Transfusion Medicine

Experienced personnel are available in the Blood Bank on a 24-hour basis to assist with the provision of blood and blood components during emergencies.

Only Blood Bank employees are allowed access to the blood inventory , or are permitted to issue blood for transfusion.

To Request Blood During an Emergency

Describe the urgency of the situation

Provide the patient's name and medical record number

Indicate the blood component and amount required

Provide the patient’s age and sex

Provide the number and name of the ordering physician

Indicate the location of the patient

Verify or correct when orders are read back to assure accuracy.

If blood is not currently available, the technologist can then determine the extent to which compatibility testing can be performed. As the amount of compatibility testing decreases, the possible risk of transfusing incompatible blood increases. Depending on the availability of a specimen and current status of testing blood may be released as

• Uncrossmatched red blood cells
• Type specific blood
• Testing in process but antibody screen, crossmatch or antibody identification incomplete; antigen negative blood unavailable

Emergency Release Documentation

• The Transfusion Record Form of emergency released units will contain the caution that the blood is being released on an emergency basis.
• The physician authorizing the emergency release must sign the Emergency Request section of the Blood Bank Requisition Form and return it to the Blood Bank.
• Blood specimens and requisitions must be appropriately labeled. Many hemolytic transfusion reactions have occurred under emergency conditions when routine patient identification procedures are ignored or circumvented.
• The Blood Bank will complete testing and notify the physician of the results of testing.
• Temperature monitors are attached to assist staff in determining if blood has been properly stored. The beads in the R & D indicator will have moved from the rounded end of the indicator if the blood has not been maintained below 10 C.

GROUP O RED BLOOD CELLS WITHOUT COMPATIBILITY TESTING

• Group O Red Blood Cellsare issued when a blood sample cannot be supplied, and/or the patient's blood is not available in the Blood Bank for typing.
• A blood sample should be drawn for typing and crossmatching before transfusion is initiated.
• Transfusion with group O Red Blood Cells usually does not preclude subsequent transfusion with group and type specific blood. The use of type specific blood in these situations, rather than group O Red Blood Cells, conserves group O Red Blood Cells for those patients who must receive it.

Location of Units Labeled for Emergency Release Revised 12/13/11