Transfuse PRBCs (Type and Cross)

Message

Order for Packed Red Blood Cells is through a discern advisor. The advisor will activate the Pediatric Set Up RBCs order for patients who weigh less than 40kg.

Test Code

ATRBC or PTRBC

Alias/See Also

TRBC
Transfuse NEO/PEDS/PICU Blood Products
PTRBC
Leukoreduced Packed Cells / RBC's
Packed Cells - Leukoreduced
RBC's
Transfuse Autologous RBC's
Transfuse Red Cells
Autologous Red Cells
Irradiated RBC's

Preferred Specimen

Pink 6.0mL

Other Acceptable Specimens

Pink 6.0mL.
Special Blood Bank Identification process is required for specimens collected for Type and Cross testing. Red top tubes are NOT the specimen of choice. Please contact the Blood Bank for samples collected in these tubes.

Instructions

All red cell transfusions require compatibility testing. Blood products may be ordered with specific special instructions. These special ordering instructions MUST be included on the requisition. These include the following:

Autologous Units: Pre-donation of autologous blood must be approved by the Laboratory Medical Director prior to donation and only applies if the patient donated their own blood for use during this hospital stay.
Donor Directed Units: The physician has ordered blood products be collected from friends/relatives designated specifically for use by this patient. The units must be available at the blood supplier.
Irradiated: If the blood product must be irradiated prior to transfusion.
Hemoglobin S Negative: If the patient requires blood products be tested for HgbS prior to transfusion.

Ordering Comments, if applicable:

Washed Red Cells: Add this comment if the blood must be washed prior to transfusion to remove anticoagulant.
CMV Seronegative: Must be approved by the Laboratory Medical Director.

For Neonatal / Pediatric transfusions, indicate transfusion volume (mL) requested on order. Indicate "Dedicated Unit" on order to hold split aliquots (4 aliquots of 1 unit) for a single baby.

Setup Schedule

For procedures on how to transfuse blood products, please see the Banner Intranet.
Product expiration:

Packed Red Blood Cells expire in 21, 35, or 42 days from the day of collection, depending on the preservative used for collection.
Irradiated products expire 28 days after irradiation.
Washed or deglycerized Red Cells expire 24 hours after washing.

Report Available

Routine results are available in less than 4 hours. For STAT expected turn around time, please see hospital specific lab information on the Banner Intranet. The type, screen, and crossmatch, at a minimum, requires 45 to 60 minutes from the time the specimen is received into the Blood Bank. A positive antibody screen will require additional testing and additional time.

Clinical Significance

Transfusion:

Symptomatic anemia (generally Hgb<7 or Hct<21)
Hypovolemia (estimated blood loss >1000cc)
Acute Bleeding (estimated 15% blood loss)

Leuko-reduced Red Blood Cells:
All hospital sites use leuko-reduced red cell products. This is a better overall product, helps reduce the number of febrile transfusion reactions, and is considered CMV safe.

Detailed information on recommendations for transfusion can be found in the "AABB Circular of Information for the Use of Human Blood and Blood Components" located on the AABB web site (link below).
http://www.aabb.org/tm/coi/Pages/default.aspx

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.