Specimen Collection by Paramedics

[THintz]

We are wondering what various institutions have for a policy on collection of pre-transfusion specimens on trauma patients by paramedics. Do you allow paramedics to collect a pre-transfusion specimen? If so, what do they use for labeling it? If collected in the field or ambulance en route to the hospital do you have the expectation that they will label it immediately using a trauma band, handwritten information, or something else? Are the paramedics included in any training that your facility might have on specimen identification/collection? We'd just like to hear what others are doing.

Thanks much!

[Mary**]

:disbeliefWe don't allow it. Our paramedics draw a "rainbow" of tubes and throw them in a ziploc and label them after they arrive with the patient. Having been transported in an ambulance as a patient, I know how busy they are working on the patient. I was grateful for their expertise, but I can' tell you how many of those bags I have seen unlabelled in the ED. As a patient, I would rather receive O negatives than take a chance on specimens not labeled at the bedside. Their procedure violates regulations.

[Malcolm Needs ☆]

This is, by no means, my area of expertise, but I can quite see from where Mary is coming.

[BBK710]

We would NEVER use a specimen drawn in the ambulance by paramedics.

[tbostock]

Same here; we don't allow it. There can be multiple victims at the scene, and their focus is on saving/stabilizing them, not ensuring proper identity. We'd rather give O Neg also. Can't say over the years, though, that the nurses have tried to sneak them by us. It's usually obvious though; wrong tube type, labeling is horrendous, etc.

[L106]

Same here; we don't allow it, and actually we have never received a specimen collected by EMTs. (Also, we use a special Blood Bank wristband for transfusion candidates, so the EMTs would not have access to these wristbands.)

[adiescast]

We don't accept EMT drawn samples. There are several ambulance services working in our area, so it would be difficult to ensure training and competency in our procedures. The other area hospitals also get patients through these ambulance services and may have different labelling requirements, which would complicate things for the EMTs. They would have to know where they were going before they drew the sample (although if the emergency was bad enough, they would know it was coming here, since we are the only level 1 trauma center in the area.)

[David Saikin]

WE only allow specimens drawn on the ambulance if we have a previous history. Shortly we will be instituting the BloodLoc system which should make for a safer transfusion event (hopefully).

[MAGNUM]

The only paramedic collected blood bank samples that we will accept are those drawn in the ED by the paramedics who work for us. If it was drawn offsite, the blood (all samples) gets filed in the red filing cabinet that has no access, i.e. the sharps container. I am very stringent on blood bank specimen collections, even down to the initials on the sample and the card, must match or its a nogo. Someone once asked me why I am so strict, to which I replied that what if it was your family member?

Scott

[Mary**]

:clap:Good for you MAGNUM!

[eric1980]

Scott, it's in the genes of all ward/clinical staff to wonder on why we BBers are so strict on such issues. But all blood bankers know that you are doing the right thing.

My hospital do not accept specimens drawn by paramedics. The specimen have to be drawn by a doctor who will have to sign on the specimen and form label anyway.