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Transfusion Services Center 

Transfusion Service Frequently Asked Questions

1. What is the difference between a "Type & Cross" and a "Type & Screen"?
2. What happens if the patient should need blood and only a Type & Screen was requested?
3. What is a "antibody screen"?
4. The physician ordered a "coombs" test and the Laboratory Survival Guide lists a Direct and Indirect.  What is the difference?
5. My patient's blood type is Group O and I was given A plasma for transfusion.  Is this ok?
6. My patient is B+ but I received O+ blood.  Is this ok?
7. What should I do if my patient has a transfusion reaction?
8. How do we request blood or blood products for transfusion?
9. What do I need to pick up a unit of blood from the blood bank? 
10. How long does it take to find compatible blood?

1.  What is the difference between a "Type & Cross" and a "Type & Screen"?

"Type & Cross" is usually requested when the potential for blood use is high (eg. trauma, open heart surgery, etc).  The physician will request a crossmatch along with an ABO/Rh blood type and antibody screen.  In the crossmatch, the patient's blood and donor blood are tested for compatibility.  

"Type and screen" may be requested in circumstances not likely to require transfusion, such as elective surgery. The patient's ABO/Rh blood type is determined, and an antibody screen is done.  No blood is crossmatched.

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2.  What happens if the patient should need blood and only a Type and Screen was requested?

Because the ABO, Rh and antibody screen have been completed, blood can be crossmatched within a few minutes.  In most cases the blood will be crossmatched and ready to issue before they arrive to pick up the blood.   If the patient had a positive antibody screen, a crossmatch would have automatically been performed and compatible blood would have been found and made available for that patient. 

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3.  What is a "antibody screen"?

In the antibody screen (also known as the Indirect Antiglobulin Test (IAT) or Indirect Coombs Test)  the patients serum is screened for irregular or clinically significant antibodies to other red cell antigens.  These antibodies can be found in patients who have had previous transfusions or pregnancies.  When present, these antibodies can limit the number of compatible units found for the patient.   

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4.  The physician ordered a "coombs" test and the laboratory survival guide lists a Direct and Indirect.  What is the difference?

Two.  In 1945, Coombs, Mourant and Race described the use of  antihuman globulin (later known as the “Coombs Test”) to aid in identifying antibodies.  Traditionally, the physician ordered a "Coombs Test".  However, this antihuman globulin is now used to detect antibodies in the patients serum (Indirect Coombs test, see question 3) or to if antibodies are attached to the patient's red blood cells (Direct Coombs Test).  This occurs in conditions such as autoimmune diseases, delayed transfusion reactions or hemolytic disease of the newborn.  

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5.  My patient's blood type is Group O and I was given Group A plasma for transfusion.  Is this ok?

In most instances we try to issue ABO identical plasma products.  However, at times it may be necessary to provide plasma of a different blood type (eg. lack of ABO identical plasma due to shortages or rare blood type).  However, when giving plasma products such as platelets, cryoprecipitate or fresh frozen it is important to know which ABO antibodies are present in the "donor's" plasma.  Failure to provide ABO compatible plasma products can result in severe transfusion reactions.  

As noted in the table below, because AB plasma does not contain ABO antibodies, it can be given to a patient with any blood type.  Because Group O patients do not have A or B antigens on their red blood cells, they can receive plasma of any blood type.  

Patient's Red Cell Blood Type	Antigens found on Patient's Red Cells	Donor Plasma Blood Type
		AB	A	B	O
		Antibodies present in donor plasma
		none	anti-B	anti-A	anti-A & anti-B
AB	A&B
A	A only
B	B only
O	None

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6.  My patient is B+ but I received O+ blood.  Is this ok to transfuse?

Yes, the blood types are compatible.  Again in most instances, we will try to provide ABO identical blood.  However, at times the patient's blood type may not be available and another blood type may be substituted.  As shown in the table below, O- blood , the universal donor, can be given to anyone.  AB+ individuals (universal recipient) can receive blood of any blood type.     

If your blood type is	You can receive
	O-	O+	A-	A+	B-	B+	AB-	AB+
AB+
AB-
A+
A-
B+
B-
O+
O-

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7.  What should I do if my patient has a transfusion reaction?

In case of a suspected transfusion reaction, please follow the instructions provided on the back of each "Blood Transfusion Record Tag".  This tag is attached to each blood product when it was issued.  

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8.  How do we request blood or blood products for transfusion?

Blood or blood products can be requested through the Physician Order Entry (POE) system or by completing the Blood Bank Divisional "Primary Request Form".  If a patient's specimen is required, the request must include the requesting physician’s name and ID number, patient's name, UH #, patient location, clinical information/diagnosis, identity of phlebotomist and date and time the patient's specimen was collected.

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9.  What do I need to pick up a unit of blood from the Blood Bank?

Currently under construction.  Please contact blood bank at ext. 21524

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10.  How long does it take to find compatible blood?

Currently under construction.  Please contact blood bank at ext. 21524

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