2 blood types

[Brenda K Hutson]

I would require a second type for group O Patients for 2 reasons (partly Patient ID, and partly Inventory Management):

1. It is still about making sure you have the correct patient, so that would include the Antibody

Screen

2. Don't want to waste group O unncessarily (granted, we are assuming there would be a very

low error rate of the incorrect patient being drawn).

Just my thoughts......

Brenda Hutson

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?

[ElinF]

We do and I love it. I feel so much more confident in issuing A, B, or AB blood. I always hated giving a "new" patient say A+ blood just off that one draw. We now have a policy for ABO repeats. Patient's without any sort of historical blood type get redrawn. An exception is if you are type O. We just go with it if you are type O. We are just looking for ABO disrepencies. If it is an emergency, say surgery or ER, we just give O blood until we can confirm type.

[AMcCord]

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.

This is our protocol as well.

[rlmirand]

We started this practice when we went live with our new computer system but experienced a lot of resistance. Our pathologist would like a concensus of how many Transfusion Services actually requires a second ABO/Rh when NO previous historical blood type is available. YES or NO answer would suffice. Thanks

[Malcolm Needs ☆]

The new 2012 BCSH Guidelines for pre-transfusion compatibility procedures in blood transfusion laboratories mandate that two samples should be obtained before anything but group O blood, or, where available, group AB plasma components (including FFP, cryo, platelets, etc) are transfused. If you put BCSH Guidelines into your search engine, you should be able to download the full guideline (for free).

[Dansket]

We started this practice when we went live with our new computer system but experienced a lot of resistance. Our pathologist would like a concensus of how many Transfusion Services actually requires a second ABO/Rh when NO previous historical blood type is available. YES or NO answer would suffice. Thanks

YES, we do

[Mabel Adams]

I was thinking about the question of 2nd samples on O patients and I find that I can't agree that it does much to really prove your patient ID. If I type a sample on a new patient as O and require a 2nd sample, even by random sampling I have about a 45% chance of getting a sample from another O patient (less if you re-do the Rh as well). That isn't very high specificity. You would really need to repeat the screen on the new sample to be sure that you have all of the same results. I am also willing to take a chance on using more O blood than needed because I hope that we will not discover a WBIT more often than once a year, if that. Not requiring it on O patients will also significantly reduce the number of redraws necessary. The only argument I can see for requiring it is the KISS principle.

[rlmirand]

Thanks.

[pbaker]

If the patient has no history, we require a second specimen before issuing any blood products (emergency excluded, of course). If the physician won't wait for a second ABO/Rh, we ask that he/she signs a legal release.