Pretransfusion Testing

Question 1

Patient ID and Sample Label

Answer 1

Confirm patient ID with at least 2 independent things
Label must have 2 patient identifiers, date and time of collection, phlebotomist initials
Sample must not be hemolyzed
Pretransfusion sample is only active for 72 hours

Question 2

Recipient Testing

Answer 2

Type and screen

Antibody ID if necessary

Question 3

Component Selection

Answer 3

ABO/Rh compatible
Correct component for patient needs
If positive Ab screen, get Ag negative blood for IDed antibody

Question 4

PreTxn Testing

Answer 4

Crossmatch: the purpose is to predict how well the donor red cells will react with the patient’s plasma in vivo, checks for ABO incompatibility and detect antibody reactivity and donor red cells
Immediate spin
Extended serological crossmatch
Computer/electronic XM

Question 5

Transfusion of Component

Answer 5

Within 30 min after issue and infused within 4 hours

2 nurses double-check unit and patient ID

Question 6

Extreme Emergency

Answer 6

No time to do pretransfusion testing
Usually occurs in the ER
Trauma pack: place in coolers with uncross matched tags
Four units of ONEG RBCs, four units of AB plasma, emergency release forms
Pretransfusion testing on recipient and donor units is completed after the fact

Question 7

Intrauterine/Infant Transfusions

Answer 7

Blood must be compatible with maternal antibodies that are capable of crossing the placenta
Type and screen can be done on the mother of the infant

Question 8

Massive Transfusion

Answer 8

Defined as either a transfusion of 8 to 10 RBC units within a 24 hour period or 4 to 5 RBC units in one hour
Must get approval from the pathologist and physician to give incompatible units
IS or computer cross match if antibody screen is negative, positive screen needs antigen-negative units
MTP pack: four units of RBCs, four units of FFP, add platelets to every other pack