So, when releasing units for emergency release, we have always followed the policy that you give O Neg until an armbanded sample can be collected and typed regardless if the patient has history or not. I have 2 questions: 

1: Is there an AABB or CAP standard to support this? If so, I cannot find it. 

2: If the patient doesn’t have a historical ABORh, and the type is completed on the armbanded sample, can we give type specific even if the 2nd confirmatory type hasn’t been collected yet?

I’m trying to update our emergency release policy, and I need some clarity. Thanks, friends!

1. See AABB Standard 5.27 Urgent Requirement for Blood and Blood components, page 43 in the 30th edition.

2.  No, if completed type on armbanded sample is not group O, we continue to issue Group O until completion of the 2nd confirmatory type.

On ‎06‎/‎15‎/‎2019 at 1:58 AM, Dansket said:

1. See AABB Standard 5.27 Urgent Requirement for Blood and Blood components, page 43 in the 30th edition.

2.  No, if completed type on armbanded sample is not group O, we continue to issue Group O until completion of the 2nd confirmatory type.

That follows our policy then. Thanks a bunch!

One thing I would add to Dansket's post is that the standard says group O, it does not say O Neg.  If your specimen types Rh Positive, you may, according to the standard, switch to O Pos and save your O Neg inventory for actual Rh Negative patients.

Just curious, is it still acceptable to provide males and women "older than child bearing age" (we used 55 as the cut off) with O pos units in an emergency situation preventing an unnecessary drain on the very limited O neg supply?  

33 minutes ago, John C. Staley said:

Just curious, is it still acceptable to provide males and women "older than child bearing age" (we used 55 as the cut off) with O pos units in an emergency situation preventing an unnecessary drain on the very limited O neg supply?  

Yes, we do that here. 

Until we have two blood types( original and confirm) O positive blood is issued for Men 18 yrs old or greater and females 50 yrs old or greater.

2 hours ago, BankerGirl said:

One thing I would add to Dansket's post is that the standard says group O, it does not say O Neg.  If your specimen types Rh Positive, you may, according to the standard, switch to O Pos and save your O Neg inventory for actual Rh Negative patients.

I was thinking the same thing. Our local supplier frequently is low on O Negs, and we keep 4-6 units of O Neg. We have a policy for transfusing O Pos units to patients in times of shortage following what slsmith just stated. Good idea.

6 hours ago, John C. Staley said:

Just curious, is it still acceptable to provide males and women "older than child bearing age" (we used 55 as the cut off) with O pos units in an emergency situation preventing an unnecessary drain on the very limited O neg supply?  

That's what we do with age 50 for women.  A bit of confusion now with extended gender choices in Epic but we haven't got a way to identify MTF trans patients adequately. 

We don't change to type specific (other than matching Rh) until we have crossmatched blood but that is because of the fear that they will think uncrossmatched is always universal donor so don't think they need to check ID when they hang it.  I keep hearing people express that thought.  "What, you need patient ID for me to pick up blood in a massive transfusion?!?"  "Yes, this is crossmatched blood."  This is on a day when we had multiple MTPs underway.  KISS principle here.  Some exceptions include a young female A neg when we have used all of the O neg units.

On ‎06‎/‎17‎/‎2019 at 8:56 AM, John C. Staley said:

Just curious, is it still acceptable to provide males and women "older than child bearing age" (we used 55 as the cut off) with O pos units in an emergency situation preventing an unnecessary drain on the very limited O neg supply?  

If we are giving unxm'd rbcs to a pt with an unknown type, O Pos unless a female of child bearing potential (up to age 50 for us).

 

Emergency Released Blood.....

Does anyone wait until the trauma patient is stable before getting a blood sample to perform a screen and XM when releasing emergency uncrossed blood?  NO...I don't wait...but I am being told by my Lab Manager that I need to do this.  ???????????

You may want your lab manager to talk to your trauma docs.  I am pretty sure that they are going to want to know that you can provide type-specific blood ASAP before the Blood Bank runs out of O negs.

Scott

On ‎06‎/‎17‎/‎2019 at 8:56 AM, John C. Staley said:

Just curious, is it still acceptable to provide males and women "older than child bearing age" (we used 55 as the cut off) with O pos units in an emergency situation preventing an unnecessary drain on the very limited O neg supply?  

We do that.  Actually were cited by FDA due to some staff releasing Rh+ rbcs when policy is to release Rh=.   It was good support for when the docs scream for O=s and we're not giving them out.

4 hours ago, ANORRIS said:

Emergency Released Blood.....

Does anyone wait until the trauma patient is stable before getting a blood sample to perform a screen and XM when releasing emergency uncrossed blood?  NO...I don't wait...but I am being told by my Lab Manager that I need to do this.  ???????????

You may have exchanged your pt by that time - then what type are you giving?   I want a sample ASAP.  I worked in a large tertiary care hospital, we would only give you one O= and then only if you gave us a specimen.  We opened that hospital brand new and set up the rules like blood bank should be run.  It was great - no one could say "we've always done it this way."

Edited July 26, 20196 yr by David Saikin

We do the type and screen  as soon as we get the sample which almost comes immediately after the patient arrives as other labs are drawn at the same time too. Not so worried about the screen part but would like the ABORH especially if it is a female of child bearing age and she is  RH pos so you don't use up the O neg supply

On ‎07‎/‎26‎/‎2019 at 5:44 AM, ANORRIS said:

Emergency Released Blood.....

Does anyone wait until the trauma patient is stable before getting a blood sample to perform a screen and XM when releasing emergency uncrossed blood?  NO...I don't wait...but I am being told by my Lab Manager that I need to do this.  ???????????

I want a specimen ASAP.  I worked in a 700+ bed tertiary care hospital.  If you wanted unxm O, you had to give a specimen.  We would only gave out 1 O= for that tube.  By the time they left and returned type specific was able to be released.   (I guess this is redundant to my post up above.  Duh!)

Edited July 31, 20196 yr by David Saikin

On ‎07‎/‎26‎/‎2019 at 5:44 AM, ANORRIS said:

Emergency Released Blood.....

Does anyone wait until the trauma patient is stable before getting a blood sample to perform a screen and XM when releasing emergency uncrossed blood?  NO...I don't wait...but I am being told by my Lab Manager that I need to do this.  ???????????

We don't wait. If we waited, we would end up giving out our entire O Neg inventory, and the physicians would rather it be that way. Typically, we don't do massive transfusions. We do have a policy should the event arise. Our current policy states (for now) that we will give 2 O Negs, and then the patient would then either get type specific, providing the 2nd confirmatory sample has been collected and typed or they will get type O, but it doesn't specify Rh Pos or Neg. So, I'm revising.

On ‎6‎/‎14‎/‎2019 at 7:34 PM, EAB81 said:

So, when releasing units for emergency release, we have always followed the policy that you give O Neg until an armbanded sample can be collected and typed regardless if the patient has history or not. I have 2 questions: 

2: If the patient doesn’t have a historical ABORh, and the type is completed on the armbanded sample, can we give type specific even if the 2nd confirmatory type hasn’t been collected yet? 

What's aggravating is when the pt has a historical type and you're waiting for a current sample, but you still have to give type O blood and you start running through your supply because the floor is being slow. Otherwise, what if the sample was WBIT, or some other factor that means the typing could be incorrect?

In that sense, if they're asking for emergency released, the pt is still getting type O until that new T/S is completed.