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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.

  1. Take a Crossmatch/Transfusion form, patient printed labels with the patient's first and last name, patient file number (PF#) or medical record number (MR#), and 1 pink-top (EDTA) tube to the patient's bedside.  
  2. Verify the patient's identity by asking the patient to state and spell his/her name, if able, while comparing the patient's identification band with the addressographed Crossmatch/Transfusion form and the patient's printed label. 
  3. The patient's name and PF# or MR# must be obtained from the patient's identification wristband. If the patient does not have a wristband, a wristband must be obtained prior to drawing the patient's blood. 
  4. Write the following data on the patient's printed or computer-generated gummed label at the bedside: 
    •  Date of phlebotomy 
    • Time of phlebotomy 
    • Legibly printed last name of phlebotomist 
  5. Affix the patient's printed gummed label to the specimen tube at the patient's bedside. 
  6. Send the labeled specimen tube with the Crossmatch/Transfusion form to the Blood Bank. 

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:

  1. Provide the patient with a copy of the state form "A Patient’s Guide to Blood Transfusions" currently available through the hospital clinics. 
  2. Document in the patient’s record that the above was accomplished 
  3. Allow the patient enough time to exercise the option(s) described in the state form. 
  4. Compliance with this law by the Medical Staff will be monitored by Quality Resource Management. 

Whole Blood or Packed Cells Transfusion

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.

Send specimen and order form to Blood Bank immediately

  • STAT (urgent) request – if type specific units are on hand in the Blood Bank, crossmatched blood will be available on 1 hour notice.
  • "Type and Screen, Hold" Request 
  1. Specimen is ABO and Rh typed, and an antibody screen is run. 
  2. Crossmatch done only on notification within 72 hours of specimen date and time. 
  3. Units NOT crossmatched and held. 
  4. Units can be crossmatched on 10 minutes' notice. 
  • Scheduled surgeries 
  1. Blood may not be available when required if requests for this blood arrive in the laboratory after 2:30 p.m. the day prior to surgery. Antibody problems and lack of units on hand may preclude the availability of the blood in time for scheduled surgery. 
  2. When patient either has been pregnant or transfused within the past six months, or when such information is uncertain or unavailable, a sample obtained within 72 hours of next scheduled transfusion or surgical procedure must be sent for compatibility testing. If the patient has not been pregnant or transfused in the last six months, a specimen may be used up to seven days, provided a medical history form stating this information accompanies the crossmatch requisition. 
All components are to be held in the Blood Bank until they are infused into the patient. They must NEVER be "held" in domestic refrigerators on the wards. If a unit is issued and transfusion plans have changed or been delayed, please return it immediately to the blood bank. If returned unopened and unused within 30 minutes of issue, it will be held in the Blood Bank refrigerators for reissue to that patient.


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

Specimen Requirements

  • Mother: 1 full 6 mL pink-top (EDTA) tube from the mother with label that includes: patient's first and last name, PF#/MR#, time, date, printed last name of phlebotomist, and indication that it is the "mom’s clot" for Baby ______, PF#/MR#______)
  • Baby: 0.5 mL blood in a pink or lavender-top (EDTA) tube with label that includes: patient's first and last name, PF#/MR#, time, date, printed last name of phlebotomist. 
  • Instructions: 
  1. Notify Blood Bank immediately of possible exchange. 
  2. It is preferable to use maternal serum for any initial antibody screening for unexpected antibodies or for crossmatching, particularly for exchange transfusion for treatment of hemolytic disease of the newborn. If the initial test for unexpected antibodies is non-reactive, subsequent tests to determine incompatibility with donor red cells, and repeated tests for unexpected antibodies may be omitted for the remainder of the neonatal period. If mother’s specimen is not available, testing should be performed on a blood sample from the baby. 
  3. Confirmation of baby’s blood type must be performed prior to the transfusion of any type specific blood product. 
  4. Blood for infants will be supplied by preparing aliquots of units of blood no more than 35 days old. 
  5. CMV negative red blood cells will be supplied for infants less than 4 months of age. 
Transfusion Reaction


A transfusion reaction can be life threatening and should always be treated on a STAT basis.

  1. STOP THE TRANSFUSION IMMEDIATELY and keep saline line open. 
  2. Compare patient identification with blood bag. Notify the physician. 
  3. Attach new intravenous tubing to infusion equipment and allow new bag of normal saline solution to flow slowly until a decision regarding parenteral fluids is made. 
  4. Notify the Blood Bank immediately. Obtain additional instructions regarding the collection of post-transfusion blood and urine specimens. 
  5. Immediately send transfusion bag and normal saline flush solution with administration tubing intact to the Blood Bank in a plastic overwrap bag. Attach completed Crossmatch/Transfusion slip to the outside of plastic overwrap bag.