Neonate Transfusion Workup

[msmc]

I am currently reviewing our SOPs and am wondering how others out there perform compatibility testing on neonates. For babies born in house we type the cord and complete a DAT. We choose washed O red cells and crossmatch with the mom's plasma. For babies born elsewhere we type and perform a DAT as well as a total crossmatch on a heelstick. My experience at another hospital was to type the cord and a heelstick (second ABO/Rh) and issue type specific red cells(also testing for passive ABO antibodies where appropriate) using a computer crossmatch (if mom's type and screen available). If the baby was born elsewhere we would do a type and screen including a passive screen when needed from a heelstick and a second ABO/Rh from a separate draw. I would like to convince the staff here that this is appropriate and less time consuming. What is everyone else doing out there?

Thanks

[Karen Olsen]

We perform a type and Rh and DAT on baby and give O Neg blood. If we have to give type specific or compatible non O we would perform the compatibility studies by taking the reverse cells through coombs as appropriate. We do not perform a screen on baby unless we have nothing on Mom or Mom has antibodies. In the latter case we would crossmatch with Mom's serum.

[John C. Staley]

We perform a type and screen on the baby. Cord blood is unacceptable due to nursings inability to ever get the correct label on a cord blood. We transfuse type specific for the baby. No crossmatches unless there in an antibody involved. Antibody is generally identified in mom and mom's serum used for the AHG crossmatch.

[Cathy]

We do a type and coombs on the baby, heelstick if the cord is unavailable. If the mom is available, we do an antibody screen on her, (on the baby if she is not). We always give group O rbcs. As long as the baby remains inhouse, we do not repeat the testing for up to 4 months. We do not crossmatch.

[Karen Olsen]

I didn't specify in my original post - but we do not use the cord blood for transfusion purposes. They are not labeled or collected as per our strict P&P. Our NICU nurses draw the baby and apply the BB armband to baby's ankle.

[Eagle Eye]

We do ABO RH & DAT on all cord specimen but require new specimen for all those who needs transfusion. We do the samething on heelstick specimen.(ABORH & DAT). If baby is transferred from other hospital we do type and DAT (& screen if mom's history is not available).