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 Blood Bank Laboratory Testing and 

Ordering Blood Components

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NOTICE:

 

Blood and blood components must be ordered by a Licensed Independent Practitioner (LIP) such as a physician or nurse practitioner. Transfusions should only be prescribed for a patient when the benefit of transfusion is likely to outweigh the risk. Refer to the UTMB Transfusion Guidelines for additional information.

Click here for Transfusion Services STAT Turn Around Times.

For Emergency Blood Product Usage, please click here.  

 

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Pre-Transfusion Testing

Correctly identifying the patient during collection of the pre-transfusion sample is vital in avoiding 'wrong blood to wrong patient' episodes.

All specimen collection and labeling must be done in accordance with the UTMB IHOP Policy 09.13.29 - Transfusion of Blood Components.

Pre-Transfusion compatibility testing prior to transfusion involves the following:

TYPE & SCREEN TESTING

  • ABO/RH Identification
  • Red Cell Antibody Screen to detect red cell antibodies
    • For patients who have 'no red cell antibodies detected,' compatible units are selected and issued electronically.
    • For patients who have 'red cell antibodies detected,' further laboratory work is required to identify the specificity of the antibody, to type the patient and donor units in order to provide specific antigen negative blood and to perform a full serological crossmatch. For patients with multiple antibodies, this work can take several hours to complete. 
    Two ABO/RH identifications MUST be on file to obtain blood components. Otherwise, emergency units and an emergency release waiver will be needed. 

ABORH CONFIRMATION TESTING

  • ABO/RH Confirmation

 

NOTE: Having a T&S ready and available for patients who may need a transfusion allows for quicker dispensing of necessary blood component when the need is determined.

FYI: If a patient is discharged or transferred from another UTMB facility, they will require a new Type and Screen collection.

Specimen Expiration:

Compatibility testing (Type and Screen sample collected to be used for transfusion) is to be repeated every 3 days, as indicated. The Type and Screen sample expires at midnight on the 3rd day after it was drawn. 

  • For Adults: The specimen expires at midnight 3 days after the specimen was collected. (Example, collected Tuesday, would expire Friday at 23:59).
  • For Infants ≥ 4 months of age, the expiration of the compatibility specimen follows the same principle as adults.
  • For Neonates < 4 months of age, the specimen expires when the infant turns 4-months of age or is discharged, whichever comes first.

FYI: If a patient is discharged or transferred from another UTMB facility, they will require a new Type and Screen collection.

Reminder: If the antibody screen is positive there will be an inherent delay to find the correct component that is compatible for the patient. The delay can range from 1-2 hours or possibly even days depending on the complexity.

 

Specimen Requirements:

  • All requests must include requesting physician's name and ID number, patient's complete name, UH number, current account number, patient location, clinical information/diagnosis, identity of phlebotomist and verifier, and date/time of sample collection.

  • The specimen must be labeled with the patient's full name and UH number. Specimens should be transported to the laboratory in a biohazard specimen bag with the request form in the pocket of the bag. All information must be complete and legible on the specimen and the requisition.

Causes for Specimen Rejection

  • Not performing Positive Patient Identification (PPID)
  • Not saving collection information
  • Incorrect or incomplete collection information
  • Incorrect or incomplete patient identifiers
  • No label on tube
  • Mixing Epic Beaker process with Downtime 
  • Wrong tube type
  • Gross hemolysis
  • Diluted specimen
  • QNS

NOTE: If a specimen is rejected, a Blood Bank technologist will contact the nurse or physician of the rejection and need for re-collection.

Ordering Blood Components

Blood components must be ordered by an Advanced Practice Professional (APP) such as a physician or nurse practitioner. Transfusions should only be prescribed for patients when the benefit of the transfusion is likely to outweigh the risk.

  • For detailed information, please refer to Guidelines for Transfusion of Blood and Blood Components  
  • Under Useful Resources at the bottom of each page are Epic Resources for Nurses and Providers for information regarding blood product administration and ordering products
  • For the APAC Surgical Blood Ordering Schedule, click here

    Useful Resources

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    Transfusion Services Quick Tools

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