Reaction) Transfusion Reaction Investigation Workup Time Management skills Technical skills Motor/Mobility skills enthusiasm, patience, logical thinking, cooperation Unit test Performance Evaluation Checklist Quizzes Periodical Examinations Class Participation Laboratory 1. Investigation of Transfusion Reactions At the end of this unit, the student is able XII. Medico-Legal Application of Blood Groups to: Lecture: 1. State the principles and laws 1 Principles and Laws of Inheritance of ABO, Rh and governing blood grouping MNS Systems 2. Apply the laws of blood grouping to 2 Application of Principles and Laws 1.1 Parentage Testing ABO, Rh and MNS Systems 3. Resolve the medico-legal cases 1.2 Resolution of Medico-legal Cases using involving disputed parentage using blood group systems blood grouping systems Laboratory: 1. Laboratory Investigation of Disputed Parentage using Blood Groups 3 hrs 1 hr Case Study: Analysis of cases on Paternity Testing Lecture/ Discussion Role play Parentage Testing Workup Time Management skills Technical skills Motor/Mobility skills Communicati on Skills awareness, enthusiasm, logical thinking Unit test Performance Evaluation Checklist Quizzes Periodical Examinations Class Participation 3 hrs PASMETH, Inc. Copyright © 2008 All Rights Reserved. Technical Working Group for Prototype Course Syllabi Development (2007-2008) Zennie Aceron Petrona Benitez Sergia Cacatian Zenaida Cajucom Edwin Cancino Jacinta Cruz De Carlos Leon Oliver Shane Dumaoal Bernard Ebuen Nini Lim Frederick Llanera Carina Magbojos Gregorio Martin Fe Martinez Josephine Milan Ferdinand Mortel Magdalena Natividad Rodolfo Rabor Ma. Teresa Rodriguez Celia Roslin Anacleta Valdez Rowen Yolo and other PASMETH members not cited in this page who in one way or another has contributed greatly to the success of this endeavor… PASMETH, Inc. Copyright © 2008 All Rights Reserved.