Blood cross matching

[Madgirl2]

Does anyone know if checks are in place in the labs when cross matching blood for a transfusion.? For example, if the patient name did not match the patient number on the blood form? I know that phlebotomists/doctors do their own checks at the time of taking the sample but just wondered if any other checks are made by the lab as a double check?

[LazyGun]

The blood sample is always checked against the xmatch request form, and at least 3 ID data have to match... surname, patient ID number and date of birth.Additionally, the sample and the request form must be signed by the requesting medic (At least, this was the case when I was working in blood banks some years ago now.)

If there is only a partial match, the sample/form are referred back to the requesting medic, and either the data is completed or a new sample is taken.

In emergency cases, the number of ID matches required is less, but it still requires at the very least matching patient ID or emergency number.

[theprof]

I know that very stringent checks are in place in the labs in the teaching hospitals attached to my university, although I'm not 100% positive the procedures are exactly the same as the last time I took an interest in them.

As I recall, the samples must be accompanied by the usual request form with the patient's surname, forenames, dob, gender, patient number, ward identifier, reason for transfusion, diagnosis etc fully completed.

If there was a discrepancy on the form, the sample and document would be returned by the MLSO's/blood bank staff to the originator, unprocessed for correction. If I remember rightly, this would happen no matter if the request was classified as urgent - departmental pressure was not an excuse.

It was vital that the blood bank verified the patient's ABO and Rh D group via their computer database/manual records and any discrepancies were resolved before blood or blood components were issued, although in life threatening situations, group O Rh D negative or positive blood was issued depending on the gender of the patient.

As a double check it was also necessary to mix a small sample of the patient's blood with the donor blood and check for signs af agglutination under the microscope. Obviously, in the event of agglutination, there was a mismatch. Specialised sampling equipment was used to perform this task in a minimum time.

[theprof]

LazyGun has just reminded me that this was one of those situations where a doctor's signature had to be on the form as an emergency contact.

Nurses were not allowed to sign and the staff absolutely forbade medical students from signing the requests.

[Peter Pedant]

what's the q ?

Are checks in place ?

yup zillions of them

(But) about 200 wrong unit transfusions take place a year (SHOT - serious hazards of transfusion report) and the GMC frequently shoot blameless doctors who get in the way.

[Madgirl2]

Thanks to everyone! I knew you guys wouldn't let me down!