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Specimen Collection for Pretransfusion Testing

The collection procedure is as follows:

1. Receive completed requisition/request for pretransfusion testing* (Type and Screen or Crossmatch) or SCM order.

2. Assemble necessary phlebotomy supplies, including a yellow RTSIS ID band.

3. For Pre-OP Assessment Clinic patients, if the corresponding section of the RTSIS has not been completed:

a) Ask the patient for transfusion and pregnancy (female patients) history. Record on the Collection Record. If either answer is yes, collection must be done within 4 days of the OR date.

b) Record the OR date and sign the Collection Record. If the date is unknown, write "unknown" do not leave blank.

4. Place a patient label on the Collection Record and Tube Labels of the  Regional Transfusion Service Identification System (RTSIS)  form (CLS0997 or TM2199). The date and time should also be written on the tube label.  Alternatively, neatly print the first and last name, date of birth and ID number (RHRN, PHN, etc.).  

5. Identify the patient as defined under Patient Identification. The person who identifies the patient MUST be different from the person who collects the specimen. Obtain the signature of the second person who has identified the patient.

   a) If patient identifies him or herself, check "Yes" in the ‘Patient Identified by self’ field.

   b) A second responsible adult (e.g. relative, nursing unit staff) must identify the patient. This person must sign the Collection Record and write their title or relationship to the patient.

6. Draw the correct volume in EDTA tube(s) as listed in the test information.

7. Label specimens using Tube Labels. The RTSIS number must be applied to the tubes for the specimen to be accepted.

a) Alternatively, apply a label with the patient's name and number or neatly print the first and last name, date of birth and ID number (RHRN, PHN, etc.) on the label that is on the tube and apply a small RTSIS label to the tube.

8. Print the current date on the wristband insert. 

9. Detach the wristband insert by tearing along the perforation. Push the wristband insert into the RTSIS (yellow) band, RTSIS number end first, and attach securely to the patient. It may be placed on the wrist, arm, leg, ankle etc. If the band is too short, it can be made longer by clasping an additional band to the end.

For the system to be effective, it is critical that the band be placed on the patient at the time of collection. Inform the patient that the RTSIS ID band must be worn until removed by hospital personnel, or after discharge. Removal of this armband will result in a new specimen being drawn and delay in blood component availability.

10. The person who collects the specimen signs and dates the 'Collection Record' section of the form.

11. Ensure that all information on the tube label matches exactly with that on the RTSIS form.

12. Deliver the specimen, requisition and RTSIS form to the appropriate Accessioning area of the laboratory for direction to Transfusion Medicine.

Failure to follow this process may result in rejection of the specimen requiring specimen recollection and delay in the blood component availability.
Uncrossmatched units can be dispensed if red cell components are required.

*NOTE: Pretransfusion testing is requested in the PathNet LIS as TS (Type & Screen). This is the same as a crossmatch.