CASE ANALYSIS. Write your answer in a one whole yellow sheet.

A. Casualties from a multiple vehicular accident were received at the Holy Name University Medical Center
Emergency room. One of the casualty was a 4th yr HNU Medical Technology student. The doctor requested for
5 units of blood to be crossmatched for transfusion but wanted two units to be started immediately. The
phlebotomist collected a sample but time was insufficient to perform an ABO and RH type before releasing the
blood units.

1. What ABO and Rh type blood unit should be given to the patient that needs to be transfused
immediately?
2. As soon as the sample is received in the blood bank and can be used for testing, what test should be
performed on this sample?
3. After the two emergency units have been released, will any tests need to be performed with the two
units?
4. How long and at what storage temperature should the specimen be kept following transfusion?
5. If additional blood units are requested for transfusion after the five units, should a new sample be
collected or the sample collected previously (before transfusion) maybe used?

B. You are working in a component laboratory of a City Blood Bank. A town hospital calls and asks for a supply
of a cryoprecipitate and fresh frozen plasma for two critically ill patients. The patients were both group AB. The
blood station-in-charge of that hospital asks you if the AB units of whole blood collected the previous day during
a blood letting activity of the hospital can be used for both cryoprecipitate and fresh frozen plasma.
1. Provide a detailed answer to the blood station in-charge’s inquiry.
2. Is there an alternate ABO group that may provide plasma products to these patients?

C. A leukemic patient has been admitted to the local hospital with fatigue, localized infection, nose bleeding
and petechiae all over the body and has been unresponsive to antibiotics. The haematologist orders a complete
blood count (CBC) and coagulation testing. The results reflected decreased values for the red blood cell count,
white blood cell count and platelet count. The coagulation tests reflect normal levels of coagulation factors.
This patient has been previously transfused. When the records are checked, fever and chills were noted with
previous transfusions. The director of the blood bank had reviewed these records and indicated that the cause
was probably sensitivity to white blood cells.
1. What components will the patient be most likely transfused with?
2. What consideration needs to be given to the sensitivity to the white cells? Does this information alter
the type of red cell component that will be chosen?
3. Compute for the platelet count increment given the following data:
Platelet count – pretransfusion – 3,500/ul
Post-transfusion – 32,000/ul
Body surface area – 1.6m2
No. Of platelet concentrate units transfused – 5 units
4. Is there an adequate platelet count increment?