kjmiller

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Good morning, Malcom. Thanks for your reply- she is 61 yrs old and KNeg. I agree also with your approach, but we also have lots of patients with chronic anemias on transfusion support for whom we aren't giving K Neg. Maybe the dr. is just being more proactive in this case.

We have a patient with autoimmune aplastic anemia and hx of anti-E. This is our first time seeing her, and current ABSC and ABID are pan-reactive due to WAA. The autocontrol and DAT ( both IgG and C3) were positive and WBC count = 1.5 K/ul. Pre-transfusion Hgb was 6.2 and over last 2 days has rec'd 2 units of E-neg "least incompatible" RBCs. Her Heme Onc is now requesting all add'l units be both E-negative and K-negative. I was not able to reach her directly, but curious why she's requesting K-neg. Anyone see the connection? All I can think of is she doesn't want to risk alloimmunizaiton to K (we do phenotypically match C, E, K, Fya/b, and S for sickle patients), but wondering if there's another indication in this situation. (Also, why not irradiated given her current white count?). Thanks for any insight!

Thank you everyone for your very helpful replies! We are definitely no longer a shared cost center, and I appreciate those who shared knowledge of the specific relevant standards. This is just what I needed. Thanks again!

Thank you, Kelly, for your reply. As it turns out, patients admitted to their new facility have unique MRNs, but patients seen at other hospitals within our system have a shared MRN. The fact that only the new facility is assigning different MRNs does complicate matters when conducting patient history searches, but I don't think that's the only reason we can't use their specimens. For example, when we admit a patient from one of our other sister hospitals - with whom we have common MRNs - we still draw and test our own specimen, and wouldn't administer blood products based on the testing done in their blood bank.

Hi all- I'm trying to find the specific standard regarding sharing of pre-transfusion testing results between hospitals. We all know that if patient receives blood at hopsital "A" and then is transferred to hospital "B" across town, that the Type & Screen and 2nd determination of blood type needs to repeated at hospital "B" before units can be allocated. So, can someone provide the specific CAP and/or AABB standard(s) that would prevent hospital B from using the results from hospital A? In case you're wondering! We're in a situation where the blood bank at our hospital has been doing pre-transfusion testing and supply of blood products to a stand-alone ED located about 10 miles away. This ED was always considered an "extension" or "area" of our hospital, and if the patient was drawn there, but then transferred to us for a higher level of care, it was seamless because the patient - and specimen - were considered "ours". However, starting last month, the ED site has now expanded to include surgical suites and been designated as a separate hospital. We still do all their testing because they do not have their own blood bank, but when we result the type and screen, we do it under their hospital ID in the LIS (Sunquest). The problem is that if one of their patient is now transfered to our facility for a higher level of care, we are having to rearmband, redraw, and retest the patient - just as if they had come from any other hospital. I don't think there's a workaround as long as the new hospital is treated as such in Sunquest, but I need to give the administrators a good reason why the patients are having to be restested. Any thoughts/guidance are much appreciated!

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