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Catalog ID RBC Order Red Blood Cells (for transfusion)

CPOE Test Name

Red Blood Cell Order (Use Blood Bank- Blood Products Adult/Pediatric Subphase to order blood products only if patient has a current type and screen)

Synonyms

Packed Cells, PRBC’s, Red Cells, RBC

Specimen Type

Blood

Specimen Requirements

Pink top (EDTA) tube. Fenwal Label. Requires Full Name, Medical Record Number, date and phlebotomist initials/Cerner ID

 

Current Type and Screen required to set up blood unless an emergency (see Emergency Transfusion).

Storage and Transport

Send patient labeled sample to Blood Bank. Issued RBCs, if not used, must be returned to Blood Bank within 30 minutes. Reissue of units returned in 30 minutes is conditional upon the container closure not being disturbed, the unit not having been allowed to warm above 10° C or cool below 1 degree C during transportation or at the location point, and the appearance of the unit meeting regulatory requirements. DO NOT store red blood cells in refrigerators that have not been approved and are not monitored by the Blood Bank.

Causes for Rejection

Improper labeling; wrong tube; gross hemolysis; insufficient volume

Interpretation

One unit of red blood cells may raise the hematocrit 3% and hemoglobin 1 g/dL in a 70 kg average size adult patient. A compatible crossmatch and negative antibody screen result indicates that testing did not identify any antibody or incompatibility. An incompatible crossmatch result indicates incompatibility between the donor and recipient. This is suggestive of a clinically significant antibody. Further testing would be indicated.

Test Consists

Patient testing consists of ABO, Rh, Antibody Screen (Indirect Coombs), and Crossmatch. The RBC unit hematocrit is generally between 50% and 80%. The volume of a RBC unit ranges from 250 – 450 mL. RBC units are stored in Blood Bank refrigerators with the temperature controlled between 1°C to 6°C. No medications or solutions may be added or infused through the same tubing with red blood cells except 0.9% Sodium Chloride, Injection (USP).

Turn Around Time

Crossmatch (Red Blood Cells)
Routine: 2 – 4 hours

Urgent: 1 – 2 hours
Emergent: 30 minutes
Emergency, uncrossmatched: 15 minutes

Methodology

Antibody Screen result positive: Requires additional testing to identify reason (panel(s), antigen typings, and other specialized tests).

 

Crossmatch results incompatible: Requires specialized testing and time to identify the reason.

 

Issuance of non-group specific RBC units, O Positive and O Negative, should only be used in extreme emergencies. When time permits, ABO group specific RBC units are preferred. RBC units should not be used to treat anemia that can be corrected with specific medication such as iron, vitamin B12, folic acid, or recombinant erythropoietin.

CPT / HCPCS Code

P9016, P9040, 86920, 86922

Reference Ranges

Not applicable

Performing Lab

Blood Bank BI-1230 721-2731