I would like to get a feel for what others are doing on an issue.

• When you receive orders for a Type and Screen with Crossmatch, do you automatically crossmatch the blood products, or wait until they actually come to pick it up (and/or call to say they are coming)?
  
• If you wait, what method of crossmatching do you perform (electronic; tube I.S.)?
  
• If they only order a Type and Screen (say for pre-op) but the Antibody Screen is positive, do you: call to notify them the screen is positive and ask if they want blood crossmatched; automatically antigen screen and crossmatch a certain number of units; neither??
  
• For those that have a policy to automatically crossmatch antigen negative units on patients with antibodies, even if not ordered (i.e. for pre-op): Which has been more cost effective: Not performing crossmatches until they actually come for the blood (or call to say they are coming) but automatically crossmatching X # of units for patients with antibodies (even if crossmatch was not initially ordered), or, crossmatching what is ordered (not knowing if it will ever be picked up or not)?
  
• Has anyone who changed to crossmatching only when actually ready to transfuse, have you documented a change in your C:T Ratio?
  

Thanks,

Brenda Hutson, CLS(ASCP)SBB

We will crossmatching for the patient with antibody even they have not order it.

Because we think it is safer than not crossmatching, we know the antibody identification is a problem of probability, we read the result from the antigen panel, but it will be right or not right, to crossmatch we will identify it or guarantee it.

Hi Brenda,

If patient qualifies for electronic crossmatch we wait to crossmatch until a unit is requested. If a type and screen is ordered and the screen is positive or there are other serological problems such as ABO discrepancy, we automatically set up 2 units of blood (we don't call the physician). I don't know if this was ever evaluated for cost effectiveness at my facility but I feel it is the right thing to do. Our C/T ratio is a little over 1.

JB

We do the same as Joanbalone. Our C/T ratio has been slightly over 1 for years.