Transfusion Medicine Rotation

The rotation in transfusion medicine encompasses 4 months, the first two early in the residency and the latter two as a senior resident. The rotation exposes residents to the basic technical, administrative, and clinical aspects of immunohematology, blood donor collections, transfusion practices, therapeutic apheresis, tissue banking, and stem cell processing storage and administration. It takes place in the Division of Transfusion Medicine, a state-of-the-art facility that works to ensure a medically safe and adequate supply of blood for Cedars-Sinai Medical Center patients and provides support services for community donors. Three full-time transfusion medicine faculty members and a staff of highly trained medical technologists, nurses and assistants provides the highest quality care for donors and patients. At the conclusion of the rotation, the resident will be prepared for further study at the fellowship level, or to provide the basic clinical services required of a Transfusion Service Medical Director with the necessary skills to serve as a clinical consultant regarding all aspects of transfusion medicine.

Rotation Structure

Following any mandatory morning conference, the resident meets with the Transfusion Medicine Fellow to attend to urgent patient care issues. At 9:00 a.m. there are daily rounds with the Fellow and Transfusion Medicine attending. The afternoon is spent in other patient care activities which include working up new apheresis patients, following continuing apheresis patients, reviewing and interpreting reported transfusion reactions and immunohematology reports. Exposure to cellular therapies also occurs during the rotation. Residents answer questions from Donor Facility staff regarding donor suitability and from Transfusion Service staff regarding component utilization.

During the rotation, the resident participates in relevant laboratory management activities such as transfusion audits and attending division management meetings. Each resident will present a focused topic review to the staff on a monthly basis. The first two months of the four month rotation are spent learning the fundamentals of Transfusion Medicine. During the second two months, residents function more independently, with graduated responsibility.


DAILY SCHEDULE
7:30 - 8:30Housestaff conference
8:30 - 9:00Meet with fellow
9:00 - 12:00Rounds with attending
12:00 - 1:00Conference
1:00 - 5:00Cover Transfusion Service, Donor Room, Therapeutic Apheresis. Must be present in Division.

Specific Transfusion Medicine Goals and Objectives

Patient Care:

  • Perform antibody screen and identification.
  • Perform and evaluate transfusion reaction workup and RhoGAM workup.
  • Write orders for and supervise therapeutic apheresis.

Medical Knowledge:

  • Describe the AABB Standards for blood banks and transfusion services, as well as cellular therapies.
  • Define the process of ABO/Rh typing and crossmatch.
  • Demonstrate the processes and reasons for filtering, washing and freezing blood.
  • Explain the requirements for special components (CMV negative, washed, leukocyte reduced, irradiated).
  • Identify the indications for therapeutic apheresis.
  • Discuss donor screening and eligibility criteria, and peripheral blood stem cell collection and processing techniques.

Interpersonal and Communication Skills:

  • Take patient histories and communicate with patients in a clear and cogent manner.
  • Provide consultation to physicians regarding appropriate utilization of blood components.

Professionalism:

  • Interact with patients, families, and health care professionals in a respectful manner.
  • Display reliability in following instructions and seeking faculty input when needed
  • Fully participate in all mandatory conferences and other required activities.
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