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Pre-Transfusion Two-Blood Group Policy


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Hello From Down Under, 

My hospital has implemented the two blood group policy for giving group specific red cells. I have had a question from our head anaesthetist about evidence that this practice is safer?  Does anyone have any links to evidence or where it is written in any other guidelines around the world?


Kelli Quantock - Mater Hospital Brisbane, Australia

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I always 'balk' at this idea because as we all know, the probability of two patients having the same blood type is high.  We have had a few instances over the past few years where a wrong patient was drawn (we use BB Bands so it's very obvious) and they were the same blood type but one had antibodies and the other didn't.  

And yes, there are those who have had to come up with 'defensive measures' to 'assure' that there is no 'cheating', e.g. RN draws 2 samples and holds one in case the BB asks for a second, a witness (do you really think that happens as intended?), different colored tubes for the second draw (assuming they don't draw the wrong patient twice).

I could go on and on about this ... but that wasn't your question, was it?

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As Joanne mentioned above, no system is fool proof and there are lots of creative, inventive fools to prove it.  Keep your system as simple as possible which should minimize the need for creative people to find ways around it.  Now to your question, does it actually help prevent problems?  Probably a few but certainly not all!  I've seen people become lax in their diligence when they assume they are protected by the system.  They seem to assume that if they make a mistake someone down the line with catch it.  This is something to be avoided if possible.  The only way that I know of to prevent this type of mind set from developing is through education and convincing everyone involved in the process that their step is critical and by keeping it simple they will be more likely to perform their step as instructed.  


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