Our patients come in up to 3 days before their procedure, depending upon their history. What I mean is that if they have a history of antibodies they must come in at least 3 days before but not longer than 3 days. New patients without a history need to come in 3 days prior, but patients with histories and no antibodies are allowed to come in the day before. I have had a procedure delayed in the past because the patient did not feel they needed to come in and had multiple antibodies that we had to deal with, their procedure was delayed approximately 7 days so that we could find suitable antigen negative units (S,E,K,c, and sickle negative).

When the patients come in prior to surgery and a type and screen is done and you identify an antibody/antibodies but they have not been transfused within 3 months or pregnant, how often do you repeat the antibody ID?

For this situation we would perform an antibody ID with the T/S specimen. If transfused we would repeat the ID with every new sample collected as the patient is being transfused. It is doubtful that an antibody would develop in 72 hours, but currently that is our practice.

John

For this situation we would perform an antibody ID with the T/S specimen. If transfused we would repeat the ID with every new sample collected as the patient is being transfused. It is doubtful that an antibody would develop in 72 hours, but currently that is our practice.

John

We use the same process here.

Hi Deny,

I found some documentation on holding samples for T/C from pre-op patients with negative histories. Check out the AABB Manual, 16th Edition, page 442, bottom paragraph on the left of the page. I think this answers the question as to how long samples may be held as AABB is leaving the door wide open on this one.

Your thoughts?

thanks,

John

This above mentioned statement in the Technical Manual is what our reference lab is basing their position upon. Our pathologist tends to play on the conservative side of decisions, so we limit to 17 days. In theory the sample could be if indefinite age as long as it "reflects the patient's current immunological status" (from the previous paragraph on the same page). Yes, that is a bit of a non-commited answer to your question. My bottom line decision is to recollect if I have any doubts as to the specimen reflecting the patient's current status. This is a bit of a judgement call I guess, but like my pathologist I tend to be conservative. Does that answer your question?

Yes, we are also on the conservative side and I agree with you. We are just getting into this arena and looking for the best way without going overboard!

thanks,

John

we do type & screen as soon we recevied the sample and if there is any antibodies we identefied the anrtibody and prepare the blood in case of any bleeding. after 72 hours the order & request will treat as cancelled.

Does anyone know if a CRNA can place an order for blood to be XM'd and brought to the OR? We are an AABB Blood Bank but I can not find it in the tech manual.

Does anyone know if a CRNA can place an order for blood to be XM'd and brought to the OR? We are an AABB Blood Bank but I can not find it in the tech manual.

That would be dependent on your state and local laws as well as your individual facility policies. The AABB standards specifiy the Blood Bank Medical Director should participate in the development of those policies and procedures, but do not specify who can be the authorized providers.

We have a sample taken 7 days before then one taken at admission. This way there are always 2 groups and a reduced risk of ABO error.

The BB's that are doing these T/S and XM's beyond 72 hours...are there only certain pre-op's you allow this to apply to or all pre-ops (other than the obvious)? Joint repairs...hysterectomy...cardiac..major vascular??

The BB's that are doing these T/S and XM's beyond 72 hours...are there only certain pre-op's you allow this to apply to or all pre-ops (other than the obvious)? Joint repairs...hysterectomy...cardiac..major vascular??

We will accept a sample up to 7 days old from a patient that has not been transfused within this period. Any preops with a previous group are not repeated on admission but ones with only the initial preop g&s are.

We wouldn't take a pre-op sample for a C-section.

Our facility draws up to 14 days before surgery. A form of course has to be signed by the patient saying they haven’t been tx’d or pregnant in the last 3 months.