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Urgent Requirements for Blood

• In situations when the patient’s life or health may be jeopardized by delaying transfusion until the pretransfusion testing is performed, the physician may choose to transfuse products in the absence of testing. The physician must specify “unmatched” in the order, or give verbal agreement to transfuse units before testing has been completed.
• It is the responsibility of the patient caregivers to communicate the urgent need for blood and blood products to Transfusion Medicine staff. Requests may be written or verbal. Verbal requests may be communicated by PCU staff or by the physician designate.
• Red cell products issued before receipt and/or testing of a properly identified specimen from the intended recipient will be issued as “unmatched”. All red cell products issued before completion of pretransfusion testing will be dispensed as “unmatched”. The transfusion tag attached to the unit will indicate that the unit is unmatched.
• In the event that a pretransfusion testing specimen has been collected but is unsuitable for testing (See Specimen Rejection Criteria), unmatched blood will be issued until the specimen can be corrected or re-collected as required.
• The presence of a known clinically significant antibody will not delay the issue of unmatched red cells. In the event that the patient is known to have a clinically significant antibody, the technologist will inform the physician that the units may be incompatible. The decision to transfuse remains with the physician.
• When units are dispensed without patient identification (such as to the ER refrigerator or to STARS), the identification of the recipient must be accurately documented and communicated to Transfusion Medicine by completion and return of the documentation that accompanies the units on issue.
• The expected turnaround time for unmatched (O, Rh-negative) is 10 minutes from the receipt of the request to the issue of the product. The expected turn around time for group specific red cells is 30 minutes from the time of specimen receipt to issue of the product.
• The expected turnaround time for delivery of products by Distribution Services staff is 20 minutes. PCU staff must transport products if required more urgently.

In order of preference, red cell products will be issued as:

1. Crossmatch compatible (all pretransfusion testing completed satisfactorily)
2. Crossmatch incomplete (in the presence of an antibody, crossmatch compatible units)
3. Group Specific unmatched (testing for ABO/Rh complete on a current specimen, antibody detection tests incomplete)
4. Emergency unmatched (ABO/Rh and antibody status of the patient undetermined from a current specimen: group O units issued.)