Collection of a properly labeled blood sample from the intended recipient of blood is critical to a safe blood transfusion. Most hemolytic transfusion reactions result from errors in patient or sample identification. Clerical errors such as improper identification of the patient at the time the specimen is drawn, transcription errors, mislabeling of the blood product or misidentification of the patient at the time of transfusion accounts for 73% of the preventable occurrences of transfusion associated fatalities.
Useful For
Determination of ABO blood group, Rh type, and antibody status for potential transfusion candidates and prenatal patients.
Method Name
Hemagglutination (Tube and Gel Methods)
Aliases
Type & Screen, Type And Crossmatch, Type And Cross, Type And Screen, Type, ABO, Screen, Antibody Screen
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 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
Antibody Screen: Negative (No clinically significant antibodies present) or Positive (Potentially clinically significant antibodies present)
Day(s) and Time(s) Performed
24 hours 7 days a week
Specimen Retention Time
Type and Screen specimens are held for 10 days.
A patient who is receiving a transfusion or inpatient prenatal patients must have a new Type and Screen specimen drawn and tested every 72 hours as they may develop clinically significant antibodies within that timeframe.
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.
- When a patient’s antibody screen is positive, potentially clinically significant antibodies may be present. An Antibody Identification test (AB ID) will reflex to investigate and determine what is causing the patient’s positive antibody screen.