8-60
c. Prepare a 2 to 5% cell suspension from the patient’s blood.
d. Obtain two test tubes, properly label the tubes, and place them in the rack.
(1) Label tube #1, “D” with the patient’s ID number.
(2) Label tube #2, “DC” with the patient’s ID number.
- Prepare the sample for Rh typing.
a. Add 1 drop of “Anti-D” and 1 drop of the patient’s cell suspension to the tube marked “D”.
b. Add 1 drop of Rh control (22% bovine albumin) and 1 drop of the patient’s cell suspension
to the tube marked “DC”. - Perform the Rh (D) typing test.
a. Mix the test tubes by gentle shaking.
b. Centrifuge the test tubes for 15 seconds.
c. Examine each test tube for hemolysis.
d. Examine each test tube for agglutination.
(1) Write “+” on the worksheet for agglutination.
(2) Write “0” on the worksheet for no agglutination. - Interpret the results of the test and determine the Rh type.
NOTE: Grade the degree of agglutination: +/-, 1+, 2+, 3+, or 4+; and annotate hemolysis. If the patient
specimen is <2+ AND the anti-D reagent is polyclonal or chemically modified, OR the control tube has
agglutination, proceed with the test for Rh variant (weak D). - Perform the test for the Rh variant (weak D antigen) if no agglutination is seen in BOTH the Anti-D
and control tube.
NOTE: The terms Rh positive and Rh negative refer to the presence or absence of the red cell antigen
“D”. - Record the results in the logbook and on the laboratory request form.
Lab Procedure: Crossmatching
18D Skills and Training ManualWhen: To determine the compatibility or incompatibility of donor blood units with a recipient and evaluate
the incompatibilities.
What You Need: Test tubes, gloves, an indelible marker, a test tube rack, 5 1/4-inch pipettes, gauze,
saline, a rubber bulb, reagents, a work sheet, a centrifuge (calibrated to 1000 RCF @ 3175 rpm), a logbook, a
completed SF 518 (Medical Record--Blood or Blood Component Transfusion), and a 37° Celsius incubator.
What To Do:
- Verify the need to perform a crossmatch procedure.
a. Check that the transfusion request (SF 518) is properly filled out.
b. Verify the number of units needed for the transfusion.
NOTE: There must be one SF 518 for each unit requested.
c. Check that the name and ID number on the blood tubes match the request form.
d. Check to ensure that the phlebotomist’s initials are on the tube with appropriate date and time. - Determine the recipient’s ABO group.
- Determine the recipient’s Rh type.
- Select the donor blood to perform the testing.
a. Obtain the donor units that are the same blood group and type as that of the recipient.
b. Select the order of preference of donor blood, if the group and type for the recipient are not
available.
(1) If recipient is Group O, give only Group O blood.
(2) If recipient is Group A, give Group A blood first and then Group O packed cells.
(3) If recipient is Group B, give Group B blood first and then Group O packed cells.
(4) If recipient is Group AB, give Group AB blood first, and then Group A packed cells, or Group B
packed cells, or Group O packed cells as a last resort, in that order.