Type and screen on all Moms??

[leslieweber]

Hi

We currently perform T and S on about 20% of our Moms to be here- the rest have hold specs drawn for BB. Many of them come in with results from another provider and that info is stored in their chart. The RN is responsible for ordering RhIg based on either the result we obtain or the historical result from another institution. We have had rare cases with a massive bleed where the lack of a current tested spec in house is a problem.

They are proposing ordering a T and S on ALL Moms - regardless of history of type with other accreditated institution or maternal risk. While I like the idea of always having a tested spec in the BB- it will cause an big increase in work and of course the majority of the Moms never need blood

What do you do?

Thank you

Leslie

Thank you.

[John C. Staley]

We have a "hold clot" drawn on all OB patients when they are admitted and then perform any testing as ordered by the physician. We feel that testing evey sample would be way over the top but having a sample in hand during a crisis adds a great deal of comfort as well as speeding the process. The vast majority of these hold clots have no testing done, no charges generated and are simply discarded.

[Mabel Adams]

We do the same as John. It saves trying to get a sample from a hemorrhaging patient with no BP in a crisis and saves the time of the draw then as well as in more mundane needs without costing much or requiring much work.

[DANDERS]

In our 129-bed hospital, we do a TS and a Hemogram on all OBs.

[OPUS104]

Just wondering.........are the "hold" clot tubes banded with transfusion info?

[Cathy]

Our OB patients also have a CBC and hold sample drawn upon admission. The hold specimen is banded for possible transfusion. The type and screen is usually requested for c-sections, and as needed otherwise.

We get all the cord bloods to hold for two weeks. When we close out this cord storage order, we fill in the mother's type. It is a required field so if the floor forgets to order a workup on an Rh neg mom, we will catch it. If we don't have a type on file, we perform a type at no charge to the patient on that hold sample.

[Karen Olsen]

We perform a T&S on all moms. We have found that on rare occasions the blood type provided by an outside source is incorrect or incorrectly documented on the chart. We also have a large population of patients that have had little or no pre-natal care. To make matters worse we have had patients who use someone elses identification when admitted with obvious negative impact. I realize these are unique situations but thought it might help to explain the why behind the T&S on all moms!

[John C. Staley]

To answer Opus124's question, Yes the "hold clot" is treated like any pre-transfusion sample. If needed it is ready for use.

Oddly enough we try to make the physicians responsible for the care of their patients. If they don't have any prenatal records for their patients it is their responsibility to order the testing and we are more than happy to perform it.