Portland Community College | Portland, Oregon

This course focuses on basic principles and procedures related to general immunology and the structure, function, and classification of antigens and antibodies. The complement system and the principles involved in agglutination reactions will be presented. ABO and Rh blood group systems will be covered with emphasis on inheritance, principles of testing and terminology. Patient confidentiality and other ethical topics pertinent in healthcare will also be discussed.

Upon successful completion students should be able to:

1. Use an understanding of appropriate collection, identification, and processing of specimens; proper use of blood bank reagents; accurate performance of blood typing procedures and grading of reaction strengths by tube method; and correct interpretation of test results to make appropriate and effective on-the-job professional decisions.
2. Recognize normal and abnormal test results and correlate these data with appropriate pathologic conditions to accurately advise health care providers.
3. Adapt laboratory techniques and procedures in a corrective manner when errors and discrepancies in results are obtained to affect resolution in a professional and timely manner.

The material in this course will be presented in a traditional classroom (Campus program), or distance-learning format (Distance learning program). Both traditional and distance learning sections include required laboratory activities. Traditional classroom instruction consists of lecture, discussion, web-based instructional media (tutorials, animations, videos, etc.) and other educationally sound practices. Distance learning sections include similar educational practices and are primarily presented in a web-based format. Both campus and distance learning sections require periodic campus based laboratory exercises. In addition, the distance learning section may have hospital-based laboratory exercises. A laboratory manual will be provided. The laboratory exercises provide an opportunity for students to employ the testing principles and methodologies discussed and allow for discussion, application and correlation of the concepts presented. The student is expected to perform all laboratory procedures according to the criteria established by the department.

The instructor will outline the methods used to evaluate student progress and the criteria for assigning a grade at the beginning of the course. Assessment methods may include written and practical examinations and laboratory write-ups. Evaluation of problem solving skills, teamwork, attendance, laboratory performance and communication skills may also be included.

• Course Themes
  • Theme 1: Basic Immunology
    • Mechanisms of protection against disease including acquired immunity
    • Components and function of haptens and complete antigens
    • Cellular and humoral immunity and the roles of tissues and related cells that may be involved in immune responses
    • Differentiating and identifying the various types of hypersensitivities and immunodeficiencies
    • The inflammatory process including cells and chemical mediators
    • Classification of immunoglobulins and properties and characteristics related to: type of L and H chain, subclasses, size and number of structural units, complement activation, placental transfer, seromucous secretion, primary function and relative concentration in serum
    • Differentiating primary and secondary (anamnestic) responses and antibody class(es) involved
    • The complement system
  • Theme 2: Testing
    • Agglutination reactions, their stages, and the factors affecting each stage
    • Problems that may be encountered such as: dosage effect, prone phenomenon, and blocking antibodies
    • Reagents commonly employed in ABO and Rh testing procedures
    • Methodologies, interpretation, and sources of error for ABO forward and reverse typing, and Rh and weak D typing
    • AHG: principles, uses, and sources of error
  • Theme 3: ABO and Rh Blood Group Systems
    • Inheritance of the ABO blood group system and related genotypes and phenotypes of the four major groups
    • The Secretor and H systems and their relationship to ABO antigens
    • The “Bombay O” type and expected ABO typing results
    • The Fisher-Race, Wiener, and currents theories of inheritance
    • The weak D genotype and phenotype
  • Theme 4: Professionalism
    • Professionalism in clinical laboratory practice and the impact on patient care
    • Accreditation, certification, and licensure: purpose, types, and processes

• Laboratory Skills
  • Proper collection and processing of peripheral blood samples for blood bank testing
  • Use a serofuge in the performance of the tube methodology, including
    • Correctly balancing the serofuge
    • Proper handling, cleaning, and storage of the serofuge
    • Correct speed and time settings for the appropriate procedure
    • Correct use of the serofuge head during cell washing procedures
  • Use of a water bath in the performance of weak D typing, including
    • Selecting the correct temperature for the procedure
    • Proper handling, cleaning, and storage of the water bath
  • Proper performance of ABO testing, including
    • Perform and interpret forward and reverse typing using the appropriate reagents and controls
    • Explain the principles involved in ABO testing and any discrepancies as well as sources of error
    • Troubleshooting and problem solving
    • Recording and interpreting results
  • Proper performance of Rh testing, including
    • Perform and interpret routine Rh typing using the appropriate equipment, reagents, and controls
    • Perform and interpret weak D testing using the appropriate equipment, reagents, and controls
    • Explain the principles involved in Rh and weak D testing and any discrepancies as well as sources of error
    • Troubleshooting and problem solving
    • Proper recording of results and use of appropriate notation
  • Troubleshooting and problem solving
    • Recognizing errors or discrepancies in results during lab procedures
    • Selecting corrective actions for problem solving

• Cognitive Skills
  • Cognitive processes, including
    • Formulating a clear, answerable question
    • Predicting expected results
    • Following written protocols and verbal instructions
  • Analysis skills, including
    • Collecting and organizing data in a systematic fashion
    • Presenting data in an appropriate form
    • Assessing the validity of the data (including integrity and significance)
    • Recognizing errors and developing a corrective course of action
    • Drawing appropriate conclusions based on the results
  • Communication skills, including
    • Discussing and presenting lab results or findings in the laboratory
  • Interpersonal and citizenry skills, including
    • Working effectively in teams or groups so that the task, results, and analysis may be shared
    • Effectively managing time and tasks allowing concurrent and/or overlapping tasks to be done simultaneously, by individuals and/or within a group
    • Integrating knowledge and making informed judgments about blood bank test results in the clinical setting

• Laboratory Safety
  • Laboratory procedures, including
    • Reporting all spills and broken glassware to the instructor and receiving instructions for clean up
    • Minimizing or containing the production of aerosols and describing the hazards associated with aerosols
    • Washing hands prior to and following laboratories and at any time contamination is suspected
    • Using universal precautions with blood and other body fluids and following the requirements of the OSHA Bloodborne Pathogen Standard
    • Disinfecting lab benches and equipment prior to and at the conclusion of each lab session, using an appropriate disinfectant and allowing a suitable contact time
    • Identification and proper disposal of different types of waste
    • Good lab practice, including returning materials to proper locations, proper care and handling of equipment, and keeping the bench top clear of extraneous materials
  • Protective procedures, including
    • Tying long hair back, wearing personal protective equipment (eye protection, coats, gloves, closed shoes), and using such equipment in appropriate situations
    • Always using appropriate pipetting devices and understanding that mouth pipetting is forbidden
    • Never eating or drinking in the laboratory
    • Never applying cosmetics, handling contact lenses, or placing objects (fingers, pencils, etc.) in the mouth or touching the face
  • Emergency procedures, including
    • Locating and properly using emergency equipment (eye wash stations, first aid kits, fire extinguishers, chemical safety showers)
    • Reporting all injuries immediately to the instructor
    • Following proper steps in the event of an emergency