Transfusion Workflow
This provides a general overview of the transfusion type and screen as well as further investigations and crossmatching workflow.
Specimen Integrity Checks
Checks for possibly discrepancies or issues affecting specimen quality and patient safety
- Correct number of tubes should be accounted for
- Labels must be fully visible without any cut-off information
- Name and MRN must match requisition
- Tubes must be initialed and dated by collector; this must match the requisition
- Sample must be <24h old
- Tube must be collected properly (adequate volume, correct tube type [EDTA])
- Must not be clotted or grossly hemolyzed
Type & Screen
- Perform IS forward and reverse typing
- Anti-A, Anti-B, Anti-D1, Anti-D2, Rh Control, A1 cell, B cell
- Record reactions, reactions are expected to be 2+ or greater
- Check for discrepancies and mixed fields
- Discrepancies may include extra or missing reverse reactions
- Mixed fields may appear as some grade of agglutination alongside a turbid/unclear background. Check microscopically to confirm (will see two populations, e.g., agglutinated cells and unagglutinated cells)
- If there are discrepancies, attempt to correct them
- Mixed field: check transfusion history in past 3 months that explains results
- Extra/missing reactions: see below
- Perform gel screening