My night shift tech had a strange situation to handle. A teenage girl was brought to the ER for hemoptysis. The physician ordered 2 units of blood, and asked that we emergency-release O negatives. While the tech starting preparing the units, a phlebotomist ran to the ER to draw a crossmatch sample, but her parents refused to allow her to be stuck (even though presumably they had agreed to the transfusion). The tech called the physician to explain that we still had to crossmatch the units, even if they were emergency-released and already hanging before the crossmatch was complete. By the time she was able to get it all explained, the physician had decided to fly the patient to a children's hospital 4 hours away, so he canceled the emergency released units. I've never had a patient willing to take blood but unwilling to provide a sample for crossmatch. I'm glad the nightshift tech stuck to her guns, but what if the doctor had insisted that the patient's life was in danger without immediate transfusion - what would be the right thing to do in those circumstances?
