Medical Education
TITLE:
CLINICAL TRANSFUSION MEDICINE
This elective at the community's blood center provides an overview of transfusion medicine that includes collection, production and usage of blood components, pretransfusion recipient testing, and transfusion ordering practices. During this elective the student will also receive an overview in the collection and clinical uses for blood products collected by apheresis and the role of HLA antigens in transfusing these products. Exposure to therapeutic apheresis is also available. Solid organ, bone marrow and peripheral blood stem cell transplantation are also described.
PREREQUISITES:
Please contact Margaret Simon @ margaret.simon@uc.edu with any questions regarding the elective or scheduling for this elective.
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GENERAL INFORMATION
INTERNATIONAL VISITING:
NO
STATUS:
Full-Time
OFFERED AS FULL-TIME AND PART-TIME:
NO
ALLOWS OVERLAP:
YES
DIRECTOR:
David Oh,
ohdd@uc.edu
513-558-1338
Hoxworth Blood Center, 5012
ADMINISTRATIVE SUPPORT PERSON:
Margaret Simon
Simonmp@ucmail.uc.edu
513-558-1335
Hoxworth Blood Center, 5010B
SITE(S):
Hoxworth Blood Center
ROTATIONS:
Rotation |
Dates |
Max |
1 |
05/06/2024 - 05/17/2024 |
1 |
2 |
06/03/2024 - 06/14/2024 |
1 |
4 |
07/29/2024 - 08/09/2024 |
0 |
4 |
08/12/2024 - 08/23/2024 |
0 |
5 |
08/26/2024 - 09/06/2024 |
0 |
6 |
10/07/2024 - 10/18/2024 |
1 |
7 |
11/04/2024 - 11/15/2024 |
0 |
8 |
12/02/2024 - 12/13/2024 |
0 |
10 |
01/13/2025 - 01/24/2025 |
1 |
NOTE: If a rotation is offered in both 2 and 4 week slots, the max capacity is limited to the actual spots offered for the 4 weeks. (ie: the 2 week rotations listed share the max of the 4 week rotation)
WORKING HOURS:
9:00 AM - 5:00 PM, Monday - Friday
REPORT 1ST DAY:
Stop at 4th Floor Receptionist, ask for Margaret Simon 558-1335. Most often emails including 2 week schedule and instructions for the first day will be provided, Margaret Simon can be emailed at any time with questions regarding elective and any scheduling issues.
INSTRUCTION
LEARNING ACTIVITIES:
- Case-Based Instruction/Learning
- Conference
- Demonstration (description, performance, or explanation of a process, illustrated by examples, observable action, specimens, etc)
- Discussion-Small Group (Small Group (=12)
- Laboratory
- Lecture
- Problem-Based Learning (PBL)
LEARNING ENVIRONMENT POLICIES:
UCCOM strives to provide medical students with a learning environment that is conducive to their professional growth. All UCCOM and visiting medical students are encouraged to review the Student Handbook.
The Office of Student Affairs and Admissions is available to all UCCOM and visiting medical students to discuss any concerns/questions related to the learning environment. Please call 558-6796 to access faculty/staff that can assist you.
TEACHING:
15% |
Attending Physician |
15% |
Other Faculty |
60% |
Other Allied Health Professional(s) |
10% |
Fellow Physician |
ASSESSMENT:
The assessment includes a pass/fail evaluation provided by the Medical School
ASSESSMENT METHODS:
Narrative Assessment
Other: Describe other methods not listed above:
Participation
FINAL GRADE:
GRADE ASSIGNED BY:
Course director
OBJECTIVES
Curricular Resources :
Reading and/or Texts
1. McCullough, J. 4th Ed. Transfusion Medicine. Wiley-Blackwell. Chichester, UK. 2016.
2. Technical Manual. American Association of Blood Banks. Bethesda: AABB, current edition.
3. Circular of Information for the use of Human Blood and Blood Components, current edition.
4. Standards for Blood Banks and Transfusion Services. American Association of Blood Banks. Bethesda: AABB, current edition.5. Multiple voice recorded lectures made available during rotation
6. Current Journal Articles from faculty
Instructional Methods:
The student has access to recorded lectures for overview of content, spends time in operational departments for viewing and sometimes performing labwork on pre-tested samples. Faculty spends time with students during rounds and weekly meetings to go over weekly cases, calls, situations occurring at the blood center. it's a hands on type of rotation, depending on what situations present themselves,
Knowledge/Skills:
Donor Services:
- Review Donor Eligibility, questions and
health history, mini physical
- Observe
multiple platforms for collection: whole blood, automated apheresis for RBC, PLT,
plasma
Components:
- Observe manufacturing
for WB into RBC, Plasma, Cryo, Platelet components
- Introduce
temperature for manufacturing, storage, transportation
- Observe modifications such as Irradiation,
- Washing,
thawing, leukoreduction process, pooling of cryo
Product Management:
- Ordering for
replacement, explanation of expected turn around time
- Imports
to Hoxworth – time delay
Red Cell Serology:
- ABO/Rh,
antibody screen and antibody identification, preparation of suitable Antigen
negative units, frequencies of antigen negative units, Transfusion
practice, Crossmatch methodologies, DAT, intra/extravascular Hemolysis.
Temp storage of components
Transfusion Service:
- Dispense
of components for transfusion, inventory challenges, time expectation To
re-order components from Hoxworth
- OR
refrigerator and policies for transfusable products
- Turn
around time for Preparation or crossmatch of components
- Initiation
of Massive transfusion protocol
- Blood
Bag Tags
Transplantation Imm:
- HLA
testing, Crossmatching of donor organs, PCR
Therapeutic Apheresis:
- Attend rounds daily, observe procedures, both for collections and infusion, Plasma exchange, Red Cell exchange, be introduced to therapies treated by apheresis
Main Course Topics :
- Blood donation
-
Blood safety
-
Blood products
-
Transfusion practices
-
Pretransfusion testing
-
Cellular therapies
-
Therapeutic Apheresis
-
Transplantation immunology
Procedures:
- Perform pretransfusion testing:
-
ABO/Rh typings
-
Antibody screen/identification
-
Direct antiglobulin test
-
Describe apheresis procedures:
-
Therapeutic
-
Product collection
-
Describe Transplant Immunology Laboratory and appropriate testing.
-
Describe tests required on all allogeneic donors of whole blood or apheresis products.
-
Describe tests required for autologous donors of whole blood products.
Remediation Plan:
Repeat the elective. It would be almost impossible to not pass. As long as the student is present, participates in discussions, presentations, and reviews the recorded lectures, they should pass. If they are not present, this would be a bigger issue.
SAMPLE WEEK
Monday:
9:00AM |
9:30AM |
Books, reading list, tour of facilities |
9:30AM |
10:00AM |
Apheresis Rounds |
10:00AM |
5:00PM |
Apheresis |
Tuesday:
9:00AM |
9:30AM |
Blood Center Rounds |
9:30AM |
10:00AM |
Donor Services: Overview of Donor Qualif |
10:00AM |
10:30AM |
Donor Services: Overview Continued |
10:30AM |
5:00PM |
Donor Services: Process of Phlebotomy and Care of Donors |
Wednesday:
9:00AM |
9:30AM |
Intro to Red Cell Testing |
9:30AM |
10:00AM |
Apheresis Rounds |
10:00AM |
5:00PM |
Intro to Red Cell Testing |
Thursday:
9:00AM |
2:00PM |
UCMC overview of transfusion service |
2:00PM |
4:00PM |
donor quality control, testing products |
Friday:
9:00AM |
9:30AM |
Cellular Therapy |
9:30AM |
10:00AM |
Apheresis Rounds |
10:00AM |
2:00PM |
Cell Therapy Lectures - voice recorded |
SCHEDULE NOTE:
The schedule shown above is intended to be an example of a typical week. The actual days and times of rotations through the various areas are determined once a student has requested the elective. The student will receive a copy of the schedule on or before the first day of their rotation. Any special circumstances requiring a change of schedule should be discussed with Margaret Simon as soon as possible.
This course is a PASS/FAIL rotation.
ATTENDANCE AND ABSENCE POLICY
Session Attendance for M4 Students
- Students may miss no more than two days of planned excused absences on a four week rotation without being required to make-up the work, at the discretion of the clerkship/elective/course director or his/her designee.
- Non-AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the clerkship director to best align with the site schedule. Students may request to schedule 1 or more of these 4 days for planned absences that fall under 1 of the categories listed below for excused absences during non-AI rotations, in consultation with the course/elective director, who may or may not approve such planned absences.
- AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the course director to best align with the site schedule. Students may request to schedule 1 or 2 of these days for planned absences that fall under 1 of the categories listed below for excused absences during AI rotations, in consultation with the course director, who may or may not approve such planned absences. Students must avoid scheduling Step 2 examinations during an Acting Internship.
- Excused Absences - The following will be considered excused absences:
- Diagnostic, preventative, and therapeutic health services (e.g. doctor appointments, physical therapy, counselling, etc).
- Personal illness, accident or a major catastrophic event
- Death or serious illness of immediate family members. Immediate family members, as defined by UC, are Grandparents, Brother, Sister, Brother-in law, Sister-in-law, Daughter-in-law, Son-in-law, Father, Mother, Mother-in-law, Father-in-law, Step-sister, Step-brother, Step-mother, Step-father, Spouse or domestic partner, Child, Grandchild, legal Guardian or other person who stands in place of parent (in Loco Parentis)
- Whenever possible, planned absences should be requested a minimum of six weeks in advance of the start of the clerkship/elective/course in which the absence will occur; this enables the clerkship/course/elective to help plan for educational event scheduling (e.g. a known appointment could be scheduled around with enough notice and the student might not have any required coursework to make up). Absences requested less than 1 week prior to the planned absence may not be considered for a possible excused absence unless extenuating circumstances prevented the student from providing timely notification per the policy. Students should first submit their request for a planned absence to the clerkship/elective/course director using the online MSSF. All planned/excused absences for any reason should be documented on the MSSF.
- The COM abides by the UC Religious Observance Policy that respects the religious diversity of its students by providing opportunities, where possible, for accommodation in cases where conflicts exist between students’ religious beliefs/practices and educational activities. In clinical settings, such accommodations must honor the primacy of a commitment to patient care and avoid unduly burdening faculty, staff and the general student population involved in the affected educational and/or patient care activity.
- The following items are explained in detail in the Medical Student Handbook:
- Excused/unexcused/unplanned absence, religious holidays, jury duty, and make-up work
See Attendance and Absences Policy, Religious Observance Policy, Medical Student Handbook.