Emergency Transfusion

Attention

When emergency transfusion of uncrossmatched blood is required because of life-threatening situations, it is imperative that a system be in place for identification of unknown patients and to assure that correctly labelled specimens for crossmatch purposes are drawn prior to infusion of the uncrossmatched blood.

A recipient whose ABO group is unknown must receive group O Red Blood Cells. Rh negative RBC should be given preferentially to children and women of childbearing age.

This identification system usually consists of pre-registered identification numbers associated with fictitious names such as Unknown male A, Unknown female B, etc. In addition, some hospitals use unique identification bands for these situations. These are sometimes referred to by the product names such as Typenex, Identiband (Hollister), Securline, I-Trac, etc.

Note: Canadian Blood Services offers no endorsement of and assumes no liability for the currency, accuracy, or availability of any information on these sites.

Once the patient's identity is known, identification banding, including the patient's correct name, a new hospital identification number, date of birth and other identifying information, is prepared and attached to the patient's wrist. At this time, a new crossmatch should be drawn using the correct patient information and sent to the hospital transfusion service. This enables the hospital transfusion service personnel to perform a history check and crossmatch as well as label additional units for transfusion. Only then should the "unknown" band be removed from the patient's wrist.

The Process must include:

• Records (lab and/or patient's medical record) should contain a signed statement of the requesting physician indicating that the clinical situation was sufficiently urgent to require release of the blood components prior to completion of compatibility testing. When possible, patient consent should be obtained. In most cases, this documentation will only be put in the chart after the patient is stabilized.
• If pre-transfusion testing cannot be completed prior to issue, a label must be placed on the unit that indicates that pre-transfusion testing had not been completed (i.e., uncrossmatched blood). If compatibility tests are completed and incompatibility is found, the physician responsible for ordering the blood must be contacted immediately according to written policies and procedures.