|Red Blood Cells (10006427, 10006423)
The patient must have a current Type and Crossmatch or Type and Screen before RBC products can be issued for transfusion. In emergency situations, the physician may sign a waiver for release of blood products prior to the completion of testing. Hematology testing may be required for some groups of patients before RBC products are released for transfusion. A telephone consultation with a blood bank physician may be necessary in some circumstances, and the UTMB Transfusion Committee may review some transfusion orders.
Transfusion of RBC products must be completed within 4 hours of the time they are dispensed from the blood bank unless stored in a validated blood bank cooler. Units will be dispensed in a cooler to the OR or whenever two or more units are issued to a patient unless the patient has multiple lines for simultaneous transfusion.
|Causes for Rejection:
Failure to meet laboratory or clinical indications as specified in the Guidelines for Transfusion of Blood and Blood Components
STAT: one hour to complete Type and Screen or Type and Crossmatch if antibody screen is negative; RBC units can be ready simultaneous to the completion of the Type and Screen or Type and Crossmatch; additional units can be crossmatched in 5-10 minutes. If the antibody screen is positive, additional testing time will be necessary to complete the Type and Crossmatch and crossmatches for additional units. Contact the Blood Bank laboratory for time estimates due to the variability of patient testing requirements for resolution of a positive antibody screen.
Compatibility testing method varies based on patient antibody screen results and history of clinically significant antibodies.
Red Blood Cell products can be ordered and picked up from the Blood Bank lab 24 hours per day (Clinical Services Wing 4.404, phone 409-772-1524).
Packed Red Cells, Red Blood Cells for Transfusion, Leukocyte Reduced Red Cells, RBC, PRBC
Refer to the UTMB Guidelines for Transfusion of Blood and Blood Components (also known as Transfusion Criteria); a link can be found on the homepage of the Laboratory Survival Guide.
One unit of packed red blood cells (RBC) in an adult and 10mL/kg in a pediatric patient will increase the hematocrit by approximately 3% and hemoglobin by 1 g/dL in a normovolemic patient.
Documentation of clinical and laboratory response to transfusion of RBC is recommended within 24 hours after the transfusion is completed.
|CPT 4 Code:
A Blood Bank physician is always available for telephone consultation regarding the use and dosage of blood and blood components, including Red Blood Cells (RBC).
|When ordering tests for which Medicare or Medicaid reimbursement will be sought, physicians should only order tests that are medically necessary for the diagnosis or treatment of the patient. Components of the organ or disease panels may be ordered individually. The diagnostic information must substantiate all tests ordered and must be in the form of an ICD-10 code or its verbal equivalent.