Just wanting to take a survey to see how everyone does their crossmatches.  Do you pull a secondary sample as a recheck for your 2nd blood type and/or do you do immediate spin crossmatch vs. electronic?  Thanks in advance for your responses!

Immediate spin xm;  we try not to draw a 2nd sample.  We use BloodLocs (which are considered barrier protection). 

No previous history on patient then do immediate spin crossmatch with type "O" blood until type is confirmed on 2nd specimen drawn at a different time form the original BB specimen. Once type is confirmed then electronic crossmatch with type specific units

For screen negative (currant and history) we do electronic crossmatches for trouble-free patients.  We use blood bank specific armbands/specimen ID bracelets.  When we do a repeat ABO/Rh it is done on the same specimen.  

Scott

We do a confirmatory ABO/Rh on non-group O patients with no ABO/Rh history using a specimen obtained from a second venipuncture.

Computer crossmatches are done using a current blood sample on patients with a negative antibody screen and no history of clinically significant antibody. Immediate-spin (gel) and IgG crossmatches are done using a current blood sample on patients with a positive antibody screen and/or a history of clinically significant antibody.

We do a confirmatory ABO/Rh on non-group O patients with no ABO/Rh history using a specimen obtained from a second venipuncture.   For group O patients we allow a repeat blood type on the same specimen to allow for computer crossmatch.  We do IS xms only if the patient has had a positive antibody screen due to an insignificant antibody (our computer won't allow EXM if the screen has ever been positive, even though that is more restrictive than the regulations).  These may include past warm autos or passive anti-D.

      We do a confirmatory ABO/Rh on all patients if we don't have a historical. We do electronic crossmatches when antibody screens are negative, no history of clinically significant antibody, and we have two types, which could include a historical. If there is only one type, we give "O" type with immediate spin until a second type is completed. the second type must be on a different specimen drawn at a different time.

2nd sample

Does anyone here use poc phlebotomy? We're looking into it and evaluating it now. I've heard of hospitals adding T&S/Xm testing to existing CBC specimens when they use the bedside labeling with patient wristband barcode scanning. In these cases I think they just run a second type on the same specimen if they do EXM. We have EXM validated (for years now), but are not using it yet due to having a timid pathologist. Currently we have a two person verification system when blood bank specimens are collected and banded and we run a second type on that same specimen. Probably not ideal if we go to EXM (eventually . . . hopefully . . . dear god please!). I've heard of other hospitals running a second type on an existing CBC specimen collected at a different time, even from up to a week old. Thoughts?

2nd specimen, or a historical blood type.  Yes, we will use a CBC tube drawn only by our Lab staff using bedside barcode ID system.