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Algorithm for determining blood group using zoliclones. Compilation of a kit and determination of blood group using standard sera Kit for determining blood group

06.10.2023

Indications: the need for blood transfusion, preparation for surgery.

Prepare: standard plate with recesses; a set of glass rods; isotonic sodium chloride solution; a set of hemagglutinating sera of groups 1, 2, 3, 4 of two series; pipettes; blood taken from a vein or finger; watch; trays; gloves; containers for waste material; containers with disinfectant solutions.

Preparation for manipulation:

The nurse is fully prepared to perform the procedure: dressed in a suit (gown), mask, gloves, cap, and replacement shoes.
Check the quality of standard hemagglutinating serums by: color marking, appearance (light, transparent); the safety of the packaging, the presence of a correctly designed label.
Prepare everything necessary to perform the manipulation.

Performing the manipulation:

On a white plate, according to the designation, sequentially apply one drop of serum from groups 1, 2, 3 of two series. Immediately lower each pipette into the same ampoule (vial) from which they were taken;

Using a glass rod, apply a drop of the blood being tested next to the indentations (6 indentations). A drop of blood should be 10 times smaller than a drop of serum;

Mark the time and mix the blood with serum 1 g with a clean, dry glass rod, then with another stick 2 g. etc. in all recesses;

As agglutination occurs, but not earlier than 3 minutes, add one drop of isotonic sodium chloride solution to those drops in which the agglutination reaction has occurred to exclude false agglutination and continue observation for 5 minutes.

Evaluation of results:

a) with a positive reaction, tiny grains visible to the eye appear in the mixture, consisting of stuck together red blood cells. Small grains merge into large grains, and sometimes into flakes, and the whey becomes discolored;

b) with a negative reaction, the liquid remains uniformly colored pink;

c) 4 combinations of positive and negative reactions are possible:

1. If there is no agglutination in any of the cells, then the blood is group I (0).

2. If there is agglutination in the first and third cells, then the blood is group II (A).

3. If agglutination is in the first and second groups, then the blood is group III (B).

4. If agglutination is in the first, second, third cells, then blood is group IV (AB).

To exclude errors, the blood is tested with serum of group 4, where there should be no agglutination.

End of manipulation:

Remove gloves and place them in a disinfectant solution.
Wash your hands and dry with a towel.

Note: Blood group determination is carried out in a room with good lighting at a temperature of 15 - 25 0 C.

Blood group determination is a required parameter for admission and preparation for various types of surgical interventions. A blood test to determine the group is important for a possible situation when there is a need for a transfusion of donor blood to the recipient, which is especially important for the military and employees of similar fields.

Among the methods for determining blood group, there is a standard method, a cross-reaction method, using zoliclones and an erythrotest-group card.

Blood group according to the method of determining group AB0 established based on the agglutination reaction.

Standard

The most popular way determination of blood group and Rh, in which standard sera are used. In its process, antigens of the AB0 system are identified. The sera used in this method consist of antibodies to particles on red blood cells. If the antigen is present, agglutination of red blood cells begins, which leads to test results.

The analysis process occurs through the following manipulations: plasma is mixed into a test tube with a solution of ordinary salt. Next, the resulting solution is pipetted and mixed in another test tube with physiological solution. Next, a tablet is used on which the serums are placed in advance. A sample is dropped near each serum drop, which is subsequently mixed with the diagnosticum.

Recently, a more modern method is often used using the gel technique, in which there is a collaboration of agglutination and the use of a gel medium. For this purpose, special diagnostic cards with microtubes are used, which contain the required gel. It may be neutral or contain antibodies and reagents. Next, the microtubes are subjected to centrifugation, during which agglutinated erythrocytes settle on the surface of the gel column.

The remaining red blood cells fall to the bottom.

After the exposure time has passed (about 5 minutes), the results are analyzed, which can be as follows:

If agglutination does not occur with all standard sera - blood of group I;
If agglutination occurred only with serum O(I) and B(III) - blood of group II;
If agglutination occurred only with O(I) and A(II) sera - blood of group III;
If agglutination occurs with all three sera, the blood is presumably group IV, but there is a high probability of panagglutination. Therefore, the analysis is supplemented with a fourth serum AB0; if after this agglutination does not occur, the blood is classified as group IV.

Cross reaction method

This method of determining blood group uses both standard serums and zoliclones mixed with standard red blood cells. Its execution is virtually identical to the previous technique, but with some amendments.

Ask your question to a clinical laboratory diagnostics doctor

Anna Poniaeva. She graduated from the Nizhny Novgorod Medical Academy (2007-2014) and Residency in Clinical Laboratory Diagnostics (2014-2016).

Indications:

Prepare: a standard plate with indentations; a set of glass rods; isotonic sodium chloride solution; a set of hemagglutinating sera of groups 1,2,3,4 of two series; pipettes; test blood taken from a vein or finger; watch; trays; gloves; containers for waste material; containers with disinfectant solutions.

Preparation for manipulation:

Check the quality of standard hemagglutinating serums by: color marking, appearance (light, transparent); the safety of the packaging, the presence of a correctly designed label.

Performing the manipulation:

Using a glass rod, apply a drop of the blood being tested next to the indentations (6 indentations). A drop of blood should be 10 times smaller than a drop of serum;

note the time and mix the blood with serum 1 g with a clean, dry glass rod, then with another stick 2 g. etc. in all recesses;

as agglutination occurs, but not earlier than 3 minutes, add one drop of isotonic sodium chloride solution to those drops in which the agglutination reaction has occurred to exclude false agglutination and continue observation for 5 minutes.

Evaluation of results:

a) with a positive reaction, tiny grains visible to the eye appear in the mixture, consisting of sticky red blood cells. Small grains merge into large grains, and sometimes into flakes, and the whey becomes discolored;

b) with a negative reaction, the liquid remains uniformly colored pink;

c) 4 combinations of positive and negative reactions are possible:

1. if there is no agglutination in any of the cells, then the blood is group I (0).

2. if there is agglutination in the first and third cells, then blood is group II (A).

3. if agglutination is in the first and second groups, then the blood is group III (B).

4. if agglutination is in the first, second, third cells, then blood is group IV (AB).

To exclude errors, the blood is tested with serum of group 4, where there should be no agglutination.

End of manipulation:

Note: Blood group determination is carried out in a room with good lighting at a temperature of 15 - 25 0C.

/ algorithm 8 determination of Rh factor

Determination of Rh factor with standard anti-Rh serum.

1Introduction: We perform blood typing with standard anti-Rhesus serum in the treatment room as prescribed by a doctor. I'm wearing a cap, glasses, mask, robe, apron, gloves. Hands are pre-treated in a hygienic manner.

2 Equipment:

Standard anti-rhesus serum

Sterile test tube

Test blood (in vitro)

Saline solution (in vitro)

Sterile pipettes 2 pcs

Container with 3% chloramine solution

3 Manipulation technique:

Pipette two drops of anti-Rhesus serum into a test tube.

Add one drop of blood using a separate pipette.

Rotate between palms for 5 minutes

Add 1 drop of saline solution if agglutination is observed.

Shake the tube and observe agglutination for 5 minutes.

Answer form: when determining the Rh factor with standard anti-Rh serum..

No agglutination is observed - Rh factor is negative

Agglutination is observed - Rh factor is positive

After the manipulation, all used items are soaked in a container with a three percent chloramine solution.

4 Possible errors:

Gross mistakes:

Failure to use health worker protective equipment.

Violation of the proportion of serum and blood 2:1

The agglutination pattern does not correspond to the conclusion about Rhesus status.

Objects in contact with blood are not disinfected

Non-blunders:

Agglutination waiting time is less than 5 minutes.

No saline solution was added in case of observed agglutination.

Performing manipulation “on weight”.

5 Evaluation criteria:

Passed – no major mistakes, no more than two minor mistakes.

Did not pass - presence of blunders, presence of more than two non-blunders.

If a serious mistake is made, the teacher may ask you to repeat the corresponding stage of the manipulation. If the error repeats, you fail. No more than one repetition is allowed.

Technique for determining the Rh factor

Indications: the need for blood transfusion, preparation for surgery.

Prepare: a bottle with anti-Rhesus serum, pipettes; test tubes; isotonic sodium chloride solution; test blood taken from a vein or finger, watch; trays; gloves; containers for waste material; containers with disinfectant solutions.

Preparation for manipulation:

The nurse is fully prepared to perform the procedure: dressed in a suit (gown), mask, gloves, cap, and replacement shoes.
Prepare everything necessary to perform the manipulation.

Performing the manipulation:

Place a drop of anti-Rhesus serum at the bottom of the test tube;

place a drop of the blood being tested here;

Turn the test tube over and mix the blood and serum with rocking movements so that the contents spread over the walls. This will speed up the agglutination reaction;

if there is agglutination, after 3 minutes, to exclude false agglutination, add 3 ml of isotonic sodium chloride solution and mix by inverting the tube twice. Do not shake!

Result evaluation:

a) in the presence of agglutination - Rh-positive blood;

b) in the absence of agglutination – the blood is Rh-negative.

End of manipulation:

Remove gloves and place them in a disinfectant solution.
Wash your hands and dry with a towel.

34. Assisting the doctor in applying adhesive skeletal traction and traction using a Glisson loop

Place the patient on a horizontal surface of the bed with a block system and a weight at the head

Attach a Gleason loop to the head or form a loop from an adhesive plaster at the base of the skull so that it is fixed at the base of the skull (under the chin and under the greater occipital protuberances)

Attach a weight weighing 6 kg (the weight of the load depends on the type of injury and is determined by the doctor)

35. Use of elastic bandages and stockings on the lower limbs

Elastic bandage

Apply in the morning to prevent blood filling and stretching of veins

Place your leg in an elevated position at an angle of 45 degrees.

Make the first rounds at the base of the fingers

Tours should apply moderate pressure to soft tissue; should not cause discomfort; toes should be pink

36. Use of a removable bandage, corset

The purpose of a bandage or corset is to fix a part of the body in a functional state, to prevent complications associated with anatomical defects of the body, which in the absence of a bandage or corset lead to more severe anatomical and functional disorders

The bandage (corset) must be kept clean

The patient must take a horizontal position before putting on the bandage (corset)

When putting it on, do not pinch the skin; avoid painful sensations

Buttons and loops should be located on the front side of the bandage; The straps should not dig into soft tissue.

Staying in a bandage (corset) should not lead to breathing or cardiac problems

37. Identification of signs of blood unsuitability for transfusion, transportation of blood from the blood transfusion department

Unsuitable blood for transfusion if:

The terms and conditions of blood storage were violated

The vial of blood does not have a seal

The top layer in the vial with blood is pink (hemolysis of red blood cells)

There are drops of fat, films, clots

Fuzzy boundary between layers of blood in a vial

Blood is stored in the refrigerator at a temperature of 4 degrees; transportation in special containers that level out changing environmental temperatures

38. Compilation of kits and determination of blood group and Rh factor

Determination of blood group using anti-A and anti-B cyclones

Prepare a plate, zoliclones, glass rods, watches, and blood to be tested.

Divide the plate into 2 parts with a felt-tip pen strip

Sign

Apply one drop each of anti-A and anti-B zoliclone to a plate

Place one drop of blood on the plate (next to the drop of tsoliklon), each of which is 10 times smaller than a drop of tsoliclone

Mix with different ends of glass rods

Swing for 2.5 minutes

no agglutination – blood group 1

agglutination in anti-A - blood group 2

agglutination in anti-B - blood group 3

agglutination in both drops – blood group 4

Determination of Rh factor

Prepare test tubes, pipettes, saline solution (0.9% sodium chloride solution), universal anti-Rhesus reagent, test blood

Apply a drop of universal anti-rhesus reagent and a drop of blood equal in size to the wall of the test tube

Swing for 3 minutes

Add 3 ml. saline solution

Turn over without shaking

Presence of agglutination – the blood being tested is Rh-positive

Absence of agglutination – the blood tested is Rh-negative

There are two ways to determine blood groups:

using standard sera, when the presence or absence of antigens A and B in erythrocytes is determined, i.e., how the blood groups of recipients are determined;
Using standard sera, antigens are determined in erythrocytes and at the same time, using standard erythrocytes, blood serum (plasma) is examined for the presence of isoagglutinins calamus (cross method).

Equipment for determining blood groups

Equipment for determining blood groups:

2 - physiological solution;

3 - glass for washing water;

4 - water for washing pipettes and sticks;

7 - five-minute hourglass;

8 - rack with standard serums;

9 - eye spatulas for mixing drops;

"Seminars on blood transfusion"

L.V.Ivanov, I.P.Danilov, B.A.Shuvaeva

Consult your doctor before following any advice.

Rules for determining blood group using zoliclones

Very often, blood group determination is performed using zoliclones. Coliclones are divided into anti-A and anti-B. Their use in medicine is popular due to the ability to determine not only blood type. They also demonstrate rhesus. For this, the ABO system is used, which replaces conventional serum, which is based on an agglutinating isohem.

To determine the group or rhesus, reagents search for the above antigens that are present in red blood cells. For this purpose, standard type antibodies are used. Also, standard red blood cells detect agglutins, regardless of whether plasma or special serum is used for the study. When it comes to analyzing donor samples, it is imperative to determine the presence of agglutinins in the serum. Standard type red blood cells are used for this purpose.

Hybridoma cell lines are used as the basis for coliclones. They are obtained by combining antibody-producing B-lymphocytes of mouse origin with myeloma cells of the same living organism. With the help of hybridomas, which are individual, antibodies of a homogeneous type are produced. In this case, there may ultimately be only one immunoglobulic class. These substances almost completely replicate the structure and activity from a biological point of view.

Preparing for work

There is a special algorithm to determine blood type and rhesus using zoliclones. This work technique involves laboratory determination. The laboratory must maintain certain temperatures - ranging from 15 to 25 degrees Celsius. In addition, good lighting is required.

Tightly closed containers are used to store all reagents. This is necessary to prevent drying out. As a result of this process, antibody activity can be seriously reduced.

For work, it is prohibited to use reagents that are cloudy with the presence of flakes. An individual pipette is used for work. To carry out the procedure, it is assumed to use a tablet painted white with a well-wetted surface. Due to factors such as the high avidity and activity of cyclones, one reagent series is sufficient for use.

To perform a blood group test, you must first prepare all the equipment and reagents. In particular:

a standard plate is prepared, dry, on which the entire analysis will be performed;
zoliclones of both types are prepared, as well as two pipettes for working with each separately and two sticks made of glass, which are used for mixing;
You will need a disposable syringe with a needle used to draw blood.

Three balls are placed in the sterilized tray, which are pre-moistened with alcohol, as well as three sterile wipes. For the fence you will need a rubber band. Collection is carried out in a centrifuge tube without any liquid. The patient's name must be clearly written on it using a glass-grapher. In addition, a form is filled out that serves as a laboratory referral. The laboratory doctor will re-determine all the main indicators and put a stamp and signature.

Defining Results

To obtain the correct analysis result, it is necessary to perform an intravenous puncture in compliance with all sampling rules. Five milliliters will be enough to determine.

Anti-A and anti-B zoliclones are applied to plates in the laboratory. It will take one large drop. Each is marked with appropriate inscriptions. A small amount of blood drops should be applied next to them.

An individual glass rod is used to mix the sample and reagents. The ratio of blood to reagents should be one to ten. Two and a half minutes are enough to observe the reaction.

Just five minutes of stirring the drops is enough to observe the result. It must be evaluated by a doctor. The table below contains the results that you should focus on when working with serum when using standard red blood cells.

If blood group AB is determined in newborns to exclude autoagglutination, a control study is required. To do this, one drop of isotonic sodium chloride solution is mixed in the above proportion with the blood sent for research. If there is no agglutination reaction, then the blood really corresponds to group AB.

To determine the Rh factor, the same preparation algorithm is used. After all items for determining the Rh factor are ready, the study is performed.

This requires applying a large drop of anti-D-super reagent to the tablet. A drop of blood sent for research is applied nearby in the same proportion of one to ten. Using an individual instrument, the reagent and blood are mixed, then the result is evaluated.

If the agglutination process has begun, then the blood has a positive Rh factor; if the process does not begin, then we are talking about a negative Rh factor. It is worth emphasizing that monoclonal reagents have some advantages over standard sera. In particular, the result in this case is much more accurate, and the procedure itself is safer, painless and does not take much time.

Compilation of kits and determination of blood group and Rh factor

Determination of blood group using anti-A and anti-B cyclones

1. Prepare a plate, zoliclones, glass rods, watches, and blood to be tested.

1. Divide the plate into 2 parts with a felt-tip pen strip

1. Apply one drop each of anti-A and anti-B zoliclone to a plate

1. Place one drop of blood on the plate (next to the drop of tsoliklon), each of which is 10 times smaller than a drop of tsoliclone

1. Mix with different ends of glass rods

1. Rock for 2.5 minutes

no agglutination – blood group 1

agglutination in anti-A - blood group 2

agglutination in anti-B - blood group 3

agglutination in both drops – blood group 4

1. Prepare test tubes, pipettes, saline solution (0.9% sodium chloride solution), universal anti-Rhesus reagent, test blood

1. Apply a drop of universal anti-rhesus reagent and a drop of blood equal in size to the wall of the test tube

1. Swing for 3 minutes

1. Add 3 ml. saline solution

Presence of agglutination – the blood being tested is Rh-positive

Absence of agglutination – the blood tested is Rh-negative

Compiling kits and conducting tests for individual compatibility of donor and recipient blood

ABO (blood group) compatibility test

1. Prepare a plate, donor blood in a vial, recipient serum in a test tube, watch and glass rods

1. Apply a drop of recipient serum and a drop of donor blood from the vial to a plate

1. Mix with glass rods and shake for 5 minutes

Presence of agglutination – blood is ABO incompatible

No agglutination – blood is ABO compatible

Rh compatibility test

1. Prepare donor blood in a vial, recipient serum in a test tube, test tube, pipettes, polygyukine solution (33%)

1. In a test tube, 2 drops of donor blood, 1 drop of recipient blood and 1 drop of polyglucin solution (33%)

1. Swing for 5 minutes

1. Add saline solution (2-3 ml)

Presence of agglutination – blood is incompatible with the Rh factor

No agglutination – blood is compatible for Rh factor

Compilation of instrument sets for venesection and catheterization of the subclavian vein

1. Prepare sterile gauze balls and anatomical tweezers in a sterile tray for processing the surgical field; syringe with novocaine solution for local anesthesia (0.25%); 2 sterile ligatures; 1 sterile catheter and sterile scalpel; sterile needle holder with needle and suture material

1. Ask the patient about novocaine tolerance

1. The operation is performed under local anesthesia in the area of the vein of the elbow (the vein is surgically isolated; 2 ligatures are placed under the vein; the first ligature is tied to the peripheral segment of the vein; the vein is incised and a catheter is inserted, which is fixed with a ligature; the wound is sutured; a system is attached to the elastic catheter for blood transfusion)

Subclavian vein catheterization kit

1. for treating skin with antiseptics, sterile gauze balls on a sterile tray

2. for pain relief, a syringe with novocaine 0.5% 10 ml

3. catheter for the subclavian vein is disposable

Using gloves and other personal protective equipment when working with blood

Before working with blood

1. Put on glasses and a mask

1. Treat your hands surgically

1. Wear sterile gloves

If the gloves were in contact with the biological media of one patient, then touching the skin (wound) of another patient or performing any invasive manipulations on another patient is unacceptable!

After working with blood

1. Immerse gloves in disinfectant solution for 1 hour

1. Place in a special bag (yellow bag, group B)

1. Send for recycling

Carrying out infusion therapy into the central vein

1. Prepare a sterile tray with a sterile syringe, dressing material, a sterile system for administering sterile solutions, two bottles of alcohol, tweezers, a tripod, 10% isotonic sodium chloride solution, heparin solution.

2.Fill the system for drip administration of sterile solutions.

3. Assemble a sterile syringe and draw 5 ml of isotonic sodium chloride solution (for flushing the catheter).

4.Ask the patient to turn his head in the opposite direction from the subclavian catheter and hold his breath.

5.Remove the plug of the subclavian catheter.

6. Place the cap in the bottle with alcohol.

7. Connect the cannula of a sterile syringe to the subclavian catheter and allow the patient to breathe.

8.Check that the subclavian catheter is in the vein (pull the syringe plunger towards you); if blood appears, inject 2 ml of isotonic sodium chloride solution.

9. Ask the patient to hold his breath.

10. Disconnect the syringe and insert a dropper cannula into the subclavian catheter.

12.Adjust a certain number of drops.

13.Close the lock on the dropper after finishing injecting the sterile solution into the subclavian catheter.

14.Ask the patient to turn his head in the opposite direction from the subclavian catheter and hold his breath.

15.Remove the IV cannula.

16.Introduce 0.2 ml of heparin with 2 ml of isotonic sodium chloride solution into the subclavian catheter to prevent the formation of blood clots (at the end of the infusion - a heparin lock).

17. Close the entrance to the subclavian catheter with a plug, removing it from the bottle with alcohol using tweezers. Continue breathing.

NOTE: During long-term intravenous infusion of sterile solutions, it is necessary to periodically check the location of the subclavian catheter in the vein under X-ray control.

Caring for a central venous catheter

1. Treat the skin around the catheter with an alcohol solution (70 degrees), brilliant green solution (1%)

1. Check for kinks and tightness of the rubber plug

1. Check the patency of the catheter: connect a syringe with 20 ml. saline solution, ask the patient to hold his breath while inhaling, pull the plunger and the blood should enter the syringe freely

1. Change the infusion system only while inhaling.

1. After each infusion, administer 5 thousand units of heparin and cap tightly.

44. Application and removal of an interrupted suture Application and removal of an interrupted suture

1) Ask the patient about drug tolerance

2) Prepare anatomical, surgical, needle holder with needle, silk, scissors on a sterile tray

3) Treat the skin with an antiseptic solution (iodonate) using anatomical tweezers

4) Grab the edge of the wound with surgical tweezers

5) Make an injection, retreating 0.5 cm from the edge of the wound

6) The opposite edge of the wound is stitched opposite the previous one (retreating 0.5 cm)

7) Tie knots on one side of the wound

9) Next seam at a distance of 1 cm

1) Lubricate the wound with iodonate solution

2) Using anatomical tweezers, grab the nodule and pull it towards the scar (not away from the scar and not up, because a young, fragile scar can separate)

3) A white undyed thread appears from the skin; cross it

Remove thread from seam channel

4) If a drop of blood, pus or lymph appears, inform the doctor, because this is inflammation

Performing dressings of patients with clean and purulent wounds

1. Wear sterile gloves

1. Before removing the bandage (dried to the wound), irrigate the bandage with a solution of hydrogen peroxide (3%)

1. Carefully remove the bandage

1. Rinse the wound with a solution of hydrogen peroxide (3%) (has broad-spectrum antiseptic properties, including destroying clostridia and fungi; eliminates unpleasant odors from the wound and stops bleeding)

1. Apply a napkin moistened with furacillin solution (1:5000)

1. Apply a sterile bandage

The procedure is the same. The wound is managed according to the rule of 3 phases of the wound process: hydration, dehydration and epithelization.

1. In the hydration phase (there is a lot of pus in the wound and pronounced swelling of the soft tissues)

Dressings with water-based ointments (disols with antiseptics), enzymes (trypsin, chymotrypsin, pepsin) are used; physical treatment is contraindicated

2. In the dehydration phase (there is little pus, swelling subsides)

Fat-based ointments are used. Dressings can be done less frequently (once every 2-3 days). Physiotherapy is possible.

3. In the epithelization phase (wound healing is completed)

In general: immunocorrection, detoxification and stimulation of reparative processes in the wound are used.

Toilet the wound

Wound toilet is carried out for fresh wounds (shallow, deep in the skin, which upon initial intention will not leave a rough scar). In other cases, PSO of the wound is performed.

1. Prepare sterile dressing material (wipes, turundas, balls), anatomical tweezers or Billroth forceps, gauze or rubber gauze drainages on a sterile tray

1. Wear sterile gloves

1. Treat the edges of the wound with an alcohol solution (70 degrees), lubricate with a solution of brilliant green (1%)

1. Apply a sterile bandage or seal with BF-6 glue

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Equipment for determining blood group

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Determination of blood group and Rh factor

Algorithm of actions for determining blood group and Rh factor

when a woman enters the maternity hospital

Determination of ABO blood group using monoclonal antibodies

Prepare:

dry glass slide (standard plate) to determine blood group;
anti-A (pink) and anti-B (blue) coliclones;
two pipettes for taking zoliclones from vials;
two glass rods for mixing the patient’s blood with zoliclones;
a disposable syringe (5-10 ml) with a needle for drawing blood from the patient’s vein;
put 3 balls moistened with alcohol and 2-3 sterile wipes into a sterile tray;
rubber tourniquet for intravenous punctures;
a dry centrifuge tube on which to clearly sign the patient’s name with a glass graph;
form - referral to the laboratory, where the doctor-laboratorian re-determines the blood type, Rh affiliation, puts a stamp and signature

Following all the rules for intravenous punctures, draw blood from the patient’s vein (at least 5 ml).

Anti-A and anti-B zoliclones are applied to a tablet or plate, one large drop (0.1) under the appropriate inscriptions: anti-A and anti-B.
Next to the drops of antibodies, the test blood is applied one small drop (0.01 ml).
After mixing the reagents and blood with different glass rods for anti-A and anti-B in a ratio of 1:10, the agglutination reaction is observed for 2.5 minutes.
Read the results after 5 minutes while stirring the drops. (from 3 to 5 minutes)
The result is assessed by a doctor. An assessment of the results of the agglutination reaction with anti-A and anti-B Tsoliklons is presented in the table, which also includes the results of determining agglutinins in donor serum (plasma) using standard erythrocytes.

In order to exclude autoagglutination, which can be observed in the umbilical cord blood of newborns, if blood group AB (IV) is established, it is necessary to carry out a control test: mix one drop (0.1 ml) of an isotonic sodium chloride solution with a small drop (0.01 ml) of the test substance blood. There should be NO agglutination reaction.

A. Carefully fill out all the columns of the form - a referral to the laboratory to determine your blood type and Rh factor with a doctor’s signature.

B. Deliver a referral form and a test tube with the patient’s blood to the laboratory for a thorough determination of the patient’s blood type and Rh status.

Determination of Rh factor using a monoclonal reagent (Coliclone anti-D Super)

A large drop of reagent (about 0.1 ml) is placed on the plate. A small drop (0.01-0.05 ml) of the blood being tested is placed nearby and the blood is mixed with the reagent. The agglutination reaction begins to develop after a second; clearly defined agglutination occurs after a second. (Rh positive, no agglutination – Rh negative). The reaction results are taken into account after 3 minutes.

After mixing the reagent with blood, it is recommended to shake the plate not immediately, but after a second, which allows a more complete large-petal agglutination to develop during this time.

Express determination of ABO and Rh blood groups using the Erythrotest-Groupcard kit

The “Erythrotest-groupcard” kit (Hematologist LLC, Moscow) is intended for determining ABO and Rhesus (RhD) human blood groups in laboratory and field conditions. The determination is carried out in a direct hemagglutination reaction and does not require any auxiliary reagents or equipment. The set includes:

“Erythrotest-group card” card;
pipette with a dosed drop volume of about 0.02 ml;
sterile packaged scarifier;
stick for mixing blood with reagent.

The wells of the card contain dried monoclonal reagents anti-A, anti-B, anti-AB and anti-D, which immediately dissolve when water is added. Monoclonal anti-D antibodies specifically detect the RhD antigen regardless of the ABO group. The last well contains a solvent to control nonspecific autoagglutination.

The determination is made in native blood with a preservative, in blood without a preservative, or in blood taken from a finger.

Open the package and take out the card without touching the holes on the working surface. Enter the patient's data, except blood type.
Add 1 drop of water (tap or distilled) to each well using the pipette included in the kit. Water is applied to the stain of the dried reagent. Do not allow the drop to dry out.
Add a small drop of blood to be tested into each well. The blood is applied next to the drop of reagent without touching it to avoid contamination of one reagent by another. A sterile scarifier is used to draw blood from a finger.
Thoroughly mix the blood with the reagent using the stick included in the kit. In each well, mixing is done only with a new stick. Using one stirring stick in different wells is not permissible, as it leads to contamination of the reagents and erroneous determination of the blood group.
They immediately rock the record. Clear agglutination occurs after s, but the final result should be taken into account after 3 minutes, because in the case of weak forms of antigen A, the reaction occurs later, and the agglutinates are smaller.
The result is assessed visually (Table 18.6). The result of the reaction with the corresponding reagent (+ or -) is written in the squares under each well.

The shelf life of the “Erythrotest-groupcard” kit is 2 years at a temperature of 2-8°C. Storage is allowed for 1 year without refrigeration if the temperature does not exceed 25°C. Storage and use of unsealed or damaged bags is not permitted.

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Technique for determining the AB0 blood group using standard sera

Indications: need for blood transfusion, preparation for surgery.

Prepare: a standard plate with indentations; a set of glass rods; isotonic sodium chloride solution; a set of hemagglutinating sera of groups 1, 2, 3, 4 of two series; pipettes; blood taken from a vein or finger; watch; trays; gloves; containers for waste material; containers with disinfectant solutions.

The nurse is fully prepared to perform the procedure: dressed in a suit (gown), mask, gloves, cap, and replacement shoes.
Check the quality of standard hemagglutinating serums by: color marking, appearance (light, transparent); the safety of the packaging, the presence of a correctly designed label.
Prepare everything necessary to perform the manipulation.