Evaluate your understanding of donor screening and blood collection with this mock test created for Medical Laboratory Students and Blood Bank Technologists. This test assesses your knowledge of donor eligibility, medical history evaluation, infectious disease testing, and proper collection techniques used in modern transfusion practice.
What This Mock Test Covers Donor selection and eligibility requirements Donor deferral and health screening Blood collection and labeling procedures Infectious disease testing protocols Donor reactions and management
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ASCP MLS Exam MCQs Chapter 62
Why Take This Mock Test? Strengthens exam confidence Highlights areas for improvement Provides practice with clinically relevant scenarios This mock test (60 MCQs (4661 – 4720) ) is part of our ongoing ASCP MLS Exam Practice Series , giving you structured preparation for all major immunology topics.
Our Blood Banking – Donor Screening and Blood Collection Mock Test is specifically designed for candidates appearing in ASCP MLS, AMT MLT/MT, AIMS, CSMLS, IBMS, HAAD/DOH, DHA, and MOH exams. This mock test mirrors the structure, difficulty level, and question style you can expect in the actual examination.
Take this test to: ✅ Strengthen your Pathology exam preparation. ✅ Boost confidence before the ASCP MLS Exam .
Who Should Use This Mock Test? Medical Laboratory Scientists and Technicians
Pathology Students
Professionals preparing for international laboratory certification exams
Anyone seeking to strengthen their knowledge of Blood Banking – Donor Screening and Blood Collection
How to Use This Mock Test Effectively Simulate Exam Conditions: Attempt the test in one sitting without referring to notes.
Track Your Time: Keep within the allotted time limit to build speed.
Review Explanations: Study the answer explanations to strengthen understanding.
Repeat for Retention: Re-attempt after revision to measure improvement.
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ASCP Exam Questions
Which of the following is a cause for indefinite deferral from blood donation?
Trypanosoma cruzi causes Chagas disease; a positive test leads to permanent deferral in most blood donor guidelines.
Babesia infection (a) often leads to temporary, not always indefinite, deferral (though some centers defer indefinitely if confirmed).
Residence in an endemic malaria region (b) typically leads to a 3-year deferral after leaving the area, not indefinite.
Chicken pox vaccination (d) is not a cause for long-term deferral.
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ASCP Exam Questions
Which of the following practices at the time of blood collection helps minimize bacterial contamination of platelet products?
During blood collection , one of the main sources of bacterial contamination in platelet products is skin bacteria entering the collection bag at the start of donation.
To minimize this risk: The first 20–30 mL of blood collected is diverted into a diversion pouch .
This diverts the initial flow of blood (which may contain skin contaminants) away from the main collection bag , greatly reducing bacterial contamination risk.
Other options:
(a) Use of 18-gauge needle → helps ensure proper blood flow, but does not specifically prevent bacterial contamination.
(c) Green soap scrub → inadequate; antisepsis requires povidone-iodine or chlorhexidine , not soap alone.
(d) UV irradiation → sometimes used after collection for pathogen reduction, but not during collection .
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ASCP Exam Questions
All donor blood testing must include which of the following?
Federal regulations (FDA) require all donor blood to be tested for syphilis (using a serological test), as well as for Hepatitis B, Hepatitis C, HIV, HTLV, and ABO/Rh.
The other tests are not universally required:
a) Complete Rh phenotyping: Only ABO and Rh(D) typing are required.
b) Anti-CMV testing: This is not a routine required test; CMV testing is only performed on specific units designated as “CMV negative.”
c) Direct antiglobulin test (DAT): This is not a mandatory donor screening test. It is sometimes used to resolve serological problems but is not required for every donation.
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ASCP Exam Questions
If a unit of autologous Red Blood Cells is collected and transfused in the same facility, which of the following is NOT required?
Autologous donations collected and used within the same facility (not stored long-term) are generally exempt from infectious disease testing requirements by FDA regulations, provided the blood is for autologous use only and clearly labeled as such.
The other options are still required:
a) ABO and Rh typing – needed for proper labeling and in case emergent crossmatch is necessary.
b) A physician’s order – required for collection and transfusion.
d) Evaluation for risk of bacteremia – part of donor screening to ensure patient safety.
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ASCP Exam Questions
Which of the following prospective donors would be accepted for blood donation?
This donor meets all criteria. There is no upper age limit for donation if the donor is otherwise healthy. The minimum hemoglobin for a male donor is 13.0 g/dL, which he exceeds.
The other donors are deferred:
a) 62-year-old female with a blood pressure of 210/80: This is severely hypertensive (systolic > 180 is a deferral criterion).
b) 18-year-old female who weighs 100 lb: This is below the minimum weight requirement of 110 lbs (50 kg) for allogeneic donation.
c) 40-year-old male with a pulse of 115: A pulse rate must be between 50-100 bpm (with some exceptions for well-conditioned athletes below 50). A rate of 115 is too high and requires deferral.
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ASCP Exam Questions
Six units of Red Blood Cells are issued to the OR in a validated cooler and returned 40 minutes later. What should be done?
For RBCs issued in a validated transport cooler, the key to re-entry into inventory is verifying that the temperature was maintained at 1-10°C throughout the transport period. Since 40 minutes is well within the typical hold time of a validated cooler (often 4-12 hours), the units can be returned to inventory only if the temperature is verified to be acceptable (e.g., by checking a temperature monitor or the units themselves feel cold). The 40-minute time frame alone is not sufficient; temperature validation is the critical step.
a) Discard the units: This is unnecessary if temperature was maintained.
c) Continue to store in cooler: The cooler is for transport, not storage; units must be returned to the blood bank refrigerator.
d) Put units back into inventory as only 40 minutes has elapsed: Time is a factor, but the definitive criterion is temperature maintenance, not just elapsed time.
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ASCP Exam Questions
The screening for hepatitis B includes detection of:
Screening for Hepatitis B in blood donors primarily includes:
The other options are incorrect:
a) Anti-HCV is for Hepatitis C screening.
c) Anti-HBs only shows immunity (from vaccination or past infection) but is not the primary screening test.
d) ALT levels are no longer routinely used for donor screening.
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ASCP Exam Questions
Which of the following is the correct storage temperature for Fresh Frozen Plasma (FFP)?
The other options are incorrect:
a) 4°C is the storage temperature for Red Blood Cells.
c) –40°C is colder than required; while acceptable, -18°C to -20°C is the standard.
d) 37°C is body temperature and is not a storage temperature for any blood component.
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ASCP Exam Questions
The primary test used for detecting HIV infection in donors is:
The primary screening test for HIV in blood donors is an ELISA (Enzyme-Linked Immunosorbent Assay) or a similar immunoassay (like Chemiluminescent Immunoassay). These tests are highly sensitive for detecting HIV antibodies and antigens.
a) Western blot: This is a confirmatory test, not the primary screening test.
c) PCR only: Nucleic Acid Testing (NAT, which uses PCR) is used to directly detect the virus and shorten the window period, but it is used in conjunction with, not instead of, the initial immunoassay.
d) Coombs test: This is for detecting antibodies coating red blood cells, not for HIV.
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ASCP Exam Questions
A prospective donor with which of the following health histories would be accepted for blood donation?
a) Hepatitis B immune globulin 2 months ago → Deferral (usually 12-month deferral after hepatitis B immune globulin).
b) HIV prevention drugs 6 months ago → If referring to PrEP (pre-exposure prophylaxis) or PEP (post-exposure prophylaxis), current FDA guidelines (as of recent changes) may have a 3-month deferral from last dose; 6 months ago would be acceptable in some systems, but earlier rules had longer deferrals. However, newer FDA guidance (2020) removed deferral for PrEP/PEP, but some centers may still ask; but compared to others, this might be acceptable depending on interpretation.
c) Blood transfusion 2 months ago → Deferral (wait 12 months after transfusion in the US).
d) Travel to a malaria-endemic country 1 month ago → Deferral (3-month deferral after travel).
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ASCP Exam Questions
In allogeneic blood donation, which of the following infectious agents must also include a nucleic acid testing (NAT) assay?
For allogeneic donations, FDA-required infectious disease testing using Nucleic Acid Testing (NAT) must be performed for HIV-1, HCV, and HBV (Hepatitis B Virus). NAT is used to directly detect the genetic material of the virus, shortening the “window period” before detection.
The other options are not routinely tested for with NAT:
b) HTLV I/II: Screened using an antibody test, not NAT.
c) Syphilis: Screened using a serological test (e.g., RPR).
d) Cytomegalovirus (CMV): Not a required test for all donations. When performed, it is an antibody (serological) test to identify CMV-negative units.
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ASCP Exam Questions
Which of the following is NOT a useful strategy to reduce bacterial contamination in platelet components?
Green soap is not an appropriate disinfectant for preparing the venipuncture site in blood donation. It is not effective in killing skin flora , which are the main source of bacterial contamination in platelet components.
Effective strategies to reduce bacterial contamination include:
(b) Diverting the first 10–40 mL of blood → removes skin plugs and bacteria from the initial flow.
(c) Performing culture-based bacterial detection on platelets → identifies contaminated units before transfusion.
(d) Pathogen reduction technology (e.g., INTERCEPT™ or Mirasol™) → inactivates bacteria, viruses, and parasites.
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ASCP Exam Questions
Which of the following blood components must be prepared within 8 hours after phlebotomy?
To preserve labile coagulation factors (especially Factor V and Factor VIII), Fresh Frozen Plasma (FFP) must be frozen solid at -18°C or colder within 8 hours of the whole blood collection.
a) Red Blood Cells: Typically prepared within 8 hours, but the critical time limit is for FFP and plasma-based components.
c) Red Blood Cells, Frozen: This process involves adding a cryoprotectant and can be done later, after the RBC unit has been stored.
d) Cryoprecipitated AHF: This is prepared from FFP, so it is indirectly subject to the 8-hour rule for the initial plasma freezing.
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ASCP Exam Questions
Which of the following constitutes permanent deferral status of a donor?
HBsAg (Hepatitis B surface Antigen) positive → indicates current or chronic hepatitis B infection → permanent deferral .
a) Tattoo 5 months previously → deferral is usually 3–12 months depending on whether it was done in a regulated facility (in many places now, if done in a licensed state-regulated facility, no deferral; if not, 12-month deferral). Not permanent.
b) Recent close contact with a patient with viral hepatitis → temporary deferral (usually 12 months after last contact).
c) 2 units of blood transfused 4 months previously → temporary deferral (12 months after transfusion).
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ASCP Exam Questions
Before donation, a brief physical exam includes:
The pre-donation physical is a brief assessment to ensure the donor is in good health for the procedure. It includes:
Temperature: To check for signs of infection.
Pulse: To assess heart rate and rhythm.
Blood pressure: To screen for hypotension or hypertension.
Hemoglobin (or hematocrit): To ensure the donor is not anemic.
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ASCP Exam Questions
Which component of CPDA-1 solution preserves red cell ATP levels?
In CPDA-1, adenine is the component that helps preserve red blood cell ATP (adenosine triphosphate) levels. ATP is the primary energy source for red cells, and maintaining adequate ATP levels is crucial for cell viability and membrane integrity during storage. Adenine is incorporated into ATP, extending the shelf life of Red Blood Cells to 35 days.
a) Citrate is the anticoagulant.
b) Dextrose provides energy for glycolysis.
c) Phosphate acts as a buffer.
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ASCP Exam Questions
Prior to blood donation, the intended venipuncture site must be cleaned with a scrub solution containing:
Before blood donation , the venipuncture site must be thoroughly cleaned to minimize the risk of bacterial contamination of the blood unit.
Standard procedure: This combination provides broad-spectrum antiseptic action against bacteria, viruses, and fungi.
Other options:
(a) Hypochlorite → used for disinfecting equipment or surfaces, not skin .
(b) Green soap → used for general cleaning, not sufficient for asepsis in blood collection.
(c) 10% acetone → harsh and not an antiseptic .
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ASCP Exam Questions
Permanent deferral applies to donors who:
Donors with confirmed positive tests for major transfusion-transmissible infections like Hepatitis B (surface antigen) and HIV are permanently deferred to protect the safety of the blood supply.
a) Have mild anemia: This is a temporary deferral until the condition is corrected.
c) Recently donated platelets: Apheresis platelet donors have a shorter waiting period (a few days to weeks), not a permanent deferral.
d) Traveled abroad: This often results in a temporary deferral based on malaria risk in the visited region.
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ASCP Exam Questions
Temporary deferral may occur for:
A recent vaccination typically results in a temporary deferral (the length depends on the type of vaccine) to avoid the risk of transmitting the live agent or because the donor might experience side effects that could be mistaken for a transfusion-related infection.
The other options are causes for permanent deferral :
b) HIV infection
c) Positive hepatitis B surface antigen
d) Heart disease (depending on the severity and history, but significant heart disease is usually a permanent deferral)
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ASCP Exam Questions
Which infectious disease is NOT routinely tested in donor screening?
The common cold virus (rhinovirus, etc.) is not tested for in donor screening. It is not considered a serious transfusion-transmitted infection, and testing is not feasible or necessary.
Routine screening includes:
a) Syphilis
c) West Nile virus (via NAT in endemic areas/seasons)
b) Malaria is not routinely tested for all donors, but donors are deferred based on travel history to endemic regions; however, it is not part of the standard universal test panel like syphilis or WNV. For this question, the clear non-routine agent is the common cold virus.
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ASCP Exam Questions
Plasma units are tested for syphilis using which method?
Plasma from blood donations is screened for syphilis using non-treponemal tests like the Rapid Plasma Reagin (RPR) or Venereal Disease Research Laboratory (VDRL) test. These are serological tests that detect antibodies to substances released by damaged host cells, which are often present during a syphilis infection.
b) ELISA is used for other infectious agents like HIV and Hepatitis.
c) Coombs test is for detecting red blood cell antibodies.
d) Western blot is a confirmatory test, not the primary screening method for syphilis in blood banks.
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ASCP Exam Questions
After donation, the donor should be advised to:
This is the standard post-donation advice. Drinking fluids helps restore the plasma volume lost during donation. Avoiding strenuous activity for a few hours prevents dizziness or fainting and allows the body to recover.
b) Taking antibiotics is unnecessary.
c) Sleep is not specifically required.
d) A cold compress is not standard; pressure is applied to the site to stop bleeding.
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ASCP Exam Questions
A donor who received a live vaccine may be deferred for:
Donors who have received a live attenuated vaccine (e.g., MMR, varicella, yellow fever) are temporarily deferred for 4 weeks .
This precaution ensures:
Safety of the recipient , as live virus could theoretically be transmitted
Accurate donor screening , since mild post-vaccination symptoms may mimic infection
Inactivated vaccines generally do not require deferral .
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ASCP Exam Questions
Upon inspection, a unit of Apheresis Platelets is noted to have visible clots. The technologist should:
Visible clots in a platelet unit are unusual and can be a sign of bacterial contamination . Bacteria can release pro-coagulant substances that activate the clotting cascade within the bag. Therefore, the unit must be quarantined and not transfused. It should be sent for further investigation, such as a Gram stain and culture, to rule out contamination.
a) Issue without concern: This is incorrect and dangerous, as it could lead to a septic transfusion reaction.
b) Filter to remove the clots: A standard blood filter will not remove bacteria, and the underlying cause of the clotting (potential contamination) remains.
c) Centrifuge to express off the clots: This is not a standard procedure and would not address the potential for bacterial contamination.
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ASCP Exam Questions
A sample from an Apheresis Platelet undergoing culture-based testing indicates bacterial growth. What must be done immediately?
AABB Standards require that when a platelet unit is reported as positive by a culture-based bacterial detection method, the blood bank or transfusion service must immediately take action to prevent transfusion. If the unit has already been issued (sent to the floor or released for a patient), it must be retrieved and quarantined. This is the most urgent and critical step to ensure patient safety.
The other actions are important but secondary:
a) Set up another culture to confirm positivity: This may be done for quality control, but the initial positive result triggers immediate action to block transfusion.
b) Determine sensitivity to antibiotics and d) Identify the organism: These are follow-up procedures that aid in patient management if a transfusion has already occurred, but they do not take precedence over preventing the transfusion in the first place.
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ASCP Exam Questions
What is the primary reason that infectious agents can be transmitted following blood transfusion?
The primary reason is the window period —the time after a donor is infected but before a screening test can detect the infection (because markers like viral antigens or nucleic acids are still below detectable levels, or antibodies have not yet formed). During this window, an infected unit can test negative and be released for transfusion.
The other options, while potential failures, are not the primary reason:
a) Pathogen reduction technology failure: Not all components undergo PRT; it’s not a universal primary cause.
c) Leukocyte-reduction failure: This is for reducing white cell-related complications, not primarily for preventing most infectious transmissions.
d) Donor history questionnaire not completed: This is a procedural error, but the core challenge is the biological window period.
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ASCP Exam Questions
What is the minimum hemoglobin concentration required for a male blood donor?
According to AABB , WHO , and most national blood donation standards , the minimum hemoglobin concentration required for blood donation is:
Males: ≥ 12.5 g/dL
Females: ≥ 12.5 g/dL
This ensures that the donor has sufficient red cell mass to safely tolerate blood loss without becoming anemic after donation.
Incorrect options:
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ASCP Exam Questions
A donor who has just donated 2 units of Apheresis Red Blood Cells will be deferred from further blood donation for a minimum of how many weeks?
Donors who give two units of Apheresis Red Blood Cells (Double RBC donation) lose approximately twice the amount of red cells compared to a whole blood donation.
Incorrect options:
(a) 8 weeks → for whole blood donation only.
(b) 12 weeks → not standard for any donation type.
(d) 24 weeks → longer than necessary.
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ASCP Exam Questions
The anticoagulant most commonly used in blood collection bags is:
CPDA-1 is the most common anticoagulant-preservative solution used in collection bags for whole blood that will be processed into components like Red Blood Cells. It contains:
Citrate: Anticoagulant (chelates calcium).
Phosphate: Buffers pH.
Dextrose: Nutrient for red cells.
Adenine: Extends RBC shelf life to 35 days.
a) Heparin: Used in some medical procedures but not for routine blood bank storage.
b) EDTA: Used in small sample tubes for lab testing, not for blood collection for transfusion.
d) Sodium citrate: Used in apheresis collections and plasma samples, but CPDA-1 is the standard for whole blood bags.
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ASCP Exam Questions
Blood pressure limits for donation are generally:
Blood pressure limits for blood donation are set to ensure donor safety:
Systolic: 90–180 mmHg
Diastolic: 50–100 mmHg
Donors below 90/50 mmHg may be at risk of hypotensive reactions.
Donors above 180/100 mmHg may be at risk of cardiovascular complications.
Exact 120/80 mmHg is ideal but not required; a safe range is acceptable.
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ASCP Exam Questions
Which of the following infectious agents relies solely on donor questioning to avoid transmission from transfused blood products?
a) Trypanosoma cruzi (Chagas disease): Donor questioning is used, but there is also an FDA-licensed blood donor screening test. It does not rely solely on questioning.
b) Plasmodium falciparum (a cause of malaria): There is no FDA-licensed blood test to screen donors for malaria. Prevention of transfusion-transmitted malaria relies entirely on donor questioning about travel and residence history in malaria-endemic areas and previous history of malaria.
c) HCV (Hepatitis C Virus): Relies primarily on highly sensitive and specific laboratory tests (nucleic acid testing and serology), not on donor questioning.
d) CMV (Cytomegalovirus): There is no routine donor questioning for CMV. Instead, it is managed by providing CMV-seronegative or leukoreduced blood products to at-risk patients. Laboratory testing is available to determine a donor’s CMV status.
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ASCP Exam Questions
A sample of blood from each allogeneic donation is tested for which of the following infectious disease agents?
HBsAg, HIV-1/2, P. falciparum, Babesia species
Dengue virus, syphilis, HCV, HBV
HBV, HCV, CMV, T. cruzi
HIV-1/2, HTLV-I/II, WNV, HCV
According to AABB and FDA requirements, all allogeneic blood donations must be tested for specific infectious disease markers to ensure transfusion safety.
Option analysis:
(a) Includes four key required agents.
(b) Includes CMV and T. cruzi — CMV is not routinely tested for all donations.
(c) Includes P. falciparum and Babesia — only regionally tested, not for all.
(d) Dengue testing is not required for donor screening.
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ASCP Exam Questions
Apheresis Platelets that will undergo pathogen reduction technology do NOT require:
Pathogen reduction technology (PRT) is designed to inactivate a broad range of pathogens, including bacteria. Therefore, for platelet components that have undergone approved PRT, AABB Standards allow for the discontinuation of routine bacterial testing (culture-based testing).
The other options are still required:
a) Hepatitis B virus NAT and c) West Nile virus NAT: PRT does not eliminate the requirement for mandatory infectious disease testing for HBV, HIV, HCV, etc., or for seasonal/residual NAT testing like WNV.
d) ABO and Rh testing: This is always required for proper labeling and transfusion compatibility.
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ASCP Exam Questions
The primary goal of donor screening is to:
The primary goal of donor screening (via the health history questionnaire and physical exam) is to protect both the donor (by ensuring they are healthy enough to donate blood without harm) and the recipient (by identifying risks that could transmit disease or cause a transfusion reaction).
a) Increasing donation frequency is an operational goal, not the primary purpose of screening.
c) Identifying rare blood groups is a beneficial outcome, but not the main goal of screening.
d) Detecting Rh antibodies is part of laboratory testing, not the core purpose of donor screening.
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ASCP Exam Questions
The first few milliliters of collected blood are used for:
The initial blood drawn (usually the first 10-40 mL) is diverted into a pouch or tubes separate from the main collection bag . This blood is more likely to contain skin cells and bacteria from the venipuncture site. Using this portion for laboratory testing (like infectious disease screening and blood typing) helps prevent contamination of the main transfusion unit.
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ASCP
American Society for Clinical Pathology (USA)
AMT
American Medical Technologists (USA)
AIMS
Australian Institute of Medical and Clinical Scientists
CSMLS
Canadian Society for Medical Laboratory Science
IBMS
Institute of Biomedical Science (UK)
HAAD
Health Authority - Abu Dhabi
MOH
Ministry of Health (UAE)
DHA
Dubai Health Authority
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