ER and Surgery Issue of Rh Immune Globulin

[ffriesen]

If a physician from the ED or surgery orders Rh Immune Globulin for a patient who has either miscarried, is spotting or post D & C, do you repeat the blood type on the patient even if you have a historical type? We currently require an ABO and Rh type plus the antibody screen if we don't already have one performed at the beginning of this pregnancy. The OB physicians are saying if this happened in their office they would just issue the RhIG without any testing. I would appreciate it if you would share your policies. Thanks.

[Deny Morlino]

Our policy is that the ABO/Rh must be determined upon each admission of an expecting female. Determination can be through historical records if we have at least two ABO/Rh's for the patient one of which must be from the current pregnancy. If these criteria are met, we skip the ABO/Rh workup and perform only the IAT.

[Lcsmrz]

We still have people using a relative's or friend's insurance info in ER. We require a current draw to confirm the Rh type, but issue RhIg before the rest of the testing is completed.

An OB Clinic record would probably have multiple ABO/Rh determinations. They know the patient and her clinical history, so they may feel comfortable with that.

[mjshepherd]

We require a new type and screen minimum for all RHIG administrations unless we have a historical type and screen within 3 days.

[MARINA]

For many years we went by the Historical type. In the last few years there has been several issues of patients using another's insurance card. We have caught these by performing the type.

[BBK710]

We require a new type and screen minimum for all RHIG administrations unless we have a historical type and screen within 3 days.

We do the same.