Samples
In the absence of a full electronic compliant bedside labelling process
the Blood Safety and Quality Regulations (BSQR UK Law 2005) state that the bottle label must be handwritten.
BT operates a zero tolerance and will reject any samples that are not labelled correctly.
Specimen Acceptance and Rejection:
The Blood Transfusion laboratory follows strict guidelines on sample labelling. Here is a list of Do’s and Don’ts for sample/request form labelling:
- Do positively identify the patient by asking them to state their name and date of birth.
– In-Patients: information on the wristband MUST match the information given by the patient.
– Out-Patients: information in the notes MUST match the information given by the patient. - Do label samples next to the patient e.g. bedside and hand write the sample tube?
- Do label the tube and request form with a biohazard sticker if this information is known?
- Do sign the declaration on the request form as this is a legal requirement.
- Don’t stick addressograph on transfusion sample tubes. They can be used for the request form.
- Don’t pre-label sample tubes.
Rejection Criteria:
Samples will be rejected in the following circumstances:
- minimum essential information is missing from the sample or request form.
- sample and request form information do not match.
- sample is unlabelled or otherwise unsuitable (e.g. wrong tube type, addressograph on sample).
Specimen acceptance and Rejection:
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Blood Transfusion
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Site |
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| Test | Specimen (s) | Result(s) available | RWT | RHH | WMH | MMUH | ||
| Urgent | Non-Urgent | |||||||
| Group and antibody Screen | Adult: 6ml EDTA – Pink Top
Paediatric:6ml EDTA or 1ml EDTA Neonate: 1ml EDTA |
1 hour | Within 48 hrs |
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| Antibody investigation | Adult: 6ml EDTA – Pink top
Paediatric:6ml EDTA |
2 – 4 hours depending on the complexity of the antibody. Extra transfusion samples may be requested to send to NHSBT for confirmation which will significantly increase the turnaround time. | Within 48 hrs |
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| Compatibility testing /
Crossmatching |
Adult: 6ml EDTA – pink top
Paediatric:6ml EDTA or 1ml EDTA Neonatal: 1ml EDTA |
1 hour . The presence of antibodies will cause a delay in the provision of red cells. If crossmatch is required to be processed by NHSBT this will significantly increase the turnaround time. | 2 hrs or longer depending on the workload priorities at that time. |
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| Cord blood investigation | 6ml EDTA | 2 hrs | Within 24 hrs | √ | √ | √ | √ | |
| Direct antiglobulin test | 6ml EDTA
4.5ml EDTA 1ml EDTA |
1 hr | Within 24 hrs |
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| Kleihauer test | 6ml EDTA
4.5ml EDTA |
2 – 4 hr Samples not processed out of hours. | Within 24 hrs | √ | √ | √ | √ | |
| HDFN Test | Maternal sample – 6ml EDTA
Cord sample – 6ml EDTA |
2 – 4 hrs
Samples are not processed out of hours. |
Within 24 hrs |
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| Transfusion Reactions | 6 ml EDTA -Pink top Transfusion testing for suspected reaction.
5 ml – Yellow top IgA, Haptoglobin,Mast cell Tryptase (must be taken within 1/ 6 / 24 hours of reactions). 5 ml – Yellow top Urea, electrolytes, bilirubin & LDH. 4.5 ml – Purple top Full blood Count 3.5ml – Blue top Coagulation screen and D-Dimer. Blood cultures (only if temp rise is greater than 2°C above the baseline or an absolute temperature of 39°C or if clinically indicated blood cultures. Post reaction urine (White top) Haemosiderin. |
1 hour for compatibility testing aspect of transfusion reaction investigation only. | Within 48 hrs. |
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Requirement for Labelling BT Request form and sample:
| Request Form | Sample | |
|---|---|---|
| Surname | Essential | Essential |
| Forename | Essential | Essential |
| Hospital/ NHS Number | Essential | Essential |
| Date of Birth | Essential | Essential |
| Gender | ||
| Date and Time | Essential | Essential |
| Name of Sample Taker | Essential | |
| Signature of Sample Taker | Essential | Essential |
| Consultant | Desirable | Not Applicable |
| Ward | Desirable | Desirable |
| Test or blood/blood product required | Essential | Not Applicable |
| Date and time blood/blood product required | Essential | Not Applicable |
| Special requirements | Essential | Not Applicable |
| Diagnosis/clinical details | Desirable | Not Applicable |
| Name of Requester | Desirable | Not Applicable |
| Contact details | Desirable | Not Applicable |
Urgent Samples
Urgent Transfusion
When a transfusion is required urgently you must telephone the blood bank to warn the staff that an emergency specimen is on the way and clearly state how soon blood is required on the request form.
Immediate Transfusion
Please send a specimen to the Blood Bank as soon as possible. If there is no time for full pre-transfusion testing then unmatched blood can issued, or major haemorrhage packs used following the declaration of a major haemorrhage. It is important that a blood specimen for Blood Transfusion is obtained from the patient at the earliest opportunity so that group specific blood can be supplied.
