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Emergency Transfusion

  • In situations when the patient’s life or health may be jeopardized by delaying transfusion until the pretransfusion testing is completed, the physician may choose to transfuse components 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 components and products to Transfusion Medicine staff. Requests may be written or verbal. Verbal requests must be communicated by healthcare professionals (i.e physician, nurse, etc).
  • Red cell units issued before receipt and/or testing of a properly identified specimen from the intended recipient will be issued as “unmatched”. All red cells 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 upon issue.
  • The expected turnaround time for unmatched (group O) red cells is 10 minutes from the receipt of the request to the issue of the red cells.    
  • The expected turnaround time for delivery by Distribution Services staff is 20 minutes. PCU staff must transport blood if required more urgently.
  • An Emergency Blood Transfusion form (AHS 103683) must be completed and placed on the patient's chart when unmatched units are transfused.

In order of preference, red cell components 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. Emergency unmatched (ABO/Rh and antibody status of the patient undetermined from a current specimen: group O red cells issued.)

If plasma units are required, group AB units will be dispensed until the completion of Type testing. Group-specific or non-group AB compatible units will be dispensed once the patient's ABO type has been determined by pretransfusion testing. Thawing time may be required for plasma units.