Responsibilities:
|TEST NAME |TUBE TYPE |TEST INFORMATION |SPECIAL INSTRUCTIONS |REFERRAL LAB |Testing/Reporting Times |
|Antibody Identification |PINK (7 mL) |Test is ordered by blood bank for all positive |Two sets of legible initials are required |Might require referral to |STAT: variable |
| |or |antibody screens. |for blood bank specimens |Vitalant |Routine: variable |
| |LAV (4 mL) | | | | |
|Antibody Titers |PINK (7 mL) |Normally only ordered on prenatal patients with a|Two sets of legible initials are required |Referred to Vitalant |STAT: 2-3 hours |
| |or |known antibody. |for blood bank specimens | |Routine: 12 hours |
| |LAV (4 mL) | | | | |
|Cord Blood Workup |RED (13 mL) or |Includes ABO/Rh and DAT (if indicated), should be|See Cord Blood Handling and Labeling Policy|No |STAT: 30 min |
| |PINK (4 mL) |ordered on all group O and Rh negative mothers. |for labeling requirements | |Routine: 4 hours |
|Direct Coombs (DAT) |PINK (7 mL) |Used to demonstrate in-vivo coating of red cells |Two sets of legible initials are required |No |STAT: 30 min |
| |or |with antibodies or complement. |for blood bank specimens | |Routine: 4 hours |
| |LAV (4 mL) | | | | |
|Rh Immune Globulin Workup|PINK (7 mL) |Should be ordered on all Rh negative mothers or |Two sets of legible initials are required |No |STAT: 60 min |
| |or |when there is a risk of Rh sensitization. |for blood bank specimens | |Routine: 4 hours |
| |LAV (4 mL) | | | | |
|Transfusion Reaction |PINK (7 mL) |Initiated by nursing service when transfusion |Always considered STAT by Blood Bank. |Might require referral to |STAT: Variable |
|Investigation |or |reaction is suspected. |Product with attached tubing should be sent|Vitalant if TRALI is suspected | |
| |LAV (4 mL) | |immediately. | | |
|Type & Screen |PINK (7 mL) |Ordered when blood use is possible. The Blood |Two sets of legible initials are required |Might require referral to |STAT: 60 min |
| |or |Bank will do the type and antibody screen and |for blood bank specimens. Can be used for |Vitalant if the patient has an |Routine: 4 hours |
| |LAV (4 mL) |antibody ID if necessary. |crossmatch for up to 3 days |atypical antibody | |
|Type & Prepare RBCs |PINK (7 mL) |Consists of a Type & Screen and Crossmatch. |Two sets of legible initials are required |Might require referral to |STAT: 60 min |
| |or |Indicate products needed. |for blood bank specimens. Can be used for |Vitalant if the patient has an |Routine: 4 hours |
| |LAV (4 mL) | |crossmatch for up to 3 days |atypical antibody | |
|Prepare RBCs Only |PINK (7 mL) |Ordered when there is a current Type and Screen |Two sets of legible initials are required |Might require referral to |STAT: 15 min (with negative |
| |or |specimen in the Blood Bank (< 3 days) and no draw|for blood bank specimens. |Vitalant if the patient has an |antibody screen) |
| |LAV (4 mL) |is necessary. | |atypical antibody |Routine: 1 hour |
Blood Products
|BLOOD PRODUCTS |PRODUCT INFORMATION |SPECIAL INSTRUCTIONS |ANALYTIC TIME |
|Emergency-release uncrossmatched RBCs and Plasma are available at all times and can be provided in less than 10 minutes |
|Red Blood Cells Leukoreduced|Must have pathologist approval if criteria not met. For transfusion criteria, see Concise Blood Product |Must have an ABO/Rh on two different |See Type & Crossmatch |
| |Ordering And Administration Guidelines |specimens before type-specific | |
| | RBCs will be given. | |
| |duct-Ordering-Administration-Guidelines.pdf | | |
|Washed Red Blood Cells |Indicated for symptomatic anemia in patients with anaphylactic or other severe transfusion reactions or |Expires 24 hours after washing. |STAT: 4-6 hours |
| |documented plasma protein allergies or IgA deficiencies. |Notify Blood Bank ASAP with request. |Routine: 8-12 hours |
| | |Must be obtained from Vitalant. | |
|Irradiated Red Blood Cells/ |Cellular blood components should be irradiated in order to reduce the risk of graft vs. host disease for |Depends on availability of products |RBCs: |
|Irradiated Platelets |patients in the following categories: | |See Type & Crossmatch |
| |Fetuses or infants who have ever received intrauterine transfusions, infants receiving exchange | | |
| |transfusions, infants weighing less than 1200 grams | |Platelets: |
| |Selected immunocompromised recipients | |STAT: 20 min |
| |Recipients of RBCs and/or platelets donated from a blood relative | |Routine: 2 hours |
| |Recipients of bone marrow transplantation | | |
| |Recipients of HLA-matched or crossmatch compatible platelets | | |
| |Patients with Hodgkin’s disease or other hematologic malignancies | | |
| |Other requests if approved by Medical Director. | | |
|Deglycerolized Red Blood |Red Blood Cells that have been frozen. Indicated for symptomatic anemia in patients with rare |Expires 24 hours after start of |STAT: 2-3 hours |
|Cells |antibodies, IgA or IgE deficiencies. |thawing. Must be obtained from |Not deglycerolized until |
| | |Vitalant. |requested. |
|Platelets Leukoreduced |Must have pathologist approval if criteria not met. For transfusion criteria, see Concise Blood Product |Depends on availability of products |STAT: 15 min |
| |Ordering And Administration Guidelines | |Routine: 2 hours |
| | | |
| |duct-Ordering-Administration-Guidelines.pdf | | |
|Pooled Cryoprecipitate |Must have pathologist approval if criteria not met. For transfusion criteria, see Concise Blood Product |Expires 6 hours after thawing. |STAT: 30 Min. |
| |Ordering And Administration Guidelines | |Routine: 2 hours |
| | |Not thawed until requested. |
| |duct-Ordering-Administration-Guidelines.pdf | | |
|Fresh Frozen Plasma or FP24 |Must have pathologist approval if criteria not met. For transfusion criteria, see Concise Blood Product |Units expire 24 hours after thawing. |STAT: 25 Min. |
| |Ordering And Administration Guidelines |Must indicate when products are to be|Routine: 2 hours |
| | and transfused. |Not thawed until requested. |
| |duct-Ordering-Administration-Guidelines.pdf | | |
|Thawed Plasma |Clinically equivalent to Fresh Frozen Plasma, with the exception of Factor V and Factor VIII levels. |Units expire 5 days after thawing. |STAT: 20 Min. |
| |Must have pathologist approval if criteria not met. For transfusion criteria, see Concise Blood Product | |Routine: 2 hours |
| |Ordering And Administration Guidelines | | |
| | | |
| |duct-Ordering-Administration-Guidelines.pdf | | |
|Liquid Plasma |Plasma product that has never been frozen. The majority of clotting factors and inhibitors retain more |26 days from day of donation |STAT: 10 min |
| |than 88% of their initial activities, with the few exceptions of factors well known to be unstable. | | |
| |Liquid plasma is indicated only for the initial treatment of patient undergoing massive transfusion. | | |
|Aliquot Fresh Frozen Plasma |Indicated for neonates requiring plasma transfusion. Preferred product is FFP (if possible), type AB pos|More than one aliquot can be taken |STAT Estimate: 1 hr |
| |or AB neg. |from each unit. |Routine: 4 hours |
|Neonatal Exchange |Only available at University of Colorado Hospital: |Notify Blood Bank ASAP with request. |STAT: 2-4 hours |
| |Indicated for neonates with excessive unconjugated bilirubin most commonly due to maternal antibody. |Must be obtained from Vitalant. | |
| |Exchange is indicated less frequently in sepsis, respiratory distress, to remove toxins, and DIC. | | |
| |Preferred product is type O pos or O neg RBC, antigen negative for maternal antibody, less than 5 days | | |
| |old, CMV negative, leukoreduced, irradiated, washed, and reconstituted with AB FFP. | | |
|Aliquot Red Blood Cells |Indicated for neonate requiring red cell transfusion. Preferred product is less than 5 days old (if |More than one aliquot can be taken |STAT Estimate: 1 hr |
|Leukoreduced |possible), CMV negative, leukoreduced, irradiated O pos or O neg. |from each unit. |Routine: 4 hours |
|Red Blood Cell or |Only available at University of Colorado Hospital: |Notify Blood Bank ASAP with request. |STAT: 4 hours |
|Reconstituted Whole Blood |Product is antigen negative for maternal antibody, less than 5 days old, CMV negative, leukoreduced, |Must be obtained from Vitalant. |If a donor needs to be found, |
|for Intrauterine Transfusion|irradiated, washed, Hct adjusted, and type O pos or O neg. Might require calling special donors with | |could be up to 3 days |
| |antigen negative blood for maternal antibody. Indicated when fetus is severely anemic due to HDN. | | |
| |Usually not feasible ................
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