Blood Typing, Antibody Screen, and Crossmatch
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ABO group and Rh typing, blood group antibodies, type and screen, type and crossmatch.
To identify ABO blood group and Rh type, typically for prenatal screen and transfusion purposes. These tests are also used to help establish compatibility for cellular therapy and solid organ transplantation (in addition to human leukocyte antigen [HLA] and HLA antibody typing).
There are no food, fluid, activity, or medication restrictions unless by medical direction.
(Method: FDA-approved reagents with glass slides, glass tubes, gel, or automated systems) Compatibility (no clumping or hemolysis).
Critical Findings and Potential Interventions
Timely notification to the requesting health-care provider (HCP) of any critical findings and related symptoms is a role expectation of the professional nurse. A listing of these findings varies among facilities.
Signs and symptoms of blood transfusion reaction range from mildly febrile to anaphylactic and may include chills, dyspnea, fever, headache, nausea, vomiting, palpitations and tachycardia, chest or back pain, apprehension, flushing, hives, angioedema, diarrhea, hypotension, oliguria, hemoglobinuria, acute kidney injury, sepsis, shock, and jaundice. Complications from disseminated intravascular coagulation (DIC) may also occur.
Possible interventions in mildly febrile reactions include slowing the rate of infusion, then verifying and comparing patient identification, transfusion requisition, and blood bag label. The patient should be monitored closely for further development of signs and symptoms. Administration of epinephrine may be ordered.
Possible interventions in a more severe transfusion reaction may include immediate cessation of infusion, notification of the HCP, keeping the IV line open with saline or lactated Ringer solution, collection of red- and lavender-top tubes for posttransfusion work-up, collection of urine, monitoring vital signs every 5 min, ordering additional testing if DIC is suspected, maintaining patent airway and blood pressure, and administering mannitol.