group 6 - immunohematology _blood banking

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PHILIPPINE ASSOCIATION OF SCHOOLS OF MEDICAL TECHNOLOGY AND PUBLIC HEALTH Prototype Course Syllabus

Course 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

Placement: Fourth Year, 1

st 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:

1. AABB Committee. Standards of Blood Banks and Transfusion Services 24th ed. USA: American Association of Blood Banks, 2006.

2. AABB Committee. Standards of Immunohematology Reference Laboratories 5th ed. USA: American Association of Blood Banks, 2007.

3. Blaney K.D. and P.R. Howard. Concepts of Immunohematology 2nd

ed. USA: Mosby, 2008. 4. Brecher, Mark. Technical Manual of the American Association of Blood Banks 15

th 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. 6. Harmening, Denise. Modern Blood Banking and Transfusion Practices 5

th ed. Thailand: Book Promotion & Service Co., Ltd., 2005.

7. Hilyer, Christopher et. al. Blood Banking and Transfusion Medicine: Basic Principles and Practice 2nd

ed. USA: Churchill Livingstone, 2006.

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8. Hilyer, Christopher et. al. Blood Banking and Transfusion Medicine. Singapore: Elsevier PTE LTD, 2003. 9. Klein H.G. and D.J. Anstee. Mollison’s Blood Transfusion in Clinical Medicine 11

th ed. USA: Wiley-Blackwell, 2005.

10. Marques, Marisa. Quick Guide to Transfusion Medicine. USA: AACC Press, 2007. 11. McClatchey, Kenneth. Clinical Laboratory Medicine 2

nd ed. USA: Lippincott Williams and Wilkins, 2002.

12. McCullough J. Transfusion Medicine 2nd

ed. USA: Churchill Livingstone, 2004. 13. Mcpherson Richard A. and Matthew R. Pincus. Henry’s Clinical Diagnosis and Management by Laboratory Methods 21

st ed. Philadelphia: Elsevier Inc., 2007.

14. Murphy M.F., D. Weatherall and Pamphilon D.H. Practical Transfusion Medicine 2nd

ed. USA: Wiley-Blackwell, 2005. 15. Reid M.E. and C. Lomas-Francis. The Blood Group Antigens FactsBook 2

nd ed. USA: Academic Press, 2003.

16. Rudmann, Sally. Textbook of Blood Banking and Transfusion. USA: Elsevier, 2005. 17. Sacher, Ronald and Richard McPherson. Widmann’s Clinical Interpretation of Laboratory Tests 11

th 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

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Teaching Strategies Learning Objectives / Intermediate Competencies

Content

T.A.

Lecture Laboratory

Skills Values Evaluation/Assessment

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

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

2 hrs 3 hrs

Film Showing Integrated Method Lecture/ PowerPoint Presentation

- Study of equipment used in a blood bank facility - Lab seatwork on genetics of blood group systems

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.

Unit test Performance Evaluation Checklist Quizzes Periodical Examinations Class Participation

At the end of this unit, the student is able to: 1. Describe the

characteristics/functions/structure/significance 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

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

2 hrs 3 hrs

Lecture/ Multimedia Presentation Discussion Case study

- Lab seatwork on antigen-antibody reactions

Technological Skills (Uses technological equipment accurately, properly and in timely manner

Honesty, Compassion Accuracy

Unit test Practical Examination Class Participation Quizzes

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

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

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3. Differentiate the different types of antiglobulin reagents

4. Discuss the significance of antiglobulin test

5. Explain the errors in antiglobulin tests and their resolutions

4.1. Direct (DAT) 4.2. Indirect (IAT)

5. Application of antiglobulin tests 6. Errors in antiglobulin tests Laboratory: 1. The Antiglobulin Test

1.1. Direct Antiglobulin Tests 1.2. Indirect Antiglobulin Test

2. Laboratory Safety 3. Laboratory Waste Management

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 immunodominant sugars

5. Describe and illustrate the formation of H, A and B red cell antigens and soluble substances

6. Explain the basis of the methods used for the determination of the 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

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 Laboratory: 1. Slide or Direct Method of ABO Typing 2. Tube Method (Forward) Method of ABO Typing 3. Reverse ABO Typing 4. Determination of Secretor Properties 5. Laboratory Safety 6. Laboratory Waste Management

6 hrs 9 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/Co-workers)

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. Discuss the principles of the Rh-Hr

V. The Rh Blood Group System Lecture: 1. Discovery

5 hrs

Class Discussion/ Analysis of

Actual Laboratory Work

Technical Skills Motor/Mobility

Prudence Honesty Honesty

Unit test Performance Practical exam

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system 2. Explain the nomenclature of the Rh-

Hr System 3. Discuss the

discovery/characteristics/inheritance of the Rh-Hr System

4. Illustrate the biochemical structure of Rh

5. Compare and contrast the genetic pathways for the inheritance of Rh antigens and the discrepancies resulting to problems in the said pathway

6. Discuss the significance of the weak D variants and other miscellaneous Rh antigens

7. Differentiate the Rh antibodies 8. Describe the techniques in Rh

grouping 9. Discuss the discrepancies related to

Rh-Hr blood grouping and their resolutions

2. Nomenclature 1.1 Weiner 1.2 Fisher-Race 1.3 Rosenfield 1.4 ISBT

3. Characteristics 4. Inheritance 5. Rh antibodies 6. Rh variants 7. Techniques in Rh Grouping

7.1 Slide Method 7.2 Tube Method 7.3 Emerging Technologies 7.4 Errors in Rh Grouping

8. Discrepancies and resolutions in Rh typing

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

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

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

VI. Other Blood Group Systems and Blood Group Collections Lecture: 1. Historical Perspectives/

Significance/Characteristics/Reactions/Antigens/Phenotypes

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

3 hrs

Integrated Method, Lecture/ Discussion, Reporting/Report-Back Session

“Multi-skilling” facilitate acquisition of knowledge from others

Prudence Integrity Respect Cooperation Commitment Compassion Love of fellowmen (Donor/Patient/Co-workers) Prudence Honesty


At the end of this unit, the student is able to: 1. Identify diseases associated with

transfusion practices 2. Discuss the diseases associated with

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

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blood banking practice 3. 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

1.2. Causes 1.3. Laboratory Investigation 1.4. Prevention and Treatment

2. Autoimmune Hemolytic Anemia 3. Others Laboratory: 1. Laboratory Investigation of HDN

3 hrs

Motor/Mobility skills

Periodical Examinations Class Participation

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

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

4 hrs 6 hrs

Case Study on selection of crossmatching method. Case Analysis

Actual Laboratory Work - Major Crossmatch - Minor Crossmatch - Antibody Screening - Antibody Identification

Technical Skills Motor/Mobility skills

Honesty Compassion Responsibility Accuracy


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

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

2 hrs

Lecture/ Discussion Reinforcement Activity on Informed Consent Proxy Consent Role Play

Alternative Classroom Learning Experience (ACLE) Immersion in Blood Letting/Donation


Prudence Integrity Respect


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phlebotomy, preservation, storage, issuance and transport of blood

6. 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

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


awareness, appreciation, logical thinking, enthusiasm, perseverance


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

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 Laboratory 1. Investigation of Transfusion Reactions

2 hrs 3 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


At the end of this unit, the student is able to: 1. State the principles and laws

governing blood grouping 2. Apply the laws of blood grouping to

ABO, Rh and MNS Systems 3. Resolve the medico-legal cases

involving disputed parentage using blood grouping systems

XII. Medico-Legal Application of Blood Groups Lecture: 1 Principles and Laws of Inheritance of ABO, Rh and

MNS Systems 2 Application of Principles and Laws

1.1 Parentage Testing 1.2 Resolution of Medico-legal Cases using

blood group systems

Laboratory: 1. Laboratory Investigation of Disputed Parentage

using Blood Groups

1 hr 3 hrs

Case Study: Analysis of cases on Paternity Testing Lecture/ Discussion Role play

Parentage Testing Workup

Time Management skills Technical skills Motor/Mobility skills Communication Skills

awareness, enthusiasm, logical thinking


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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…

group 6 - immunohematology _blood banking

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