Requiring two ABO's on pretransfusion patients

[Brenda K Hutson]

Well, then your anesthesia group is more "user friendly" than ours proved to be! They are simply refusing to replace the band anywhere while the patient is in surgery. They just pretty much told the Medical Director that they will cut them off (regarless of where it was placed) and that they do not want them on during surgery. But having worked elsewhere where the OR wasn't even allowed to cut them off, it clearly is not an issue of what "can" be done; but what they "will or will not" do!

Brenda

Like Brenda we have had issues with the patient's BB ID being removed in the surgery suite. Working with surgery we attempt to place the ID band on the side opposite the surgery site. This has helped improve the process as well as having a good relationship with the anesthesia groups serving our facilities (they are normally the "culprits" removing the ID bands during surgery). Not perfect by a long shot, but better than in the past.

[Brenda K Hutson]

I do not use the typenex armband # as one of the unique identifiers. It is referenced as a possibility in the Technical Manual, but to me, a unique identifier is something that will not change from admission to admission (Name, D.O.B., Hospital MR#). I would not call another Hospital for results on a patient of mine that had been there, and say "do you have results on the patient whose armband # is......" But that is just my own bias. So for inpatients, they use the name and MR#; for outpatients, the name and D.O.B. So that information is on the typenex band. You may say, "why do you need that if they also have a white hospital band on?"

1. Not every patient will have a red armband; only the ones drawn for the Transfusion Service. In the case I know of where the absence of a red armband saved the incorrect patient from being transfused, the phlebotomist had gone into the room and asked the patient "are you John Smith; for example;" rather than "tell me your name." The patient that was supposed to be drawn, had been moved to another room. Now before you all start thinking "well who would want a phlebotomist like that working for you anyway," let me just say that it was ME! In my last year of college, I worked as a phlebotomist in a small hospital. It wasn't the greatest Hospital, I have to say; and I did not get much training. I certainly learned my lesson from that (and it is then somewhat ironic that I went on to be a Blood Bank Specialist) but when I was in my Med Tech Internship (at a very good Medical Center) and we had phlebotomy training, we were adamantly told to ask the patient their name. But the Nurse did not transfuse the patient when she could not find the red armband.

2. It is a closed system with that same typenex number going onto the specimen and armband at the time of draw (then into the Blood Bank computer system; thus printing out on the paperwork that is attached to the unit); a little extra measure of safety.

But again, I think there are pros and cons; and better solutions are on the horizon.

Brenda Hutson, CLS(ASCP)SBB

I do not like the idea of blood bank armbands. You buy a box of a 1000. Patient Jones gets BB0001. Patient Smith gets BB0002. Yes each patient gets a unique identifier but the "uniqueness" is a one character change. The advantage of a second sample is the statistical probablity of two mislabeled samples is significantly greater than the possibility someone miss reading a armband.