Transfusion Medicine
This section provides service information regarding the provision of blood products by Transfusion Medicine. Information regarding specific Transfusion Medicine testing is listed alphabetically in the Lab Tests section. CLS Transfusion Medicine provides all blood components and products distributed by Canadian Blood Services (CBS).
Service Through Patient Service Centres
Please note the following in regards to transfusion service requests:
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If…
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Then…
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The patient must arrive with the Pretransfusion Testing Requisition and Regional Transfusion Service Identification System (RTSIS) forms. If the patient presents without either form, it must be obtained from the physician or clinic referring the patient. Collect the specimen using the RTSIS.
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The patient has attended the Preoperative Assessment Clinic…
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The patient must arrive with the Pretransfusion Testing Requisition and Regional Transfusion Service Identification System (RTSIS) forms. If the patient presents without either form, it must be obtained from the physician or clinic referring the patient. Collect the specimen using the RTSIS and give the patient a copy of the Identification Band for Pretransfusion Blood Testing information sheet.
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The patient is the potential donor of directed blood products (Directed donations are units collected from a donor that are directed to a specific recipient such as a parent to a child)...
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Physicians may call FMC Transfusion Medicine at 403-944-1367 for direction. FMC staff will request the necessary information and provide the appropriate form.
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Services Provided to Calgary Area Urban Sites
| Site |
Pretransfusion/ Diagnostic Testing |
Product Procurement Availability |
Emergency Unmatched Blood Availability |
| ACH |
On-site testing, Monday to Friday from 0730 to 1545 only
Referred after hours
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24 hours/ 7 days a week |
Yes |
| FMC |
On-site, 24 hours/ 7 days a week |
24 hours/ 7 days a week |
Yes |
| PLC |
On-site, 24 hours/ 7 days a week |
24 hours/ 7 days a week |
Yes |
| RGH |
On-site, 24 hours/ 7 days a week |
24 hours/ 7 days a week |
Yes |
| SCHC |
Referred |
During clinic operational hours only
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No |
| SMCHC |
Referred |
24 hours / 7 days a week |
Yes |
| ACHC |
Referred |
RhIg only. During laboratory operational hours |
No |
Patient Transfers Between Acute Care Sites:
To reduce unnecessary duplication of testing and provide seamless patient care, protocols have been established to enable the transfer of pretransfusion testing when the patient is transferred between all acute care sites. Appropriate communication is critical to the success of the process. Failure to inform Transfusion Medicine of patient transfers may lead to unrealistic expectations of blood product availability.
In order to accommodate this process, the following procedure must be adhered to:
Sending Site:
- Inform the Transfusion Medicine department at the receiving site of the patient transfer.
- Ensure that the patient is wearing the yellow RTSIS ID band.
Receiving Site:
- Provide the site Transfusion Medicine with notification confirming the patient’s provincial health care number (PHN) with the hospital medical record number of the receiving site.
- Patient care unit staff must follow the direction of the Transfusion Medicine technologist regarding the need to recollect pretransfusion testing to ensure blood products are available when required.
Services Provided to Sites External to CLS
TM Test Requests:
- For all specimen referrals to Transfusion Medicine, the requesting site must complete the Faxed Transfusion Medicine Request From Sites External to CLS (TM2089) form and fax it to Foothills Medical Centre (FMC) Transfusion Medicine (403) 270-7205. Completion of the Pretransfusion Testing Requisition- REQ9004TM (TM 2028) is optional. If a CLS Pretranfusion Testing Requisition- REQ9004TM (TM 2028) is not used, please complete the requisition utilized at the requesting site.
- For Pretransfusion testing, if the outdate of the type and screen is to be extended beyond 96 hours, the following information is required:
- Has the patient been transfused within the last 3 months
- Has the patient been pregnant within the last 3 months
- Antibody investigation requests should include a copy of the investigation already performed at the referring site.
- When requesting Mother and Cord Blood investigations, complete a separate CLS General Requisition (Form 1788C1) for the mother and the cord specimen with patient demographics and the Provincial Healthcare Number. Ensure the cord blood specimen is labelled "cord".
Specimen Collection and Handling:
- If a Transfusion identification system other than the Regional Transfusion Service Identification System (RTSIS) is used for pretransfusion testing, provide that unique identifier number on the specimen and requisition. See Pretransfusion Testing for more information on patient identification, specimen collection, and specimen rejection.
- Specimens should be shipped at room temperature (no ice in transport box).
- Security seals must be applied to all transport boxes containing units of blood but are not required for the return of empty boxes. Security seals are preferred but not required on transport boxes containing specimens.
- When sending specimens via Greyhound, use "Door to Station" or "Station to Station" service to reduce risk of misplaced and/or delayed specimens. No special priority is given to packages labelled as "specimen" or "human blood".
- Choosing a priority option of "Next Bus Out (NBO)" guarantees the package will be processed expeditiously. Without the NBO option a package may not be placed on the next outgoing bus or may be removed from a bus and replaced with a package having this priority. Packages transported during the Christmas season will not be assigned a priority due to the extremely large volume of packages being processed at this time. To reduce the risk of delay or loss of pretransfusion specimens, use the NBO priority option.
- Greyhound prefers the use of preprinted waybills which state the following:
Destination Station:Calgary, AB
Consignee:Transfusion Medicine, Foothills Medical Centre
Consignee Phone Number:403-944-1367
Address:6th Floor, 1403-29th Street NW, Calgary, AB T2N 2T9
- Preprinted waybills can be obtained from Greyhound.
- Freight will only be handled during business hours. The operational hours of Greyhound Courier Express (GCE) in Calgary are as follows:
Monday to Friday- 0800 to 2000
Saturday and Sunday- 0900 to 1800
Contact phone number- 403-263-1234
- Review the GCE schedule prior to shipping to ensure that specimens will arrive at the Calgary GCE depot during regular business hours.
Adverse Reactions to Transfusion:
- The site is responsible for recording and reporting all adverse events related to transfusion. FMC performs only the serologic investigation. Responsibility for reporting serious adverse events to CBS and follow up of the patient remain the responsibility of the site.
- To request a serological investigation, complete the Notification of Adverse Reactions To Blood Products (TM2034) form and send to FMC TM with post transfusion specimen. (See "Adverse Reaction to Transfusion" in the alphabetical test list in this guide).
Products Dispensed to Hospital Sites:
The transfusion site is responsible for retaining records pertaining to the final disposition of units and for all activities related to lookback of units and traceback of patients.
All unmatched red cell units have had the ABO group and Rh type confirmed. No additional documentation is placed on the unit of blood to indicate that this testing has been done.
No additional antigen testing (eg. C, E, K) is performed on O Rh Negative units that are intended for use as unmatched units.
A three week rotation of unmatched units will be scheduled to maintain adequate inventories while allowing the recycling of the units for optimal utilization. This will also allow Canadian Blood Services to supply the required units as a standing order.
Sites that keep an inventory of 4 unmatched units will receive all 4 units every 3 weeks.
Replacement of unmatched units will automatically be sent from CLS Transfusion Medicine to each site.
Sites using courier services will be responsible for arranging the pick up of the transport box at CLS Transfusion Medicine, Foothills Medical Centre.
CLS Transfusion Medicine will arrange transportation with Greyhound.
The return date for unmatched units will be written on the transfusion tag as “Cancellation Date”.
Return unused unmatched units with the transfusion tag attached.
Use of either “Headwaters Region” or CLS transport boxes is acceptable.
Sites may request unmatched O Rh Negative units at any time to replace used inventory. These requests will be handled as a Stat request.
Each site is responsible for identification and documentation of the recipient of the unmatched blood.
Recycling Blood Products
Products that were not dispensed from CLS may be sent to the Foothills Medical Centre in order to allow them to be used prior to outdating.
The sending site is responsible for ensuring the products is suitable for transfusion prior to sending. The declaration on the Recycling Blood and Blood Products form must be signed.
Products must be packed and transported in compliance with CSTM standards.
Complete a Recycling Blood and Blood Products form and included it in the transport box with the product.
Sites using the PathNet LIS -
Transfer blood components to FMC using the appropriate application. Include the transfer report in the transport box as well as the Recycling Blood and Blood Products form. Transfer plasma protein products (lot numbered) by disposing the product in PathNet with the appropriate disposal reason.
Products Dispensed to Physicians' Offices:
Physicians offices that infuse Rh immune globulin or other products derived from human blood must complete the forms provided with the product. The completed forms must be returned to the dispensing site before more product will be dispensed.
Physician offices storing Rh immune globulin or other products derived from human blood are responsible for ensuring that products are stored according to the manufacturer's recommendations.
The transfusion of all blood products must be documented on the patient's chart. The record must include the product type, the date and time of infusion and the unique unit or lot number.
A Notification of Administration of Blood or Blood Products (AHS 103684) card, which accompanies the product, must be given to the patient when the product is administered. The form must be placed on the patients chart.
Requests for TM Supplies:
Complete the CLS Extra Regional Supply Form (FIN7408) available from the CLS Purchasing Department. This includes all requests for Ident-A-Band bracelets, Pretransfusion Testing Requisitions- REQ9004TM (TM2028), Regional Transfusion Service Identification System (RTSIS) forms (CLS0997) and Request From Sites External to CLS (TM2089) form. Transfusion Medicine will fill the order for these supplies from the Quality Office.
Blood product inventory fax forms may be obtained by faxing a request to the TM Quality Office at 403-770-3775.
Autologous Blood Services
Information may be obtained by calling the Perioperative Blood Conservation Program Coordinator at 403-944-4710.
Directed Donor Services
Information may be obtained by calling CBS at 403-410-2694. Physicians may make arrangements for preliminary testing of potential donors and recipients by calling FMC Transfusion Medicine at 403-944-1367.
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