Establish methods to identify each key step in the blood compatibility test and other test processes, and adopt control methods to ensure that the test results meet the requirements

Patient specimens are identified using barcode labels or traditional handwritten labels

The remaining specimens after the test should be stored for 7 days as required

Titer standard: The agglutination titer of anti-A against type A1, A2, and A2B red blood cells is not less than 128, 32, and 16 respectively; the agglutination titer of anti-B against type B red blood cells is not less than 128

Specificity: Anti-A should agglutinate with type A1 and A2B red blood cells, but not with type B and O red blood cells; anti-B should agglutinate with type B red blood cells, but not with type A1 and type O red blood cells; there is no hemolysis or other difficult-to-distinguishment Phenomenon

Affinity: The agglutination of anti-A and A1, A2, and A2B red blood cells should be less than 15 seconds, 30 seconds, and 45 seconds respectively; the agglutination of anti-B and B red blood cells should be less than 15 seconds, and the clot should reach more than 1mm2 within 3 minutes.

Reagents such as anti-D, reagent red blood cells, and microcolumn cards are subject to quality inspection according to the standards provided by the manufacturer.

The doctor accurately fills in the patient information, diagnosis, nature of blood transfusion (blood preparation, emergency or outpatient blood transfusion), past blood transfusion history, pregnancy history, etc. on the blood transfusion application form.

Only blood transfusion applications with complete, accurate and clear information will be accepted

Labels are attached before specimen collection. The labels must contain necessary and unique patient information.

After the collection is completed, the collector should sign the blood transfusion application form

Confirm that all identification information on the blood transfusion application form is consistent with the blood sample test tube label information

If the label information is inconsistent, refuse to accept the specimen and blood transfusion application form, and notify the blood department to re-collect the specimen.

Use the test tube method or microcolumn method, not the slide method

ABO blood type positive and negative typing is required

Reagents

method

The method used in the screening test should be performed under 37°C incubation conditions to ensure the detection of clinically significant unexpected antibodies.

Establish indoor quality control methods and rules for antibody screening laboratories to ensure accurate and reliable test results

Before the experiment, carefully check that the information on the blood transfusion application form is consistent with the information on the test tube label of the blood recipient's specimen.

It can detect two kinds of red blood cell antibodies, IgM and IgG, to confirm whether the ABO blood types are the same or compatible, and whether there are unexpected antibodies against red blood cell antigens IgM or IgG.

Establish indoor quality control methods and rules to ensure reliable test results under controlled conditions

Establish a computer system to carry out automatic comparison procedures to ensure that the relevant information of the second blood transfusion during this hospitalization is compared with the last blood transfusion (ABO blood type, RhD blood type and unexpected antibody detection)

Can effectively detect wrong specimens taken by clinical departments

Before whole blood, various red blood cell components, machine-collected or manually collected platelets are sent out, ABO blood type identification should be performed; if the label is RhD negative, the RhD blood type should be reviewed. Only when the test results are consistent with the blood bag label can a cross-match test be performed.

Pay attention to the control of important links that affect the test results, such as the ratio of serum and red blood cells, concentration of red blood cell suspension, reagent selection and use, test temperature and incubation time, centrifugation, accurate interpretation and interpretation of agglutination and/or hemolysis reactions, etc.

The cross-matching test requires one person to complete the entire test process. The ABO blood type of the recipient and the donor must be verified correctly before the cross-matching test can be performed.

Patients who have received blood transfusion or blood products containing red blood cells 3 months ago, pregnant women who are more than 3 months pregnant, and those whose medical history is unclear or unable to provide relevant medical history should use samples collected within 3 days before applying for blood transfusion for cross-matching tests (" "Clinical Blood Transfusion Technical Specifications" requirements)

When performing a cross-matching test using the test tube method, the direct centrifugation test with saline medium must not be ignored.

If the antibody screening is positive, antibody identification should be carried out to clarify which antigen the antibody targets, and blood that lacks the corresponding antigen should be selected for transfusion to the patient.

The surface of the blood bag must be marked when blood is issued (containing important personal and unique information of the blood recipient to facilitate verification by nurses before transfusion)

Type O patients

Type A patients

Type B patients

Type AB patients

Type O patients

Type A patients

Type B patients

Type AB patients

In principle, RhD-negative women of childbearing age cannot infuse RhD-positive blood components

When transfusing RhD-positive red blood cells, it should be confirmed that the recipient does not have anti-D, and a cross-match test should prove blood compatibility.

RhD-negative patients can be transfused with RhD-positive machine-collected platelets (the machine-collected platelets have less red blood cells remaining and there is no RhD antigen on the surface of the platelets)

Refers to emergency measures to issue and transfuse the same type or compatible blood without completing cross-matching if delayed blood transfusion will endanger the life of the recipient.

Medical institutions should develop procedures to standardize emergency blood use; before initiating emergency blood use procedures, doctors should inform patients or family members and record them in medical records.

People with unknown ABO blood type

If the ABO blood type is known but the cross-match test cannot be completed, the patient can only receive whole blood and red blood cells of the same type or red blood cells with compatible blood types.

Collect the patient's blood samples as early as possible before emergency blood transfusion, conduct a remedial cross-matching test on the issued blood, and notify the clinical department of the test results in a timely manner

If it is found that a certain amount of blood is incompatible with the patient, the department should be notified as soon as possible to stop the transfusion of the blood and take corresponding measures.

ABO blood type identification uses positive and negative typing

It is best to choose test tube method or micro column method

Control anti-A detection ability: use type A quality control reagent red blood cells as positive control, use type B quality control reagent red blood cells as negative control

Control the anti-B detection ability: use type B quality control reagent red blood cells as a positive control, and use type A quality control reagent red blood cells as a negative control

Control anti-D detection ability: use RhD-positive red blood cells as positive control and RhD-negative red blood cells as negative control

indirect antiglobulin technology

polybrene method