Projective Exercise 8

As a transfusion medicine physician, I must know if I can trust my staff’s interpretation of immunohematology testing.  I may be called at night and they will provide me with results and I must use these to make a medical judgment.  If their interpretation is flawed, I might make a decision that harms the patient.

I really don’t like multiple-choice questions, but nowadays this is often the norm.  For my staff, especially senior staff and those who want to be promoted to senior staff, I have developed a series of projective exercises to help me understand their thought processes.  I emphasize that I do not want a mere regurgitation of isolated facts:  I want integration of the facts into useful information!!

The following is my favorite assessment, offered to advanced staff and candidates for senior technologist, supervisors, and technical manager positions.  Usually, these staff have SBB, ART, FIBLS or equivalent qualifications.

You are reviewing abnormal test results and receive the following case:

Anti-A:           4+

Anti-B:           0

Anti-A,B        4+

A1 cells         0

B cells           3+

Anti-D            3+

D-control      0

Antibody Screen:  3+ in SC1 (R1R1), 4+ in SC2 (R2R2), 0 in SC3 (rr)

Antibody Identification:  Anti-D

Give possible explanation(s) for this situation.  Request any additional information you need.

What blood type will you transfuse?

Solution will follow in a subsequent post.