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Pre-Op Type/Screens and Crossmatches


rjjosvai

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Our patients come in up to 3 days before their procedure, depending upon their history. What I mean is that if they have a history of antibodies they must come in at least 3 days before but not longer than 3 days. New patients without a history need to come in 3 days prior, but patients with histories and no antibodies are allowed to come in the day before. I have had a procedure delayed in the past because the patient did not feel they needed to come in and had multiple antibodies that we had to deal with, their procedure was delayed approximately 7 days so that we could find suitable antigen negative units (S,E,K,c, and sickle negative).

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For this situation we would perform an antibody ID with the T/S specimen. If transfused we would repeat the ID with every new sample collected as the patient is being transfused. It is doubtful that an antibody would develop in 72 hours, but currently that is our practice.

John

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For this situation we would perform an antibody ID with the T/S specimen. If transfused we would repeat the ID with every new sample collected as the patient is being transfused. It is doubtful that an antibody would develop in 72 hours, but currently that is our practice.

John

We use the same process here.

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Hi Deny,

I found some documentation on holding samples for T/C from pre-op patients with negative histories. Check out the AABB Manual, 16th Edition, page 442, bottom paragraph on the left of the page. I think this answers the question as to how long samples may be held as AABB is leaving the door wide open on this one.

Your thoughts?

thanks,

John

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This above mentioned statement in the Technical Manual is what our reference lab is basing their position upon. Our pathologist tends to play on the conservative side of decisions, so we limit to 17 days. In theory the sample could be if indefinite age as long as it "reflects the patient's current immunological status" (from the previous paragraph on the same page). Yes, that is a bit of a non-commited answer to your question. My bottom line decision is to recollect if I have any doubts as to the specimen reflecting the patient's current status. This is a bit of a judgement call I guess, but like my pathologist I tend to be conservative. Does that answer your question?

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  • 7 months later...
Does anyone know if a CRNA can place an order for blood to be XM'd and brought to the OR? We are an AABB Blood Bank but I can not find it in the tech manual.

That would be dependent on your state and local laws as well as your individual facility policies. The AABB standards specifiy the Blood Bank Medical Director should participate in the development of those policies and procedures, but do not specify who can be the authorized providers.

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The BB's that are doing these T/S and XM's beyond 72 hours...are there only certain pre-op's you allow this to apply to or all pre-ops (other than the obvious)? Joint repairs...hysterectomy...cardiac..major vascular??

We will accept a sample up to 7 days old from a patient that has not been transfused within this period. Any preops with a previous group are not repeated on admission but ones with only the initial preop g&s are.

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  • 2 months later...

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