rrcc1974 Posted March 3, 2008 Share Posted March 3, 2008 We are Meditech C/S and have a Blood Type Newborn group and a Blood Type Cord group. The Newborn is used to test heelpoke samples and the Cord is only for cord blood samples. Currently the Blood Type Cord is updating the BBK History. I feel this needs to be changed. I believe the cord blood specimen is not ideal for creating a blood type in a patient's history which then could be used as a historical blood type for Type & Screens/Crossmatches. Please comment. Link to comment Share on other sites More sharing options...
Mabel Adams Posted March 3, 2008 Share Posted March 3, 2008 Whichever specimen gives you the most positive ID of the patient would be paramount. The other factors that may be involved with testing newborns (subgroup expression, no reverse etc.) would be the same whether it is cord blood or not. I have never seen Wharton's Jelly interference, but that is the only other difference I can think of. Link to comment Share on other sites More sharing options...
Mary Posted March 3, 2008 Share Posted March 3, 2008 Another complication to having these post as a historical type is when the weak D cannot be determined due to a positive direct coombs test. Link to comment Share on other sites More sharing options...
Lcsmrz Posted March 4, 2008 Share Posted March 4, 2008 We have an occasional problem with positive ID of cord bloods -- nurses are "too busy" at delivery to properly label the sample, so it sits around in the room or at the nurse's station until they get a chance.We refuse to use them for crossmatch testing ... Link to comment Share on other sites More sharing options...
Eagle Eye Posted March 4, 2008 Share Posted March 4, 2008 We do not use cord result for crossmatching/issuing the blood. If patient require transfusion, we get 2nd specimen which is collected from heelstick. Link to comment Share on other sites More sharing options...
cinbb Posted April 6, 2009 Share Posted April 6, 2009 We use cord for ABOR and DAT only. If cord sample is >24 hrs. old we require a heelstick sample. For crossmatch we prefer Mom's sample to crossmatch, but will use heelstick when Mom is not available. Do other facilities have the cord blood labeled with Mom's info or Baby's info? This is a point I'd like to hear about. Link to comment Share on other sites More sharing options...
John C. Staley Posted April 6, 2009 Share Posted April 6, 2009 Maybe the question really is: "If I don't consider a cord blood sample as acceptable for "REAL" testing then why would I want to consider it as a historically valid type for comparrison with future testing?" I can't answer that for you and not even sure if I can answer it for myself but then I don't have to any more. Link to comment Share on other sites More sharing options...
AMcCord Posted April 6, 2009 Share Posted April 6, 2009 As to labeling cord bloods, since the type is baby's, our primary label info is baby's. The cord blood panel is ordered on baby's visit ID. The label does also include mother's name and med record # so we can cross reference for possible RhoGAM. Link to comment Share on other sites More sharing options...
galvania Posted April 7, 2009 Share Posted April 7, 2009 Surely you would not want to use anything for a historical group that cannot be fully grouped ie forward and reverse?? Link to comment Share on other sites More sharing options...
KarenJ Posted April 8, 2009 Share Posted April 8, 2009 We do not use cords for historical types due to all the reasons already stated. Our labor nurses label with preprinted computer labels, and rarely even date time and initial. It was pointed out to them that no other area is allowed to use preprinted labels and they were shocked that hand labelling and bedside identification was required. What can you do??? Link to comment Share on other sites More sharing options...
Mary** Posted April 8, 2009 Share Posted April 8, 2009 :cool:Will it ever get better? Link to comment Share on other sites More sharing options...
adiescast Posted April 8, 2009 Share Posted April 8, 2009 (edited) The cord blood does not update our ABO/Rh record for an infant. We use the heelstick sample for the type and screen before issuing blood for an infant. I have wondered about using the cord sample as the "second type" because you would not get a back type on an infant anyway. We are relying on the cord blood sample for RhIg eligibility determination. If it is OK to use to treat Mom, why is it not OK to use for a confirmatory type for the infant?Cindy - we have the mother's information on the cord blood label because nursing claims they do not have the infant's information at the time the cord blood is collected. They hand write the baby's gender and label it with letters for a multiple birth. Edited April 8, 2009 by adiescast answered question about cord label Link to comment Share on other sites More sharing options...
whbb Posted April 8, 2009 Share Posted April 8, 2009 Our facility has been using Meditech since 1997, and we have never had to edit a cord blood type. I believe the usefulness of having the cord blood type in history outweighs the remote possibility that it is incorrect. There is a reason why this blood type is reported as the "cord blood" type. We would not use the cord blood results for transfusion purposes.Although our cord bloods are labeled with the mother's information, Meditech has a built-in connection to the infant's information. The two admit infos are available on both the infant and mother's account. Prior to having this connection, we added queries for the nurses to answer so we would have the mother's info at the time the order is being created.The cord blood type is a "temporary" blood type for an infant. If we were unable to determine the Rh of an infant due to a positive DAT, we would call them Rh negative until we could prove it otherwise. We would add a comment to their history.I tried something that may help Meditech users. If you DID NOT want to report to history the blood type from a cord blood, consider the following:1) Remove the blood type interpretation from the cord blood type test. You could either create a new T-type test and enter the blood type (make it reportable), or do not result the type at all in results. The blood type would not go to history. However, your users will not be able to see the cord blood type either (Rhogam candidates, etc) unless you make it a reportable result.2) You can have a cord blood type if you go the the "Change Blood Type" routine and enter the infant's blood type as "UNKNOWN", and give the infant a temporary blood type the same as the cord blood type. This would allow users to see the temporary blood type in PCI.3) When you order and result a regular blood type for this patient, the "temporary" blood type will now be reported and replace the "UNKNOWN" blood type. If you try to enter a blood type other than the temporary blood type, the user will receive a warning, and will not be able to result the blood type from the result screen.I'm not thinking of doing this, but it was interesting to see if I could come up with a solution. Link to comment Share on other sites More sharing options...
cinbb Posted April 8, 2009 Share Posted April 8, 2009 Thanks for the feedback on the labeling of cord blood samples. Our facility labels with Mom's info, baby's sex, date and time of collection. For multiple births they number 1-2 etc... Link to comment Share on other sites More sharing options...
Tony Lyn Posted April 23, 2009 Share Posted April 23, 2009 We are Meditech C/S and have a Blood Type Newborn group and a Blood Type Cord group. The Newborn is used to test heelpoke samples and the Cord is only for cord blood samples. Currently the Blood Type Cord is updating the BBK History. I feel this needs to be changed. I believe the cord blood specimen is not ideal for creating a blood type in a patient's history which then could be used as a historical blood type for Type & Screens/Crossmatches. Please comment.I agree with your conclusion, as apart from the agrument of "whose blood is this, mother/baby, combination" I have seen in the past errors made when submitting cords on multiple births. The newborn sample (heel *****) I would think would be a better representative or reflection of the baby's blood group. If you wish, it would mitigate the risk of registering a wrong group for historical purpose. Link to comment Share on other sites More sharing options...
Mary** Posted April 23, 2009 Share Posted April 23, 2009 :clap:In Cerner Millenium you can determine which ABO&Rh results post to history. You just have to name them differently, i.e. ABO&Rh for non-newborns and ABO&Rh Fetal for newborns. Link to comment Share on other sites More sharing options...
Mary Ann Posted December 11, 2009 Share Posted December 11, 2009 I'm with you on that one,I thought ABO type can change up to 3 yrs for newborns and our facility uses peripheral blood sample for neo transfusion never cord blood samples.Interesting! Have a good one. Link to comment Share on other sites More sharing options...
jcdayaz Posted February 11, 2010 Share Posted February 11, 2010 Do other facilities have the cord blood labeled with Mom's info or Baby's info? This is a point I'd like to hear about.Ours are required to have BOTH Mom and Baby's info. We will not begin testing until both people's information is on our cord sample. Link to comment Share on other sites More sharing options...
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