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Second ABO/Rh tests prior to transfusion


John C. Staley
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18 hours ago, John C. Staley said:

Wow, just wow.  I can't even imagine a blood banker in the US considering this as acceptable.  Our usual assumption has always been, if we didn't do it then it's probably wrong.  Our paranoia runs deep and swift.  Now, before anyone gets too upset with me please know that I was one of you for 35 years so I can play the what if game with the best of you.  I'm just noting what I observed over many years.  If anyone in the US is actually accepting the results from other facilities at face value and acting on them, please let me know, I would love to be wrong.

:coffeecup:

 

At my previous hospital we would accept and use a historical ABO from another lab but only if it came from within our hospital system.

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We have 2 sister hospitals in our system and we share the same database. When they enter a blood type, it updates our database to show the patient has a blood type. In fact it can be confusing to us when one of their patients has a crossmatch completed and then are transferred to us. If we look in the computer when a nurse calls and it looks like the patient has blood ready here.

In fact I called CAP once to ask if we had to perform a new T/S when a patient is transferred to us from one of these sister hospitals. She said no, as long as we shared a database of info and if the patient had a transfusion reaction, we had a process to get the original specimen to do the workup. We always get a new sample but you know how exciting it can get when a bleeding patient is transferred. It is nice to know we have the option to do a quick computer crossmatch.

As far as accepting an ABORH from another hospital, never, nope, nada! Type O until we get a second type. We don't trust ABO's from hospitals who are not part of our system. 

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From the  hospitals in the system since we follow the same procedures , perform the same competencies and share the same data base we accept the results. Although we do perform another ABORH (not a standard just our process).

From another hospital system we will honor any antibody that is reported, just to be safe( never the ABORH). We have a test that we can order that allows us to entered it into computer without charging the patient for a test we didn't do but stops someone from issuing blood not antigen negative for that antibody.

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We share an LIS with a couple of other hospitals.  We allow those previous blood groups to be the confirmation sample.

We have access to a validated computer system that pulls results from other hospital LIS systems and matches using a unique ID (here in Ontario Canada it is the OHIP number).  Names/DOB are double checked.  We allow those for the second blood group as well.

All our labs are accredited.  I'm not sure what the difference between using the other hospital result in the LIS vs the other validated computer system would be.

Also... my experience has been that blood testing done recently is MUCH more reliable than testing from many years ago - even if in the same hospital.  Use of automation and positive patient ID systems has greatly reduced the risk of error.

sandra

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  • 1 month later...
On 5/3/2021 at 2:59 PM, Malcolm Needs said:

And if the blood in the tube was taken from the wrong patient?

Then a phlebotomist is in deep doo? We do a two person witness on BB collections. Something I guess.

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On 5/20/2021 at 9:22 AM, John C. Staley said:

Wow, just wow.  I can't even imagine a blood banker in the US considering this as acceptable.  Our usual assumption has always been, if we didn't do it then it's probably wrong.  Our paranoia runs deep and swift.  Now, before anyone gets too upset with me please know that I was one of you for 35 years so I can play the what if game with the best of you.  I'm just noting what I observed over many years.  If anyone in the US is actually accepting the results from other facilities at face value and acting on them, please let me know, I would love to be wrong.

:coffeecup:

I would love a national medical record so we could all have access to the type of anyone that walks through the door and has a history.

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On 5/20/2021 at 9:22 AM, John C. Staley said:

Wow, just wow.  I can't even imagine a blood banker in the US considering this as acceptable.  Our usual assumption has always been, if we didn't do it then it's probably wrong.  Our paranoia runs deep and swift.  Now, before anyone gets too upset with me please know that I was one of you for 35 years so I can play the what if game with the best of you.  I'm just noting what I observed over many years.  If anyone in the US is actually accepting the results from other facilities at face value and acting on them, please let me know, I would love to be wrong.

:coffeecup:

I agree John.  We would informally file the info but never act on it.  The only thing I would consider is an antibody ID from one of the teaching hospitals, and even then as a guide, but I would have to respect their id.  We also will not accept a specimen not obtained by our organization.  We will only accept ambulance specimens if we have a history on the patient.  No history, new sample. 

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  • 2 weeks later...
On 10/8/2004 at 8:48 PM, Dawn said:

We require a second ABO/Rh for all new patients. We use the same tube. Currently we do not bill for this testing. But we are moving to electronic crossmatch and will lose the revenue we previously earned from immediate spin crossmatches. So we will begin to bill for this second ABO/Rh.

Interesting! We still do not charge for our ABO Rechecks while having the electronic crossmatch capability.  Is this something that is billable? 

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  • 1 month later...

32 years of hospital TS, multiple facilities and states.  I have seen a lot.  We-

Never accept outside Blood Types. Always honor other facilities non-ABO antibodies (unless it does not make sense).  Never type the same sample for ABORh Confirmation (do not agree with the AABB on that one.), Electronic bracelet or not.  WBIT is real.  Never bill for ABORh Confirmation, as we should get it right the first time.  It's standard of care, so not billable here.

 

 

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       We do a second tube and have a different person draw it. We place the order for the second tube once we get the first tube. If not, we are sure they are drawn the same time especially by nursing. We do charge for the second type. Our first tube must be drawn by positive patient ID. We do know that positive patient ID this can be completed and still draw the wrong patient. I have seen this in a previous job. 

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