We are going to implement electronic crossmatching soon.  Right now we save segments from all of our crossmatches with the patient's specimen, but if we perform this testing electronically, do we still keep them?  I am wondering about delayed transfusion reaction workups where nursing has already discarded the bag.  Thanks for your input!

We don't do electronic XMs yet, but we have always removed a segment when a unit is issued.  They are left in a box in the fridge at the end of the day and thrown out on the same weekday the next week.

 

Scott

We do electronic crossmatching.

 

The STAT portion of  our Investigation of Reported Adverse Reaction to Blood Transfusion does not require any testing on the donor unit or a donor tubing segment unless a positive result is detected in this portion of the investigation.  If the clerical check is unremarkable, if the post-reaction DAT is negative and if the ABO/Rh done on the pretransfusion and postreaction patient blood samples agree, no further testing is done. (99.99% of reports)

 

We retain a donor tubing segment (labeled with the DIN) at the time of donor unit ABO/Rh confirmation testing for 56 days (42 days + 14 days).

We are going to implement electronic crossmatching soon.  Right now we save segments from all of our crossmatches with the patient's specimen, but if we perform this testing electronically, do we still keep them?  I am wondering about delayed transfusion reaction workups where nursing has already discarded the bag.  Thanks for your input!

 

You will still need to keep a segment.  Maybe you could keep them in a bag instead of keeping it with the patient sample.   

Yes, we pull a segment when we do electronic crossmatching. We save them in a small stackable bin for each day; we keep them in the refrig for 10 days, in case of a delayed transfusion reaction.

We do the same as Dansket.

We pull segments while doing donor unit retyping and save them for 2 months. If you're following up on a reaction or whatever, it's easy to find them by checking what day they were logged into the LIS and checking the archive bag for that day.

At the time of logging in the units, we remove 2 segments; one for confirming the unit type and the other is saved until 10 days after the unit outddate in case of delayed reaction. We store them in plastic bags with the date of receipt, the date of outdate and the pitch date. These are kept in order in a couple of boxes in the bottom of one of the fridges. Each night the night tech pitches whatever bag or bags are ready to go.

At or facility they used to keep the segment at the time of issue but we have very busy OR...some time we were running out of segments and we had too many bags to worry about so the practice was changed almost 10 years ago...

We pull out two segments at the time of receiving the unit in our inventory.

Why two? Incase patient has delayed reaction and we use the segments for the workup and for any reason if we are not able to complete the workup and need to send it out to ref. lab....Yes we had that happened at our place that is why we pull out two segments and keep them for two months. we have bags labeled for each day and the box label for a month. On 1st October we will discard July box...

I have found the best way to save segments is to pull one when the units come into the blood bank.  we date the small bag and put an expiration date of the freshest unit received.  At the end of the week, all the small bags are put into a larger bag and then labeled with the received date range and the expiration date is the longest date PLUS 7 days to ensure we meet AABB/CAP regs.

 

We used to pull with specimen but we only kept them 10 days and then we would have a delayed transfusion reaction and no segment to work with.  When we would have a trauma or someone bleeding out, it is too time consuming to pull tails when you are trying to crossmatch and get units out and we would miss some, same goes at issuing.

At or facility they used to keep the segment at the time of issue but we have very busy OR...some time we were running out of segments and we had too many bags to worry about so the practice was changed almost 10 years ago...

We pull out two segments at the time of receiving the unit in our inventory.

Why two? Incase patient has delayed reaction and we use the segments for the workup and for any reason if we are not able to complete the workup and need to send it out to ref. lab....Yes we had that happened at our place that is why we pull out two segments and keep them for two months. we have bags labeled for each day and the box label for a month. On 1st October we will discard July box...

 

We also pull two, just as a precaution. We've never run into issues and we do still do IS XM, hopefully switching to EXM by the end of this calendar year.

We just went live with elctronic crossmatches a few days ago. We had been pulling a segment off at issue. With EXMs, we are pretty much just doing them as blood is requested for issue. We put the segment in a tube with a bar code sticker, scan it when doing the EXM, and stick the tube in the daily specimen rack.