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comment_48404

Does anyone require 2 blood types from different phlebotomies before issuing type specific plasma products?

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comment_48413

We require two blood types,from different phlebotomies before we issue any blood product.

comment_48419

Yes. Recipients are usually frequent fliers, or have been in the house long enough to get a few venipunctures at different times, so it's generally not a big deal to get that second specimen.

comment_48429

We require a "Retype" before issuing any type-specific blood products.

comment_48430

Prior to transfusion of any blood component, we require ABO grouping on blood samples from two different venipunctures for all non-group O patients with no historical ABO on file.

comment_48433
Does anyone require 2 blood types from different phlebotomies before issuing type specific plasma products?

yes in order to depend computer registered blood groub in issuing plasma or platelet, the blood group should done on two different sample.

comment_48445
Does anyone require 2 blood types from different phlebotomies before issuing type specific plasma products?

Although a requirement only for electronic crossmatches (for now anyways), I think it's a good idea to have 2 blood types prior to issuing blood on patients without historical data.

comment_48447

When an unidentified trauma patient is admitted through the ER we do not process that sample until we get a second sample from another location. The two samples are then run in parallel. Until this is done we give O cells and AB plasma. The rationale is that in the "heat" of the moment the ER/Trauma staff is more likely to mislabeled samples or misidentified patients (in the case of multiple trauma). If the patient is admitted through the ER or any other location and has a medical record # and historical blood type then we only need 1 sample but we perform a type and screen and an ABO confirm, meaning two different techs are checking the ABO results, before we XM any units for the patient, this of course if times permits, if they need blood STAT we need Dr. approval to give type specific before we complete the ABO confirm.

comment_48449
We require two blood types,from different phlebotomies before we issue any blood product.

Same here

comment_48450
Does anyone require 2 blood types from different phlebotomies before issuing type specific plasma products?

This is the gold standard for correct classification of a patient ABO prior to blood transfusion. ABO typing of two independently collected blood samples will detect WBIT (Wrong Blood In Tube). Testing the same blood sample twice may detect testing/clerical errors but not blood sample collection errors. The reason we do this for plasma components is standardization of the process (establishing the patient ABO type) that minimizes the number of decisions to be made prior to issue of blood for transfusion. We follow the same process (specimen collection and pretransfusion testing) for Type and Screen or Type and Crossmatch. The decision to collect a second blood sample is made by the person doing pretransfusion testing, not the person doing specimen collection. Unsolicited blood samples are rejected and discarded.

comment_48456
This is the gold standard for correct classification of a patient ABO prior to blood transfusion. ABO typing of two independently collected blood samples will detect WBIT (Wrong Blood In Tube). .

We all want to detect WBIT, so a lot of us do the two typings before we give out non-group O RBC. Why not do the same for plasma products? Admitedly, it's a tad harder to maim or kill your patient with minor side mismatched plasma products but it still can happen. The downside? Giving a few more AB FFPs which most of us have in inventory anyway and an occassional AB platelet unit? I think it's well worth it.

comment_48566

We do not. However we do require two different technologist perform types on current specimens on new patients. At my neightboring hospital, they require two specimens for every new patient. Either way is correct according to AABB standards.

comment_48614

We require 2 specs on every new patient. And a spec from this admission before giving plasma products or platelets.

comment_48684

we require 2 blood types on file, so one can be historic. I do require a current blood type on this admission, since patients tend to borrow insurance cards and you don't want to give someone 300-600 cc of incompatible plasma

comment_48691
We require two blood types,from different phlebotomies before we issue any blood product.

We do the same.

  • 2 weeks later...
comment_48875

We are in the process of setting this up. We will require 2 blood types for all blood/blood product transfusions. At my last facility we tried dropping the requirement for plasma but the medical directors said NO. They felt (and I agree) that having a single standard for all products was less confusing for the cross-trained generalists.

comment_48916

We require either a 'retype' on the same specimen (different tech or ProVue) or a matching historical blood type. Our specimens, xm/assigned units, patient and all documents have a unique BB ID number that must match before transfusion.

comment_48922

Not yet....but we are moving in that direction. Look at CAP Checklist Question TRM.30575. It is only 1 proposed method of decreasing risks for transfusions; but one that I am seeing more and more places initiate. I have had a lot going on since moving to a new Hospital a little over a year ago (and a totally different State); and, we are moving into a brand new Hospital building at the end of this year. Once all of the dust settles, this is one of the projects I want to undertake (and prior to implementation of the Electronic Crossmatch). Currently (historical Procedure here), 2 blood types are performed on the same specimen; and both types may be by same person (though it is required that the "initial" type be from the ProVue (so kind of like 2 different people). But of course, if the specimen was not drawn on the correct patient, all of that is for naught (as we all know).

Brenda Hutson, CLS(ASCP)SBB

comment_49005

All of our plasma comes from male donors except AB. The blood supplier can't keep up with demand with only male donors yet. So they have sent a letter saying not to give AB plasma to non-AB patients if possible to limit TRALI. So, a simple system for all products that increases a few patients' risk for TRALI or separate system for "yellow" products to reduce that small TRALI risk (for which we have an official letter, says the lawyer) but adds complexity to the process. And of course, if you don't require redraws on group O pts for RBCs, you would want that exception to apply to AB pts for plasma, right?

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