For patient safety, it is essential that the following be adhered to when submitting blood specimens for crossmatching purposes. Use special pink-top (EDTA) tubes.
If the Blood Bank does not have a previous ABO/Rh on file for the patient, and the patient's initial blood type is other than type O, the Blood Bank will request a second sample to be collected for an ABO/Rh confirmation.
Failure to properly label the tubes will require that the specimens be redrawn. If the patient requires blood as an emergency and another sample cannot be drawn, an Emergency Release Form must be signed for uncrossmatched group O blood.
Compliance with the Gann Act
California Health and Safety Code 1645
The most recent update of the California State Law mandates that every physician who determines that there is a reasonable possibility that his/her patient may require a blood transfusion must:
Whole Blood or Packed Cells Transfusion
1 full 6 mL pink-top (EDTA) tube with label that includes: patient's first and last name, PF#/MR#, time, date, printed last name of phlebotomist.
Send specimen and order form to Blood Bank immediately
If it is anticipated that the transfusion will exceed four hours, special arrangements should be made with the Blood Bank to split the unit prior to transfusing.
Pheresis (White cell concentrate or single donor platelet concentrate)
White Cell Concentrate Specimen Requirements
1 full 6 mL pink-top (EDTA) tube with label that includes: patient's first and last name, PF#/MR#, time, date, printed last name of phlebotomist. By appointment only. Consult with Director of Blood Bank, ext. 5716 Platelet Pheresis Specimen Requirements (if Blood Bank does not have patient's ABO/Rh on file): 1 full 6 mL pink-top (EDTA) tube with label that includes: patient's first and last name, PF#/MR#, time, date, printed last name of phlebotomist.
A platelet count must be completed before these components may be ordered. If the Platelet count is greater than 50,000 per mm3, the request for these components must have the approval of the Blood Bank Medical Director. Information necessary for ordering is patient diagnosis, ordering physician and time of transfusion.
Exchange transfusion for Hemolytic Disease of the Newborn
A transfusion reaction can be life threatening and should always be treated on a STAT basis.
Microbiology Specimen Collection and TransportDeliver all specimens as soon as possible to the Clinical Microbiology Laboratory 6004 BT. Collection devices are available from Hospital Stores.
Bacterial Cultures: Transport at room temperature unless otherwise specified.
Mycobacterial Culture (AFB Culture)
Viral/Molecular Infectious Disease PCR Testing
Collect specimens for PCR testing early in illness when viral shedding is maximal. Place swabs in viral transport medium (33595, 33625). Collect bronchoalveolar lavage and specimens from normally sterile sites in a sterile, leak-proof container (37777). Transport the specimen to the Microbiology laboratory (6004 BT) immediately.
Respiratory Virus PCR: This panel covers these analytes: Influenza A (includes H1N1/2009), Influenza B, Parainfluenza 1, 2, 3, and 4, Respiratory Syncytial virus A and b, Adenovirus, Human Metapneumovirus, Human Rhinovirus/Enterovirus (not distinguished), Coronavirus, Chlamydia pneumoniae and Mycoplasma pneumoniae.
Nasopharyngeal swab: Collect specimen using the flexible minitip flocked swab (Hospital Stores #33595). Measure the distance from the patient's nostril to the nasopharynx (half the distance from nostril to base of the ear) and hold the swab at that location. Do not advance the swab beyond that point. Gently insert the swab along the base of one nostril (straight back, not upwards) and continue along the floor of the nasal passage until reaching the nasopharynx. Rotate swab 2-3 times and hold in place for 5 seconds. Place swab in tube containing viral transport medium. Break off the excess length of swab at the score mark to permit capping of the tube.
Mycoplasma PCR: Collect throat swab in ESwab (74541).
PCR Assays are available for the following viruses: BKV (blood and urine), HSV1&2, VZV, enterovirus (CSF), EBV (Blood and CSF) and CMV (blood, CSF, or BAL). PCR testing requires a dedicated collection tube and cannot be added onto a previously opened Vacutainer® tube. For CSF from lumbar puncture, most patients should have an order placed for the Meningitis/Encephalitis Panel (LAB8514).
Clinician-Collected Rectal Swab Specimen Collection
Clinician-Collected Pharyngeal Swab Specimen Collection
Endocervical Specimen Collection
Patient-Collected Vaginal Swab Specimen Collection
Urine Specimen Collection (First Catch)