Any thoughts on this would be greatly appreciated.

For pre-op patients, how far in advance is the type and screen done at your facility?

We only use/draw ours within 72 hours of the surgery. Policy is currently being revised to do a T/S up to a month before the surgery. However, we are not going to use this specimen for the XM. If patient needs blood during/after surgery, a new specimen will be drawn, with a T/S and XM. The purpose of this is to eliminate multiple trips to the facility (one for all other pre-op work, and one for the T/S)

which is happening now. If you do have something like this in place, what are the advantages/drawbacks of this?

One obvious drawback is if blood is needed urgently, and the whole T/S is being done while the patient is on the table.

Thanks for all your input!!!

We draw the sample within 3 days of surgery, with the day of draw counted as "day 0.".

Pre admission testing (PAT) for blood bank can be performed up to 14 days in advance at our facility provided:

1) the patient is not pregnant

2) the patient has not been transfused within the last 3 months.

For these situations we hold to the three day rule with the draw date being day 0.

For surgeries requiring a type and cross, the patient is redrawn the day of surgery but the ab screen is honored from PAT testing. We are switching the process of determining how blood bank knows a patient has arrived prior to surgery. In the past we depended upon notification from OP registration once the patiebt arrived. Now the techs check the order entry system to determine when the patient has arrived (working with surgery we determined the "regular" amount of time a patient was supposed to arrive prior to surgery). Once the patient has shown up in order entry, the tech contacts the floor they have been admitted to so a double check of arrival is confirmed and to attempt to catch any "draw prior to surgery" orders that inevitably are entered STAT because someone forgot. Phlebotomy then redraws the patient verifying the BB ID band. Specimens are transported to lab for testing. OR also has a check in their presurgical list to verify the presence of a blood bank ID band too.

These changes have gone into place this week. The process change was the result of surgery and blood bank working together on the problem. The last thing anyone in surgery wants is to have lab need to come into an OR suite to draw blood. We normally don't understand sterile fields, etc. and our goal was to eliminate the need for phlebotomy to need to enter an OR suite.

The specimens collected the day allow us to cross match units using a fresh specimen. If for any reason the crossmatch is incompatible, we have a fresh specimen to try to find the cause and hopefully resolve it prior to surgery.

We have two options for preop at our facility. A patient who has not been transfused in the last 90 days, has no history of antiibodies and is not pregnant is eligible for a 10 expiration on their blood bank specimen. They must come in no earlier than 9 days before surgery to be drawn. Units are set up on those patients the evening before the AM of surgery. All other cases get a 72 hour expiration.

Does anybody (Malcolm?) have any papers of anybody having actually done a serious study on how long it takes blood group antibodies to form and become detectable by normally used techniques? I would love to have some real scientific evidence for the 72-hour rule

Thanks in advance

Anna

Does anybody (Malcolm?) have any papers of anybody having actually done a serious study on how long it takes blood group antibodies to form and become detectable by normally used techniques? I would love to have some real scientific evidence for the 72-hour rule

Thanks in advance

Anna

There are a whole load of papers quoted in Mollison's Blood Transfusion in Clinical Medicine. Unfortunately, I can't look them up at the moment, because I'm away from home and base at a two day (boring) meeting, but will have a proper look when I get home.

:redface:

We allow 7 days for preop TS if no transfusion/pregnancy in the past 3 months. Absc has to be performed within 3 days of collection.

We do the same as adiescast.

We recognize that the Type & Screen can be done earlier, but a good percentage of our T&S's involve OB patients, and we chose not to ask and document whether all other patients have been recently pregnant or transfused somewhere else. For our rotating staff (and constant turnover of phlebotomy staff), it just works out to be the safest route to go for us.