Blood Type (ABO Rh) – Blood Bank

The ABO system contains four major ABO groups: A, B, O, and AB and is the most important blood group system in transfusion medicine. The four phenotypes are determined by the presence or absence of two antigens (A and B) on red cells. The ABO system is also characterized by the presence or absence of naturally occurring antibodies directed against then missing A and B antigens. virtually everyone over the age of six months who lacks the A or B antigen produces antibodies. The Rh system is the second most important blood group system after ABO in transfusion medicine. The D antigen is highly immunogenic and complex. “Rh positive” or “Pos” and “Rh negative” or “Neg” refer to the presence or absences of the D antigen. The high anti-D immunization risk, the impact of alloimmunization in D-negative females of childbearing potential, and the significant risk of harm to a D-positive fetus makes testing for the D antigen a routine practice.

Useful For

Determination of ABO blood group and Rh type for potential transfusion candidates and prenatal patients.

Method Name

Hemagglutination (Tube and Gel Methods)

Aliases

Blood Type, Type, Type And Hold, Type And Rh, ABO And Rh, ABO, ABORH, Blood Type

Specimen Type

Whole Blood

Specimen Required

Large lavender-top (EDTA) tube, approximately 7 mL.

After the patient is positively identified, the sample is drawn and fully labeled with the following information either electronically or handwritten:

  • Patient’s full First and Last Name
  • Date of Birth or Medical Record Number (MRN#)
  • Date and Time specimen was drawn
  • Blood Bank Armband Number (BBID) (see below for more information)
  • Identify of the person who collected the specimen (Ex: Cerner ID or personnel initials)

All inpatients, or patients potentially receiving a transfusion, must have a blood bank armband (BBID) applied to their wrist and the Blood Bank ID (BBID) number written on the tube. This blood bank armband is a secondary patient identifier that helps ensure a safe and accurate transfusion. Specimens received without a blood bank armband will be rejected. See special instructions for more information.

Specimen Minimum Volume

1.0 – 4.0 mL

Specimen Stability Information

Stable at room temperature for 24 hours.

Rejected Due To

  • If the patient’s full first and last name and date of birth are not clear, accurate, and/or readable the specimen must be rejected.
  • If the Blood Bank Armband Number (BBID) from the Blood Bank Armband is missing, inaccurate, illegible and/or can not be confirmed on all inpatient and outpatient potential transfusion specimens, the specimen must be rejected and sample redrawn.
  • Specimens may be rejected for insufficient quantity and/or quality reasons (Ex: Hemolysis, dilution, etc).
  • If there is any doubt as to the identity of the sample, a new sample must be obtained.
  • If a specimen is rejected on a trauma, OR, or other critical patient when blood is needed urgently/immediately, have the specimen redrawn in accordance with this policy and follow the policy “Issue of Blood in Urgent Situations”. Uncrossmatched blood can still be given in an emergent situation.

Special Instructions

The person drawing the blood sample must confirm the patient’s identity by checking at least two independent identifiers before collected a specimen such as: first name, last name, date of birth, and medical record number. If possible, patient identification should be obtained verbally directly from the patient. The phlebotomist must not rely on a bed tag or on charts or records placed nearby. After positively identifying the patient, the sample is drawn and fully labeled with the following information either electronically or handwritten: Patient’s full first and last name, date of birth or medical record number (MRN#), date and time specimen was drawn, Blood Bank Armband Number (see below for more information), and identify of the person who collected the specimen (Ex: Cerner ID or personnel initials).

All inpatients, or patients potentially receiving a transfusion, must have a Blood Bank Armband applied to their wrist and the Blood Bank Armband Number (BBID) number written on the tube. Please write the number clearly and do not use a gel pen (anything written in gel pen smears as the specimen is transported in a bag to the lab). This blood bank armband is a secondary patient identifier that helps ensure a safe and accurate transfusion. Specimens received without a blood bank armband ID will be rejected.

An ABO/Rh retype is drawn on patient’s that do not have a historical blood type on file in the LIS system to confirm their blood type before the patient is transfused. The ABO/Rh retype is to be drawn at a different time and by a different phlebotomist in order to confirm the patient’s blood type to prevent a mistransfusion.

Performing Laboratory

STAT turn around time approximately 15-30 minutes.

Routine inpatient samples around time is approximately 1- 4 hours.

Routine outpatient samples to 1-2 days.

Reference Values

ABO/Rh Blood Types: O pos, O neg, A pos, A neg, B pos, B neg, AB pos, AB neg

Day(s) and Time(s) Performed

24 hours 7 days a week

Specimen Retention Time

ABO/Rh specimens are held for 10 days.

Reflex Tests

ABO/Rh retype when a historical blood type is not on file in the LIS system on a patient. Required before a patient is transfused with ABO type specific blood.