Te Matau a Māui | Laboratory Services - User contributions [en]

Transfusion Medicine Department Information

2026-02-20T03:55:41Z

Jmayes: /* Transfusion Therapy */

== Specimens for pre-transfusion testing ==

=== '''Specimen''' ===
{| class="wikitable"
|Type
|6 mL Pink Top (Crossmatch)
|-
|Volume
|Normally 6mL. Greater volumes may be required for certain individuals.

Minimum 2mL (generally paediatric)
|-
|Haemolysis
|Sample must not be grossly haemolysed
|}

=== '''Specimen Collection and Labelling''' ===
'''Correctly identifying the patient before collection of the blood sample is essential.'''

• If the patient is in hospital and does not have a wristband, ask the ward staff to apply one before collecting the sample.

• '''At the time of sample collection''' ask the patient to state (if able) their family name, given name(s) and date of birth.

• '''If a wristband is not provided''' (for example: in an outpatient setting) ask the patient to state '''and spell''' (if able) their family name, given name(s) and date of birth.

• '''In an extreme emergency''' a Red Bracelet number with unique NHI may be used. This number must be copied from the patient’s wristband.

• In the case of an '''unconscious patient or person unable to comply with the request for information,''' copy the patient identification details from the patient’s wristband, and if possible confirm with a relative.

• '''Check all the information supplied''' (by patient or relative, on wristband and on request form) to ensure they match. '''DO NOT''' proceed with sample collection if there are discrepancies.

• The patient’s identity must be re-established if the collector leaves the patient’s location prior to initiating the blood collection procedure.

'''Sample tubes must not be labelled in advance of the sample collection.'''

'''The sample tubes must be accurately labelled BEFORE leaving the patient.   '''

'''DO NOT copy patient details from the patient’s notes or charts.'''

'''DO NOT apply a computer generated Bradma label to the sample.'''

Legible hand written patient details must be recorded on the sample tube(s) with pen.

'''The following information MUST be included on the sample tube(s):'''

   Surname (unabbreviated)

   First name (unabbreviated)

Date of Birth

   NHI Number

   Time and date of collection

   Signature of person who collected the sample

Failure to provide any of this information will result in the specimen being rejected for processing.

'''In an Emergency:'''

Unique ED Red Bracelet Identification Code Number may be used along with the Hospital Number allocated to this unique number. (This information should be attached to the patient, for example: wristband).

   Time and date of collection

Signature of person who collected the sample

'''Following specimen labelling:'''

• Check the request form and the sample tube have identical patient information.

• Complete Step 4: “Specimen Collector Declaration” on the request form with the time and date, your name and signature.

=== '''Completion of the NZBlood Blood Bank Request Form''' ===
Full and accurate completion of the request form is essential for ensuring that the right test or quantity of blood component or product, is available at the right place at the right time.

Patient details are to be recorded on NZBlood Blood Bank Request Form using preferably a computer generated label or legible handwriting.

The request form '''MUST''' contain the following patient information:

• Patient’s registered surname name and given name/s (unabbreviated).

• Hospital number (NHI) and/or date of birth.

• Name of patient’s consultant/practitioner.

• Name and signature of the person completing the request form. This may be a nurse on behalf of the requesting doctor.

• Details of tests required and/or indication of the quantity and time that blood components or products are required (such as date and type of planned surgery).

• Any special requirements for components, for example: Irradiated.

• Signed declaration by the collector confirming that the patient was positively identified at the time of collection and that the samples were labelled before leaving the patient.

• Date and time of collection of blood sample.

The request form should also include:

• Clinical diagnosis and indication for transfusion.

• Record of any known previous transfusions or pregnancy within the last three months.

• Patient’s location.

• Gender.

• Date of surgical procedure (if applicable).

'''Note: ''' The actual prescription for the blood component is the charting of the blood by the attending Medical Officer in the patient’s medical record.

== Requirements for pre-transfusion testing ==
'''Important: ''' It is not possible to over-emphasise the importance of proper patient identification.

Most errors relating to transfusion practice arise from administrative and clerical error. These errors can have serious consequences for patients and are sometimes fatal.

=== '''Blood Products and Components Available''' ===
{| class="wikitable"
|'''Blood Components'''
|'''Special Requirements'''
|-
|Red Cells Resuspended
|Irradiated Red Cells by special request
|-
|Platelet Concentrates
|Contact Blood Bank about availability before requesting
|-
|Fresh Frozen Plasma (FFP)
|
|-
|Cryoprecipitate
|
|-
|'''Albumin Products'''
|
|-
|Alburex 5 NZ
Alburex 20 NZ
|
|-
|'''Immunoglobulins'''
|
|-
|Rh(D) Immunoglobulin (250IU and 625IU vials)

Hepatitis B Immunoglobulin - Neonatal Dose

Tetanus Immunoglobulin
|
|-
|Privigen NZ (Intravenous Normal Immunoglobulin)

Hizentra (Subcutaneous Normal Immunoglobulin)

GamaSTAN (Intramuscular Normal Immunoglobulin)

Hepatitis B Immunoglobulin - Adult Dose

Zoster Immunoglobulin

Rabies Immunoglobulin
|By special request - NZBS approval may be required
|-
|'''Coagulation Factors'''
|
|-
|Beriplex NZ (Factors II, VII, IX, X and Proteins C & S)
Recombinant Factor VIII

Recombinant Factor IX

Biostate (Recombinant Factor VIII & von Willebrand Factor)
|
|}
A completed NZBlood Blood Bank Request Form is required for plasma products. Request the name of the product and quantity or dose required. The patient’s full details need to be included along with the date required and time if applicable.

=== '''Transfusion Therapy''' ===
Please refer to Blood Transfusion - [https://hauoraaotearoa.sharepoint.com/sites/1000577/Published%20Documents/Forms/AllItems.aspx?id=%2Fsites%2F1000577%2FPublished%20Documents%2FBlood%20Transfusion%20%2D%20Minimum%20Orders%20%2D%20IVTG626%20%28Feb%2D20%29%2Epdf&parent=%2Fsites%2F1000577%2FPublished%20Documents Minimum Orders Policy HBDHB/IVTG/626]

=== '''Procedures:''' ===

==== '''Antibody Screen (ABS)''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Blood Group''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cold Agglutinin Screen''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cord Blood Screen''' ====
Specimen required: 4mL Purple Top (EDTA) tube.

==== '''Crossmatch (X Match)''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

Use NZBlood Blood Bank Request Form.

• Fill in the areas on the form especially previous transfusions or pregnancies within the last 3 months and Clinical Details (Pre-op is not helpful!).

• Start date and time when blood may be required. Failure to supply any of this information may cause unnecessary delays.

• Crossmatched units will only be held for 24 hours except by special arrangement with the Transfusion Medicine Department.

• In the event of postponement or cancellation of surgery, please notify the Transfusion Medicine Department.

==== '''Direct Antiglobulin Test (DAT)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

==== '''Group, Screen and Hold (GSH)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

Use NZBlood Blood Bank Request Form.

==== '''Transfusion Reaction Investigations''' ====
{| class="wikitable"
|'''Specimens Required'''
|'''Consider Need For'''
|-
|6 mL Pink top (Crossmatch) tube
|Blood cultures if sepsis suspected
|-
|10 mL Red top (plain) tube
|Blood gases if respiratory distress present
|-
|4 mL Purple (EDTA) tube
|Urine to check for haemoglobinuria
|-
|4.5 mL Lithium heparin (Pale green top) tube
|Coagulation screen if bleeding
|-
|Blood unit(s) implicated in reaction investigation
|
|}
After hours - investigations are only generally performed if the reaction is considered serious and the laboratory is contacted.

=== '''Specimen Validity''' ===
Samples from patients for red cell transfusion are valid for 72 hours, 7 days or 21 days depending on transfusion history, pregnancy and information supplied on the request form.
{| class="wikitable"
|'''Clinical Situation'''
|'''Specimen Validity Time'''
|-
|Patient transfused with red cell, platelet or allogeneic HPC components in the last 3 months.
| rowspan="2" |

Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Patient is pregnant or has been pregnant within the last 3 months (excluding placental risk and planned caesarean sections - see below).
|-
|Patient with placental risk.
|Sample valid for 7 days unless patient transfused red cell or platelet components within the last 3 months.

Once transfusion occurs, units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.
|-
|Patient with planned caesarean section.
|Sample valid for 72 hours, however if the section is planned Monday, the sample may be collected on the preceding Friday and valid for 96 hours.
|-
|Transfusion request form does not clearly exclude transfusion or pregnancy within the last 3 months (i.e. history section of form not completed).
|Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the last 3 months.
|Sample valid for 7 days but only 72 hours after transfusion has commenced.
|-
|Elective procedures (pre-admission samples), where the transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the past three months and clearly indicates the date that blood transfusion could occur, is more than 7 days after sample collection.
|On request, the sample may be valid for up to 21 days provided history is validated (for example: the eTraceline transfusion file shows no evidence of transfusion in past 3 months).

Once transfusion occurs units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.

Plasma/serum will be separated as soon as possible (and no more than 7 days following collection) and frozen to 20°C or below.
|}
If unsure of the validity that will be applied in a specific scenario, contact Transfusion Medicine Department for advice.

== Contact ==
Transfusion Medicine (Blood Bank) Laboratory - (06) 878 1692 ext 2645

'''Tony Morgan''' (Head of Department) - ext 2629

== Related Links ==
[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/transfusion-medicine-handbook Transfusion Medicine Handbook]

[https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Blood Transfusion Minimum Orders (IVTG626)]

[https://www.clinicaldata.nzblood.co.nz/resourcefolder/index.php?dhbid=14 NZ Blood Service Resource Folder]

[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/clinical-newsletter/ NZ Blood Service Clinical Newsletters]

[https://www.nzblood.co.nz/ NZ Blood Service Website]

Tests:First Antenatal Screen DHB

2026-02-10T22:55:19Z

Jmayes:

{{DISPLAYTITLE: First Antenatal Screen DHB}}

[[Category:Tests]]
[[Category:Transfusion]]
[[Category:Haematology]]
{| class="wikitable"
|'''Synonym(s)'''
|1st AN bloods, Includes: Group and Screen, CBC, HBsAg serology, HIV serology, Rubella IgG serology, Syphilis serology
|-
|'''Specimen'''
|6 mL EDTA (Pink top) + 2 x 4 mL EDTA (Purple top) + 10 ml plain (RED - NO GEL). Minimum labelling - Surname + Forename + NHI Number and/or Date of Birth
|-
|'''Paediatric Specimen'''
|N/A
|-
|'''Minimum Volume'''
|250uL for CBC
|-
|'''Add-on conditions'''
|Please view individual tests (serology specimen stored for 12 months)
|-
|'''Test Availability'''
|Mon - Fri 0800 - 1600
|-
|'''Turnaround Time'''
|Hastings / Central HB / Wairoa 24 hours
|-
|'''Where analysed'''
|Hastings
|-
|'''Department'''
|Haematology, Microbiology and Transfusion Medicine (06) 878 1308 ext. 2445, 2637 or 2645
|-
|'''Registration Code'''
|CBCD + HBA + AN1
|-
|'''Deletion Code'''
|N/A
|-
|'''Useful Information'''
|
|-
|'''Measurement Uncertainty'''
|N/A
|}

Tests:First Antenatal Screen - Hospital

2026-02-10T22:54:57Z

Jmayes: Removed BB test code

{{DISPLAYTITLE:First Antenatal Screen - Hospital}}

[[Category:Tests]]
[[Category:Transfusion]]
[[Category:Haematology]]
{| class="wikitable"
|'''Test'''
|First Antenatal Screen - Hospital
|-
|'''Synonym(s)'''
|First Antenatal, AN1, 1st Antenatal, Includes: Group and Screen, CBC, HBsAg serology, HIV serology, Rubella IgG serology, Syphilis serology
|-
|'''Specimen'''
|6 mL EDTA (Pink top) + 2 x 4 mL EDTA (Purple top) + 10 ml plain (RED - NO GEL) or SST. Minimum labelling - Surname + Forename + NHI Number and/or Date of Birth
|-
|'''Paediatric Specimen'''
|N/A
|-
|'''Minimum Volume'''
|250uL for CBC
|-
|'''Add-on conditions'''
|Please view individual tests (serology specimen stored for 12 months)
|-
|'''Test Availability'''
|Mon - Fri 0800 - 1600
|-
|'''Turnaround Time'''
|3 - 7 days
|-
|'''Where analysed'''
|Hastings
|-
|'''Department'''
|Haematology, Microbiology and Transfusion Medicine (06) 878 1308 ext. 2445, 2637 or 2645
|-
|'''Registration Code'''
|CBCD + HBA + AN1
|-
|'''Deletion Code'''
|N/A
|-
|'''Useful Information'''
|Hospital requests have CBC, HBA, Serology and group and hold performed at the DHB.
|-
|'''Measurement Uncertainty'''
|N/A
|}

Tests:First Antenatal Screen - Community

2026-02-10T22:54:31Z

Jmayes: Removed BB test code

{{DISPLAYTITLE:First Antenatal Screen - Community}}

[[Category:Tests]]
[[Category:Transfusion]]
[[Category:Haematology]]
{| class="wikitable"
|'''Synonym(s)'''
|First Antenatal, AN1, 1st Antenatal, Includes: Group and Screen, CBC, HBsAg serology, HIV serology, Rubella IgG serology, Syphilis serology
|-
|'''Specimen'''
|6 mL EDTA (Pink top) + 2 x 4 mL EDTA (Purple top) + 10 ml plain (RED - NO GEL) or SST. Minimum labelling - Surname + Forename + NHI Number and/or Date of Birth
|-
|'''Paediatric Specimen'''
|N/A
|-
|'''Minimum Volume'''
|250uL for CBC
|-
|'''Add-on conditions'''
|Please view individual tests (serology specimen stored for 12 months)
|-
|'''Test Availability'''
|Mon - Fri 0800 - 1600
|-
|'''Turnaround Time'''
|3 - 7 days
|-
|'''Where analysed'''
|Hastings and External Laboratory
|-
|'''Department'''
|Biochemistry, Haematology, Microbiology and Transfusion Medicine (06) 878 1308 ext. 2447, 2445, 2637 or 2645
|-
|'''Registration Code'''
|CBCD + HBA + SCL
|-
|'''Deletion Code'''
|N/A
|-
|'''Useful Information'''
|Private midwives and GP requests have CBC, HBA and group and hold performed at the DHB. Serology is performed by SCL
|-
|'''Measurement Uncertainty'''
|N/A
|}

Tests:Antibody Titration - Antenatal ONLY

2026-02-10T22:54:07Z

Jmayes:

{{DISPLAYTITLE:Antibody Titration - Antenatal ONLY}}
{| class="wikitable"
|'''Test'''
|Antibody Titration - Antenatal ONLY
|-
|'''Synonym(s)'''
|Titration, Antibody Titre, Titre
|-
|'''Specimen'''
|6 mL EDTA (Pink top). Minimum labelling - Surname + Forename + NHI Number and/or Date of Birth
|-
|'''Paediatric Specimen'''
|N/A
|-
|'''Add-on conditions'''
|3 days @ 4°C
|-
|'''Test Availability'''
|Mon - Fri 0800 - 1600
|-
|'''Turnaround Time'''
|Hastings / Central HB / Wairoa 3 - 5 days
|-
|'''Where analysed'''
|NZ Blood Service, Auckland
|-
|'''Department'''
|Transfusion Medicine, (06) 878 1308 ext. 2645
|-
|'''Registration Code'''
|
|-
|'''Deletion Code'''
|N/A
|-
|'''Useful Information'''
|
|-
|'''Measurement Uncertainty'''
|N/A
|}

[[Category:Tests]]
[[Category:Transfusion]]

Tests:Antenatal Screen - Subsequent

2026-02-10T22:53:17Z

Jmayes: Removed BB test code

{{DISPLAYTITLE:Antenatal Screen - Subsequent}}
{| class="wikitable"
|'''Test'''
|Antenatal Screen - Subsequent
|-
|'''Synonym(s)'''
|Antenatal, Subsequent
|-
|'''Specimen'''
|6 mL EDTA (Pink top) + 2 x 4 mL EDTA (Purple top). Minimum labelling - Surname + Forename + NHI Number and/or Date of Birth
|-
|'''Paediatric Specimen'''
|N/A
|-
|'''Minimum Volumes'''
|250uL for CBC
|-
|'''Add-on conditions'''
|Please view individual tests (serology specimen stored for 12 months)
|-
|'''Test Availability'''
|Mon - Fri 0800 - 1600
|-
|'''Turnaround Time'''
|3 - 7 days
|-
|'''Where analysed'''
|Hastings
|-
|'''Department'''
|Haematology and Transfusion Medicine (06) 878 1308 ext. 2445 or 2645
|-
|'''Registration Code'''
|CBCD
|-
|'''Deletion Code'''
|N/A
|-
|'''Useful Information'''
|Requests have CBC, and group and hold performed at the DHB. Includes: Group and Screen and CBC only.
|-
|'''Measurement Uncertainty'''
|N/A
|}
[[Category:Tests]]
[[Category:Transfusion]]
[[Category:Haematology]]

Tests:Antenatal Blood Group and Antibody Screen

2026-02-10T22:52:40Z

Jmayes: Removed BB test code

{{DISPLAYTITLE:Antenatal Blood Group and Antibody Screen}}
{| class="wikitable"
|'''Test'''
|Antenatal Blood Group and Antibody Screen
|-
|'''Synonym(s)'''
|Antibody Screening, antenatal group and screen, Blood Group, also see 1st and 2nd Antenatal
|-
|'''Specimen'''
|6 mL EDTA (Pink top). Minimum labelling - Surname + Forename + NHI Number and/or Date of Birth
|-
|'''Paediatric Specimen'''
|N/A
|-
|'''Add-on conditions'''
|3 days @ 4°C
|-
|'''Test Availability'''
|Mon - Fri 0800 - 1600
|-
|'''Turnaround Time'''
|Hastings / Central HB / Wairoa 24 hours
|-
|'''Where analysed'''
|Hastings
|-
|'''Department'''
|Transfusion Medicine, (06) 878 1308 ext. 2645
|-
|'''Registration Code'''
|
|-
|'''Deletion Code'''
|N/A
|-
|'''Useful Information'''
|
|-
|'''Measurement Uncertainty'''
|N/A
|}
[[Category:Tests]]
[[Category:Transfusion]]

Transfusion Medicine Department Information

2025-08-08T02:24:43Z

Jmayes: /* Blood Products and Components Available */

== Specimens for pre-transfusion testing ==

=== '''Specimen''' ===
{| class="wikitable"
|Type
|6 mL Pink Top (Crossmatch)
|-
|Volume
|Normally 6mL. Greater volumes may be required for certain individuals.

Minimum 2mL (generally paediatric)
|-
|Haemolysis
|Sample must not be grossly haemolysed
|}

=== '''Specimen Collection and Labelling''' ===
'''Correctly identifying the patient before collection of the blood sample is essential.'''

• If the patient is in hospital and does not have a wristband, ask the ward staff to apply one before collecting the sample.

• '''At the time of sample collection''' ask the patient to state (if able) their family name, given name(s) and date of birth.

• '''If a wristband is not provided''' (for example: in an outpatient setting) ask the patient to state '''and spell''' (if able) their family name, given name(s) and date of birth.

• '''In an extreme emergency''' a Red Bracelet number with unique NHI may be used. This number must be copied from the patient’s wristband.

• In the case of an '''unconscious patient or person unable to comply with the request for information,''' copy the patient identification details from the patient’s wristband, and if possible confirm with a relative.

• '''Check all the information supplied''' (by patient or relative, on wristband and on request form) to ensure they match. '''DO NOT''' proceed with sample collection if there are discrepancies.

• The patient’s identity must be re-established if the collector leaves the patient’s location prior to initiating the blood collection procedure.

'''Sample tubes must not be labelled in advance of the sample collection.'''

'''The sample tubes must be accurately labelled BEFORE leaving the patient.   '''

'''DO NOT copy patient details from the patient’s notes or charts.'''

'''DO NOT apply a computer generated Bradma label to the sample.'''

Legible hand written patient details must be recorded on the sample tube(s) with pen.

'''The following information MUST be included on the sample tube(s):'''

   Surname (unabbreviated)

   First name (unabbreviated)

Date of Birth

   NHI Number

   Time and date of collection

   Signature of person who collected the sample

Failure to provide any of this information will result in the specimen being rejected for processing.

'''In an Emergency:'''

Unique ED Red Bracelet Identification Code Number may be used along with the Hospital Number allocated to this unique number. (This information should be attached to the patient, for example: wristband).

   Time and date of collection

Signature of person who collected the sample

'''Following specimen labelling:'''

• Check the request form and the sample tube have identical patient information.

• Complete Step 4: “Specimen Collector Declaration” on the request form with the time and date, your name and signature.

=== '''Completion of the NZBlood Blood Bank Request Form''' ===
Full and accurate completion of the request form is essential for ensuring that the right test or quantity of blood component or product, is available at the right place at the right time.

Patient details are to be recorded on NZBlood Blood Bank Request Form using preferably a computer generated label or legible handwriting.

The request form '''MUST''' contain the following patient information:

• Patient’s registered surname name and given name/s (unabbreviated).

• Hospital number (NHI) and/or date of birth.

• Name of patient’s consultant/practitioner.

• Name and signature of the person completing the request form. This may be a nurse on behalf of the requesting doctor.

• Details of tests required and/or indication of the quantity and time that blood components or products are required (such as date and type of planned surgery).

• Any special requirements for components, for example: Irradiated.

• Signed declaration by the collector confirming that the patient was positively identified at the time of collection and that the samples were labelled before leaving the patient.

• Date and time of collection of blood sample.

The request form should also include:

• Clinical diagnosis and indication for transfusion.

• Record of any known previous transfusions or pregnancy within the last three months.

• Patient’s location.

• Gender.

• Date of surgical procedure (if applicable).

'''Note: ''' The actual prescription for the blood component is the charting of the blood by the attending Medical Officer in the patient’s medical record.

== Requirements for pre-transfusion testing ==
'''Important: ''' It is not possible to over-emphasise the importance of proper patient identification.

Most errors relating to transfusion practice arise from administrative and clerical error. These errors can have serious consequences for patients and are sometimes fatal.

=== '''Blood Products and Components Available''' ===
{| class="wikitable"
|'''Blood Products and Components'''
|'''Special Requirements'''
|-
|Red Cells Resuspended
|Irradiated Red Cells by special request
|-
|Fresh Frozen Plasma (FFP)
|
|-
|Platelet Concentrates
|Enquire about availability before requesting
|-
|Cryoprecipitate
|
|-
|Biostate (Recombinant Factor VIII also available)

Recombinant Factor IX available
|By special request
|-
|Privigen NZ

Alburex 5

Alburex 20

Rh(D) Immunoglobulin (250IU and 625IU vials)

Hepatitis B Immunoglobulin - Neonatal Dose

Tetanus Immunoglobulin

Beriplex NZ
|
|-
|Normal Immunoglobulin

Hepatitis B Immunoglobulin (Adult dose)

Zoster Immunoglobulin

Hizentra NZ

Hizentra
|By special request

|}
A completed NZBlood Blood Bank Request Form is required for plasma products. Request the name of the product and quantity or dose required. The patient’s full details need to be included along with the date required and time if applicable.

=== '''Transfusion Therapy''' ===
Please refer to Blood Transfusion - [https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Minimum Orders Policy HBDHB/IVTG/626]

=== '''Procedures:''' ===

==== '''Antibody Screen (ABS)''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Blood Group''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cold Agglutinin Screen''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cord Blood Screen''' ====
Specimen required: 4mL Purple Top (EDTA) tube.

==== '''Crossmatch (X Match)''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

Use NZBlood Blood Bank Request Form.

• Fill in the areas on the form especially previous transfusions or pregnancies within the last 3 months and Clinical Details (Pre-op is not helpful!).

• Start date and time when blood may be required. Failure to supply any of this information may cause unnecessary delays.

• Crossmatched units will only be held for 24 hours except by special arrangement with the Transfusion Medicine Department.

• In the event of postponement or cancellation of surgery, please notify the Transfusion Medicine Department.

==== '''Direct Antiglobulin Test (DAT)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

==== '''Group, Screen and Hold (GSH)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

Use NZBlood Blood Bank Request Form.

==== '''Transfusion Reaction Investigations''' ====
{| class="wikitable"
|'''Specimens Required'''
|'''Consider Need For'''
|-
|6 mL Pink top (Crossmatch) tube
|Blood cultures if sepsis suspected
|-
|10 mL Red top (plain) tube
|Blood gases if respiratory distress present
|-
|4 mL Purple (EDTA) tube
|Urine to check for haemoglobinuria
|-
|4.5 mL Lithium heparin (Pale green top) tube
|Coagulation screen if bleeding
|-
|Blood unit(s) implicated in reaction investigation
|
|}
After hours - investigations are only generally performed if the reaction is considered serious and the laboratory is contacted.

=== '''Specimen Validity''' ===
Samples from patients for red cell transfusion are valid for 72 hours, 7 days or 21 days depending on transfusion history, pregnancy and information supplied on the request form.
{| class="wikitable"
|'''Clinical Situation'''
|'''Specimen Validity Time'''
|-
|Patient transfused with red cell, platelet or allogeneic HPC components in the last 3 months.
| rowspan="2" |

Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Patient is pregnant or has been pregnant within the last 3 months (excluding placental risk and planned caesarean sections - see below).
|-
|Patient with placental risk.
|Sample valid for 7 days unless patient transfused red cell or platelet components within the last 3 months.

Once transfusion occurs, units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.
|-
|Patient with planned caesarean section.
|Sample valid for 72 hours, however if the section is planned Monday, the sample may be collected on the preceding Friday and valid for 96 hours.
|-
|Transfusion request form does not clearly exclude transfusion or pregnancy within the last 3 months (i.e. history section of form not completed).
|Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the last 3 months.
|Sample valid for 7 days but only 72 hours after transfusion has commenced.
|-
|Elective procedures (pre-admission samples), where the transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the past three months and clearly indicates the date that blood transfusion could occur, is more than 7 days after sample collection.
|On request, the sample may be valid for up to 21 days provided history is validated (for example: the eTraceline transfusion file shows no evidence of transfusion in past 3 months).

Once transfusion occurs units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.

Plasma/serum will be separated as soon as possible (and no more than 7 days following collection) and frozen to 20°C or below.
|}
If unsure of the validity that will be applied in a specific scenario, contact Transfusion Medicine Department for advice.

== Contact ==
Transfusion Medicine (Blood Bank) Laboratory - (06) 878 1692 ext 2645

'''Tony Morgan''' (Head of Department) - ext 2629

== Related Links ==
[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/transfusion-medicine-handbook Transfusion Medicine Handbook]

[https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Blood Transfusion Minimum Orders (IVTG626)]

[https://www.clinicaldata.nzblood.co.nz/resourcefolder/index.php?dhbid=14 NZ Blood Service Resource Folder]

[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/clinical-newsletter/ NZ Blood Service Clinical Newsletters]

[https://www.nzblood.co.nz/ NZ Blood Service Website]

Tests:Transfusion Reaction Investigation

2025-08-06T02:46:09Z

Jmayes:

{{DISPLAYTITLE:Transfusion Reaction Investigation}}

[[Category:Tests]]
[[Category:Transfusion]]
{| class="wikitable"
|'''Synonym(s)'''
|Investigation of adverse transfusion reaction, TRI
|-
|'''Specimen'''
|Please contact Transfusion Medicine to discuss
|-
|'''Paediatric Specimen'''
|Please contact Transfusion Medicine to discuss
|-
|'''Add-on conditions'''
|48 hours @ 4°C
|-
|'''Test Availability'''
|Call Transfusion Medicine
|-
|'''Turnaround Time'''
|Contact Transfusion Medicine to discuss
|-
|'''Where analysed'''
|Hastings
|-
|'''Department'''
|Transfusion Medicine, (06) 878 1692 ext. 2645
|-
|'''Registration Code'''
|N/A
|-
|'''Deletion Code'''
|N/A
|-
|'''Useful Information'''
|
|-
|'''Measurement Uncertainty'''
|N/A
|}

Tests:Donor Specific Antibody

2025-08-06T02:45:15Z

Jmayes:

{{DISPLAYTITLE:Donor Specific Antibody}}

[[Category:Tests]]
[[Category:Transfusion]]
{| class="wikitable"
|'''Synonym(s)'''
|Donor Specific Antibodies
|-
|'''Specimen'''
|10 mL plain (RED - NO GEL) Minimum labelling - Surname + Forename + NHI Number and/or Date of Birth
|-
|'''Paediatric Specimen'''
|10 mL plain (RED - NO GEL)
|-
|'''Add-on conditions'''
|N/A
|-
|'''Test Availability'''
|Call Transfusion Medicine
|-
|'''Turnaround Time'''
|Contact Transfusion Medicine to discuss
|-
|'''Where analysed'''
|NZBS Tissue Typing Lab, Auckland
|-
|'''Department'''
|Transfusion Medicine, (06) 878 1308 ext. 2645
|-
|'''Registration Code'''
|N/A
|-
|'''Deletion Code'''
|N/A
|-
|'''Useful Information'''
|
|-
|'''Measurement Uncertainty'''
|N/A
|}

Tests:Crossmatch

2025-08-06T02:43:34Z

Jmayes:

{{DISPLAYTITLE:Crossmatch}}

[[Category:Tests]]
[[Category:Transfusion]]
{| class="wikitable"
|'''Synonym(s)'''
|Transfusion, Xmatch, XM
|-
|'''Specimen'''
|6 mL EDTA (Pink top). Specific request form ([https://www.nzblood.co.nz/assets/Transfusion-Medicine/PDFs/111F159.pdf click here]) & labelling required
|-
|'''Paediatric Specimen'''
|Contact Transfusion Medicine
|-
|'''Add-on conditions'''
|Contact Transfusion Medicine
|-
|'''Test Availability'''
|Mon - Sun, 24 hours
|-
|'''Turnaround Time'''
|Hastings 2 - 4 hours / Central HB & Wairoa 24 hours
|-
|'''Where analysed'''
|Hastings
|-
|'''Department'''
|Transfusion Medicine, (06) 878 1308 ext. 2645
|-
|'''Registration Code'''
|N/A
|-
|'''Deletion Code'''
|N/A
|-
|'''Useful Information'''
|
|-
|'''Measurement Uncertainty'''
|N/A
|}

Transfusion Medicine Department Information

2025-08-06T02:35:42Z

Jmayes: /* Completion of the NZBlood Blood Bank Request Form */

== Specimens for pre-transfusion testing ==

=== '''Specimen''' ===
{| class="wikitable"
|Type
|6 mL Pink Top (Crossmatch)
|-
|Volume
|Normally 6mL. Greater volumes may be required for certain individuals.

Minimum 2mL (generally paediatric)
|-
|Haemolysis
|Sample must not be grossly haemolysed
|}

=== '''Specimen Collection and Labelling''' ===
'''Correctly identifying the patient before collection of the blood sample is essential.'''

• If the patient is in hospital and does not have a wristband, ask the ward staff to apply one before collecting the sample.

• '''At the time of sample collection''' ask the patient to state (if able) their family name, given name(s) and date of birth.

• '''If a wristband is not provided''' (for example: in an outpatient setting) ask the patient to state '''and spell''' (if able) their family name, given name(s) and date of birth.

• '''In an extreme emergency''' a Red Bracelet number with unique NHI may be used. This number must be copied from the patient’s wristband.

• In the case of an '''unconscious patient or person unable to comply with the request for information,''' copy the patient identification details from the patient’s wristband, and if possible confirm with a relative.

• '''Check all the information supplied''' (by patient or relative, on wristband and on request form) to ensure they match. '''DO NOT''' proceed with sample collection if there are discrepancies.

• The patient’s identity must be re-established if the collector leaves the patient’s location prior to initiating the blood collection procedure.

'''Sample tubes must not be labelled in advance of the sample collection.'''

'''The sample tubes must be accurately labelled BEFORE leaving the patient.   '''

'''DO NOT copy patient details from the patient’s notes or charts.'''

'''DO NOT apply a computer generated Bradma label to the sample.'''

Legible hand written patient details must be recorded on the sample tube(s) with pen.

'''The following information MUST be included on the sample tube(s):'''

   Surname (unabbreviated)

   First name (unabbreviated)

Date of Birth

   NHI Number

   Time and date of collection

   Signature of person who collected the sample

Failure to provide any of this information will result in the specimen being rejected for processing.

'''In an Emergency:'''

Unique ED Red Bracelet Identification Code Number may be used along with the Hospital Number allocated to this unique number. (This information should be attached to the patient, for example: wristband).

   Time and date of collection

Signature of person who collected the sample

'''Following specimen labelling:'''

• Check the request form and the sample tube have identical patient information.

• Complete Step 4: “Specimen Collector Declaration” on the request form with the time and date, your name and signature.

=== '''Completion of the NZBlood Blood Bank Request Form''' ===
Full and accurate completion of the request form is essential for ensuring that the right test or quantity of blood component or product, is available at the right place at the right time.

Patient details are to be recorded on NZBlood Blood Bank Request Form using preferably a computer generated label or legible handwriting.

The request form '''MUST''' contain the following patient information:

• Patient’s registered surname name and given name/s (unabbreviated).

• Hospital number (NHI) and/or date of birth.

• Name of patient’s consultant/practitioner.

• Name and signature of the person completing the request form. This may be a nurse on behalf of the requesting doctor.

• Details of tests required and/or indication of the quantity and time that blood components or products are required (such as date and type of planned surgery).

• Any special requirements for components, for example: Irradiated.

• Signed declaration by the collector confirming that the patient was positively identified at the time of collection and that the samples were labelled before leaving the patient.

• Date and time of collection of blood sample.

The request form should also include:

• Clinical diagnosis and indication for transfusion.

• Record of any known previous transfusions or pregnancy within the last three months.

• Patient’s location.

• Gender.

• Date of surgical procedure (if applicable).

'''Note: ''' The actual prescription for the blood component is the charting of the blood by the attending Medical Officer in the patient’s medical record.

== Requirements for pre-transfusion testing ==
'''Important: ''' It is not possible to over-emphasise the importance of proper patient identification.

Most errors relating to transfusion practice arise from administrative and clerical error. These errors can have serious consequences for patients and are sometimes fatal.

=== '''Blood Products and Components Available''' ===
{| class="wikitable"
|'''Blood Products and Components'''
|'''Special Requirements'''
|-
|Red Cells Resuspended
|Irradiated Red Cells by special request
|-
|Fresh Frozen Plasma (FFP)
|
|-
|Platelet Concentrates
|Enquire about availability before requesting
|-
|Cryoprecipitate
|
|-
|Biostate (Recombinant Factor VIII also available)

Recombinant Factor IX available
|By special request
|-
|Privigen NZ

Alburex 5

Alburex 20

Rh(D) Immunoglobulin - VF

Hepatitis B Immunoglobulin - Neonatal Dose

Tetanus Immunoglobulin - VF

Beriplex NZ
|
|-
|Normal Immunoglobulin - VF

Hepatitis B Immunoglobulin - VF (Adult dose)

Zoster Immunoglobulin - VF

Hizentra NZ

Hizentra
|By special request

|}
A completed NZBlood Blood Bank Request Form is required for plasma products. Request the name of the product and quantity or dose required. The patient’s full details need to be included along with the date required and time if applicable.

=== '''Transfusion Therapy''' ===
Please refer to Blood Transfusion - [https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Minimum Orders Policy HBDHB/IVTG/626]

=== '''Procedures:''' ===

==== '''Antibody Screen (ABS)''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Blood Group''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cold Agglutinin Screen''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cord Blood Screen''' ====
Specimen required: 4mL Purple Top (EDTA) tube.

==== '''Crossmatch (X Match)''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

Use NZBlood Blood Bank Request Form.

• Fill in the areas on the form especially previous transfusions or pregnancies within the last 3 months and Clinical Details (Pre-op is not helpful!).

• Start date and time when blood may be required. Failure to supply any of this information may cause unnecessary delays.

• Crossmatched units will only be held for 24 hours except by special arrangement with the Transfusion Medicine Department.

• In the event of postponement or cancellation of surgery, please notify the Transfusion Medicine Department.

==== '''Direct Antiglobulin Test (DAT)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

==== '''Group, Screen and Hold (GSH)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

Use NZBlood Blood Bank Request Form.

==== '''Transfusion Reaction Investigations''' ====
{| class="wikitable"
|'''Specimens Required'''
|'''Consider Need For'''
|-
|6 mL Pink top (Crossmatch) tube
|Blood cultures if sepsis suspected
|-
|10 mL Red top (plain) tube
|Blood gases if respiratory distress present
|-
|4 mL Purple (EDTA) tube
|Urine to check for haemoglobinuria
|-
|4.5 mL Lithium heparin (Pale green top) tube
|Coagulation screen if bleeding
|-
|Blood unit(s) implicated in reaction investigation
|
|}
After hours - investigations are only generally performed if the reaction is considered serious and the laboratory is contacted.

=== '''Specimen Validity''' ===
Samples from patients for red cell transfusion are valid for 72 hours, 7 days or 21 days depending on transfusion history, pregnancy and information supplied on the request form.
{| class="wikitable"
|'''Clinical Situation'''
|'''Specimen Validity Time'''
|-
|Patient transfused with red cell, platelet or allogeneic HPC components in the last 3 months.
| rowspan="2" |

Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Patient is pregnant or has been pregnant within the last 3 months (excluding placental risk and planned caesarean sections - see below).
|-
|Patient with placental risk.
|Sample valid for 7 days unless patient transfused red cell or platelet components within the last 3 months.

Once transfusion occurs, units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.
|-
|Patient with planned caesarean section.
|Sample valid for 72 hours, however if the section is planned Monday, the sample may be collected on the preceding Friday and valid for 96 hours.
|-
|Transfusion request form does not clearly exclude transfusion or pregnancy within the last 3 months (i.e. history section of form not completed).
|Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the last 3 months.
|Sample valid for 7 days but only 72 hours after transfusion has commenced.
|-
|Elective procedures (pre-admission samples), where the transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the past three months and clearly indicates the date that blood transfusion could occur, is more than 7 days after sample collection.
|On request, the sample may be valid for up to 21 days provided history is validated (for example: the eTraceline transfusion file shows no evidence of transfusion in past 3 months).

Once transfusion occurs units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.

Plasma/serum will be separated as soon as possible (and no more than 7 days following collection) and frozen to 20°C or below.
|}
If unsure of the validity that will be applied in a specific scenario, contact Transfusion Medicine Department for advice.

== Contact ==
Transfusion Medicine (Blood Bank) Laboratory - (06) 878 1692 ext 2645

'''Tony Morgan''' (Head of Department) - ext 2629

== Related Links ==
[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/transfusion-medicine-handbook Transfusion Medicine Handbook]

[https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Blood Transfusion Minimum Orders (IVTG626)]

[https://www.clinicaldata.nzblood.co.nz/resourcefolder/index.php?dhbid=14 NZ Blood Service Resource Folder]

[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/clinical-newsletter/ NZ Blood Service Clinical Newsletters]

[https://www.nzblood.co.nz/ NZ Blood Service Website]

Transfusion Medicine Department Information

2025-08-06T02:33:37Z

Jmayes: /* Completion of the NZBlood Blood Bank Request Form */

== Specimens for pre-transfusion testing ==

=== '''Specimen''' ===
{| class="wikitable"
|Type
|6 mL Pink Top (Crossmatch)
|-
|Volume
|Normally 6mL. Greater volumes may be required for certain individuals.

Minimum 2mL (generally paediatric)
|-
|Haemolysis
|Sample must not be grossly haemolysed
|}

=== '''Specimen Collection and Labelling''' ===
'''Correctly identifying the patient before collection of the blood sample is essential.'''

• If the patient is in hospital and does not have a wristband, ask the ward staff to apply one before collecting the sample.

• '''At the time of sample collection''' ask the patient to state (if able) their family name, given name(s) and date of birth.

• '''If a wristband is not provided''' (for example: in an outpatient setting) ask the patient to state '''and spell''' (if able) their family name, given name(s) and date of birth.

• '''In an extreme emergency''' a Red Bracelet number with unique NHI may be used. This number must be copied from the patient’s wristband.

• In the case of an '''unconscious patient or person unable to comply with the request for information,''' copy the patient identification details from the patient’s wristband, and if possible confirm with a relative.

• '''Check all the information supplied''' (by patient or relative, on wristband and on request form) to ensure they match. '''DO NOT''' proceed with sample collection if there are discrepancies.

• The patient’s identity must be re-established if the collector leaves the patient’s location prior to initiating the blood collection procedure.

'''Sample tubes must not be labelled in advance of the sample collection.'''

'''The sample tubes must be accurately labelled BEFORE leaving the patient.   '''

'''DO NOT copy patient details from the patient’s notes or charts.'''

'''DO NOT apply a computer generated Bradma label to the sample.'''

Legible hand written patient details must be recorded on the sample tube(s) with pen.

'''The following information MUST be included on the sample tube(s):'''

   Surname (unabbreviated)

   First name (unabbreviated)

Date of Birth

   NHI Number

   Time and date of collection

   Signature of person who collected the sample

Failure to provide any of this information will result in the specimen being rejected for processing.

'''In an Emergency:'''

Unique ED Red Bracelet Identification Code Number may be used along with the Hospital Number allocated to this unique number. (This information should be attached to the patient, for example: wristband).

   Time and date of collection

Signature of person who collected the sample

'''Following specimen labelling:'''

• Check the request form and the sample tube have identical patient information.

• Complete Step 4: “Specimen Collector Declaration” on the request form with the time and date, your name and signature.

=== '''Completion of the NZBlood Blood Bank Request Form''' ===
Full and accurate completion of the request form is essential for ensuring that the right test or quantity of blood component or product, is available at the right place at the right time.

Patient details are to be recorded on NZBlood Blood Bank Request Form using preferably a computer generated label or legible handwriting.

The request form '''MUST''' contain the following patient information:

• Patient’s registered surname name and given name/s (unabbreviated).

• Hospital number (NHI) and/or date of birth.

• Name of patient’s consultant/practitioner.

• Name and signature of the person completing the request form. This may be a nurse on behalf of the requesting doctor.

• Details of tests required and/or indication of the quantity and time that blood components or products are required (such as date and type of planned surgery).

• Any special requirements for components, for example: Irradiated.

• Signed declaration by the collector confirming that the patient was positively identified at the time of collection and that the samples were labelled before leaving the patient.

• Date and time of collection of blood sample.

The request form should also include:

• Clinical diagnosis and indication for transfusion.

• Record of any known previous transfusions or pregnancy within the last three months.

• Patient’s location.

• Gender.

• Date of surgical procedure (if applicable).

'''Note: ''' The actual prescription for the blood component is the charting of the blood by the attending Medical Officer in the patient’s medical record.

== Requirements for pre-transfusion testing ==
'''Important: ''' It is not possible to over-emphasise the importance of proper patient identification.

Most errors relating to transfusion practice arise from administrative and clerical error. These errors can have serious consequences for patients and are sometimes fatal.

=== '''Blood Products and Components Available''' ===
{| class="wikitable"
|'''Blood Products and Components'''
|'''Special Requirements'''
|-
|Red Cells Resuspended
|Irradiated Red Cells by special request
|-
|Fresh Frozen Plasma (FFP)
|
|-
|Platelet Concentrates
|Enquire about availability before requesting
|-
|Cryoprecipitate
|
|-
|Biostate (Recombinant Factor VIII also available)

Recombinant Factor IX available
|By special request
|-
|Privigen NZ

Alburex 5

Alburex 20

Rh(D) Immunoglobulin - VF

Hepatitis B Immunoglobulin - Neonatal Dose

Tetanus Immunoglobulin - VF

Beriplex NZ
|
|-
|Normal Immunoglobulin - VF

Hepatitis B Immunoglobulin - VF (Adult dose)

Zoster Immunoglobulin - VF

Hizentra NZ

Hizentra
|By special request

|}
A NZBlood Blood Bank Request Form is required for plasma products. Request the name of the product and quantity or dose required. The patient’s full details need to be included along with the date required and time if applicable.

=== '''Transfusion Therapy''' ===
Please refer to Blood Transfusion - [https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Minimum Orders Policy HBDHB/IVTG/626]

=== '''Procedures:''' ===

==== '''Antibody Screen (ABS)''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Blood Group''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cold Agglutinin Screen''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cord Blood Screen''' ====
Specimen required: 4mL Purple Top (EDTA) tube.

==== '''Crossmatch (X Match)''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

Use NZBlood Blood Bank Request Form.

• Fill in the areas on the form especially previous transfusions or pregnancies within the last 3 months and Clinical Details (Pre-op is not helpful!).

• Start date and time when blood may be required. Failure to supply any of this information may cause unnecessary delays.

• Crossmatched units will only be held for 24 hours except by special arrangement with the Transfusion Medicine Department.

• In the event of postponement or cancellation of surgery, please notify the Transfusion Medicine Department.

==== '''Direct Antiglobulin Test (DAT)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

==== '''Group, Screen and Hold (GSH)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

Use NZBlood Blood Bank Request Form.

==== '''Transfusion Reaction Investigations''' ====
{| class="wikitable"
|'''Specimens Required'''
|'''Consider Need For'''
|-
|6 mL Pink top (Crossmatch) tube
|Blood cultures if sepsis suspected
|-
|10 mL Red top (plain) tube
|Blood gases if respiratory distress present
|-
|4 mL Purple (EDTA) tube
|Urine to check for haemoglobinuria
|-
|4.5 mL Lithium heparin (Pale green top) tube
|Coagulation screen if bleeding
|-
|Blood unit(s) implicated in reaction investigation
|
|}
After hours - investigations are only generally performed if the reaction is considered serious and the laboratory is contacted.

=== '''Specimen Validity''' ===
Samples from patients for red cell transfusion are valid for 72 hours, 7 days or 21 days depending on transfusion history, pregnancy and information supplied on the request form.
{| class="wikitable"
|'''Clinical Situation'''
|'''Specimen Validity Time'''
|-
|Patient transfused with red cell, platelet or allogeneic HPC components in the last 3 months.
| rowspan="2" |

Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Patient is pregnant or has been pregnant within the last 3 months (excluding placental risk and planned caesarean sections - see below).
|-
|Patient with placental risk.
|Sample valid for 7 days unless patient transfused red cell or platelet components within the last 3 months.

Once transfusion occurs, units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.
|-
|Patient with planned caesarean section.
|Sample valid for 72 hours, however if the section is planned Monday, the sample may be collected on the preceding Friday and valid for 96 hours.
|-
|Transfusion request form does not clearly exclude transfusion or pregnancy within the last 3 months (i.e. history section of form not completed).
|Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the last 3 months.
|Sample valid for 7 days but only 72 hours after transfusion has commenced.
|-
|Elective procedures (pre-admission samples), where the transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the past three months and clearly indicates the date that blood transfusion could occur, is more than 7 days after sample collection.
|On request, the sample may be valid for up to 21 days provided history is validated (for example: the eTraceline transfusion file shows no evidence of transfusion in past 3 months).

Once transfusion occurs units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.

Plasma/serum will be separated as soon as possible (and no more than 7 days following collection) and frozen to 20°C or below.
|}
If unsure of the validity that will be applied in a specific scenario, contact Transfusion Medicine Department for advice.

== Contact ==
Transfusion Medicine (Blood Bank) Laboratory - (06) 878 1692 ext 2645

'''Tony Morgan''' (Head of Department) - ext 2629

== Related Links ==
[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/transfusion-medicine-handbook Transfusion Medicine Handbook]

[https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Blood Transfusion Minimum Orders (IVTG626)]

[https://www.clinicaldata.nzblood.co.nz/resourcefolder/index.php?dhbid=14 NZ Blood Service Resource Folder]

[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/clinical-newsletter/ NZ Blood Service Clinical Newsletters]

[https://www.nzblood.co.nz/ NZ Blood Service Website]

Transfusion Medicine Department Information

2025-08-06T02:33:02Z

Jmayes: /* Completion of the NZ Blood Request for Blood Bank Tests & Blood Components or Products Form */

== Specimens for pre-transfusion testing ==

=== '''Specimen''' ===
{| class="wikitable"
|Type
|6 mL Pink Top (Crossmatch)
|-
|Volume
|Normally 6mL. Greater volumes may be required for certain individuals.

Minimum 2mL (generally paediatric)
|-
|Haemolysis
|Sample must not be grossly haemolysed
|}

=== '''Specimen Collection and Labelling''' ===
'''Correctly identifying the patient before collection of the blood sample is essential.'''

• If the patient is in hospital and does not have a wristband, ask the ward staff to apply one before collecting the sample.

• '''At the time of sample collection''' ask the patient to state (if able) their family name, given name(s) and date of birth.

• '''If a wristband is not provided''' (for example: in an outpatient setting) ask the patient to state '''and spell''' (if able) their family name, given name(s) and date of birth.

• '''In an extreme emergency''' a Red Bracelet number with unique NHI may be used. This number must be copied from the patient’s wristband.

• In the case of an '''unconscious patient or person unable to comply with the request for information,''' copy the patient identification details from the patient’s wristband, and if possible confirm with a relative.

• '''Check all the information supplied''' (by patient or relative, on wristband and on request form) to ensure they match. '''DO NOT''' proceed with sample collection if there are discrepancies.

• The patient’s identity must be re-established if the collector leaves the patient’s location prior to initiating the blood collection procedure.

'''Sample tubes must not be labelled in advance of the sample collection.'''

'''The sample tubes must be accurately labelled BEFORE leaving the patient.   '''

'''DO NOT copy patient details from the patient’s notes or charts.'''

'''DO NOT apply a computer generated Bradma label to the sample.'''

Legible hand written patient details must be recorded on the sample tube(s) with pen.

'''The following information MUST be included on the sample tube(s):'''

   Surname (unabbreviated)

   First name (unabbreviated)

Date of Birth

   NHI Number

   Time and date of collection

   Signature of person who collected the sample

Failure to provide any of this information will result in the specimen being rejected for processing.

'''In an Emergency:'''

Unique ED Red Bracelet Identification Code Number may be used along with the Hospital Number allocated to this unique number. (This information should be attached to the patient, for example: wristband).

   Time and date of collection

Signature of person who collected the sample

'''Following specimen labelling:'''

• Check the request form and the sample tube have identical patient information.

• Complete Step 4: “Specimen Collector Declaration” on the request form with the time and date, your name and signature.

=== '''Completion of the NZBlood Blood Bank Request Form''' ===
Full and accurate completion of the request form is essential for ensuring that the right test or quantity of blood component or product, is available at the right place at the right time.

Patient details are to be recorded on NZ Blood Request for Blood Bank Tests & Blood Components or Products Form using preferably a computer generated label or legible handwriting.

The request form '''MUST''' contain the following patient information:

• Patient’s registered surname name and given name/s (unabbreviated).

• Hospital number (NHI) and/or date of birth.

• Name of patient’s consultant/practitioner.

• Name and signature of the person completing the request form. This may be a nurse on behalf of the requesting doctor.

• Details of tests required and/or indication of the quantity and time that blood components or products are required (such as date and type of planned surgery).

• Any special requirements for components, for example: Irradiated.

• Signed declaration by the collector confirming that the patient was positively identified at the time of collection and that the samples were labelled before leaving the patient.

• Date and time of collection of blood sample.

The request form should also include:

• Clinical diagnosis and indication for transfusion.

• Record of any known previous transfusions or pregnancy within the last three months.

• Patient’s location.

• Gender.

• Date of surgical procedure (if applicable).

'''Note: ''' The actual prescription for the blood component is the charting of the blood by the attending Medical Officer in the patient’s medical record.

== Requirements for pre-transfusion testing ==
'''Important: ''' It is not possible to over-emphasise the importance of proper patient identification.

Most errors relating to transfusion practice arise from administrative and clerical error. These errors can have serious consequences for patients and are sometimes fatal.

=== '''Blood Products and Components Available''' ===
{| class="wikitable"
|'''Blood Products and Components'''
|'''Special Requirements'''
|-
|Red Cells Resuspended
|Irradiated Red Cells by special request
|-
|Fresh Frozen Plasma (FFP)
|
|-
|Platelet Concentrates
|Enquire about availability before requesting
|-
|Cryoprecipitate
|
|-
|Biostate (Recombinant Factor VIII also available)

Recombinant Factor IX available
|By special request
|-
|Privigen NZ

Alburex 5

Alburex 20

Rh(D) Immunoglobulin - VF

Hepatitis B Immunoglobulin - Neonatal Dose

Tetanus Immunoglobulin - VF

Beriplex NZ
|
|-
|Normal Immunoglobulin - VF

Hepatitis B Immunoglobulin - VF (Adult dose)

Zoster Immunoglobulin - VF

Hizentra NZ

Hizentra
|By special request

|}
A NZBlood Blood Bank Request Form is required for plasma products. Request the name of the product and quantity or dose required. The patient’s full details need to be included along with the date required and time if applicable.

=== '''Transfusion Therapy''' ===
Please refer to Blood Transfusion - [https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Minimum Orders Policy HBDHB/IVTG/626]

=== '''Procedures:''' ===

==== '''Antibody Screen (ABS)''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Blood Group''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cold Agglutinin Screen''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cord Blood Screen''' ====
Specimen required: 4mL Purple Top (EDTA) tube.

==== '''Crossmatch (X Match)''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

Use NZBlood Blood Bank Request Form.

• Fill in the areas on the form especially previous transfusions or pregnancies within the last 3 months and Clinical Details (Pre-op is not helpful!).

• Start date and time when blood may be required. Failure to supply any of this information may cause unnecessary delays.

• Crossmatched units will only be held for 24 hours except by special arrangement with the Transfusion Medicine Department.

• In the event of postponement or cancellation of surgery, please notify the Transfusion Medicine Department.

==== '''Direct Antiglobulin Test (DAT)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

==== '''Group, Screen and Hold (GSH)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

Use NZBlood Blood Bank Request Form.

==== '''Transfusion Reaction Investigations''' ====
{| class="wikitable"
|'''Specimens Required'''
|'''Consider Need For'''
|-
|6 mL Pink top (Crossmatch) tube
|Blood cultures if sepsis suspected
|-
|10 mL Red top (plain) tube
|Blood gases if respiratory distress present
|-
|4 mL Purple (EDTA) tube
|Urine to check for haemoglobinuria
|-
|4.5 mL Lithium heparin (Pale green top) tube
|Coagulation screen if bleeding
|-
|Blood unit(s) implicated in reaction investigation
|
|}
After hours - investigations are only generally performed if the reaction is considered serious and the laboratory is contacted.

=== '''Specimen Validity''' ===
Samples from patients for red cell transfusion are valid for 72 hours, 7 days or 21 days depending on transfusion history, pregnancy and information supplied on the request form.
{| class="wikitable"
|'''Clinical Situation'''
|'''Specimen Validity Time'''
|-
|Patient transfused with red cell, platelet or allogeneic HPC components in the last 3 months.
| rowspan="2" |

Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Patient is pregnant or has been pregnant within the last 3 months (excluding placental risk and planned caesarean sections - see below).
|-
|Patient with placental risk.
|Sample valid for 7 days unless patient transfused red cell or platelet components within the last 3 months.

Once transfusion occurs, units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.
|-
|Patient with planned caesarean section.
|Sample valid for 72 hours, however if the section is planned Monday, the sample may be collected on the preceding Friday and valid for 96 hours.
|-
|Transfusion request form does not clearly exclude transfusion or pregnancy within the last 3 months (i.e. history section of form not completed).
|Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the last 3 months.
|Sample valid for 7 days but only 72 hours after transfusion has commenced.
|-
|Elective procedures (pre-admission samples), where the transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the past three months and clearly indicates the date that blood transfusion could occur, is more than 7 days after sample collection.
|On request, the sample may be valid for up to 21 days provided history is validated (for example: the eTraceline transfusion file shows no evidence of transfusion in past 3 months).

Once transfusion occurs units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.

Plasma/serum will be separated as soon as possible (and no more than 7 days following collection) and frozen to 20°C or below.
|}
If unsure of the validity that will be applied in a specific scenario, contact Transfusion Medicine Department for advice.

== Contact ==
Transfusion Medicine (Blood Bank) Laboratory - (06) 878 1692 ext 2645

'''Tony Morgan''' (Head of Department) - ext 2629

== Related Links ==
[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/transfusion-medicine-handbook Transfusion Medicine Handbook]

[https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Blood Transfusion Minimum Orders (IVTG626)]

[https://www.clinicaldata.nzblood.co.nz/resourcefolder/index.php?dhbid=14 NZ Blood Service Resource Folder]

[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/clinical-newsletter/ NZ Blood Service Clinical Newsletters]

[https://www.nzblood.co.nz/ NZ Blood Service Website]

Transfusion Medicine Department Information

2025-08-06T02:32:11Z

Jmayes: /* Specimen Collection and Labelling */

== Specimens for pre-transfusion testing ==

=== '''Specimen''' ===
{| class="wikitable"
|Type
|6 mL Pink Top (Crossmatch)
|-
|Volume
|Normally 6mL. Greater volumes may be required for certain individuals.

Minimum 2mL (generally paediatric)
|-
|Haemolysis
|Sample must not be grossly haemolysed
|}

=== '''Specimen Collection and Labelling''' ===
'''Correctly identifying the patient before collection of the blood sample is essential.'''

• If the patient is in hospital and does not have a wristband, ask the ward staff to apply one before collecting the sample.

• '''At the time of sample collection''' ask the patient to state (if able) their family name, given name(s) and date of birth.

• '''If a wristband is not provided''' (for example: in an outpatient setting) ask the patient to state '''and spell''' (if able) their family name, given name(s) and date of birth.

• '''In an extreme emergency''' a Red Bracelet number with unique NHI may be used. This number must be copied from the patient’s wristband.

• In the case of an '''unconscious patient or person unable to comply with the request for information,''' copy the patient identification details from the patient’s wristband, and if possible confirm with a relative.

• '''Check all the information supplied''' (by patient or relative, on wristband and on request form) to ensure they match. '''DO NOT''' proceed with sample collection if there are discrepancies.

• The patient’s identity must be re-established if the collector leaves the patient’s location prior to initiating the blood collection procedure.

'''Sample tubes must not be labelled in advance of the sample collection.'''

'''The sample tubes must be accurately labelled BEFORE leaving the patient.   '''

'''DO NOT copy patient details from the patient’s notes or charts.'''

'''DO NOT apply a computer generated Bradma label to the sample.'''

Legible hand written patient details must be recorded on the sample tube(s) with pen.

'''The following information MUST be included on the sample tube(s):'''

   Surname (unabbreviated)

   First name (unabbreviated)

Date of Birth

   NHI Number

   Time and date of collection

   Signature of person who collected the sample

Failure to provide any of this information will result in the specimen being rejected for processing.

'''In an Emergency:'''

Unique ED Red Bracelet Identification Code Number may be used along with the Hospital Number allocated to this unique number. (This information should be attached to the patient, for example: wristband).

   Time and date of collection

Signature of person who collected the sample

'''Following specimen labelling:'''

• Check the request form and the sample tube have identical patient information.

• Complete Step 4: “Specimen Collector Declaration” on the request form with the time and date, your name and signature.

=== '''Completion of the NZ Blood Request for Blood Bank Tests & Blood Components or Products Form''' ===
Full and accurate completion of the request form is essential for ensuring that the right test or quantity of blood component or product, is available at the right place at the right time.

Patient details are to be recorded on NZ Blood Request for Blood Bank Tests & Blood Components or Products Form using preferably a computer generated label or legible handwriting.

The request form '''MUST''' contain the following patient information:

• Patient’s registered surname name and given name/s (unabbreviated).

• Hospital number (NHI) and/or date of birth.

• Name of patient’s consultant/practitioner.

• Name and signature of the person completing the request form. This may be a nurse on behalf of the requesting doctor.

• Details of tests required and/or indication of the quantity and time that blood components or products are required (such as date and type of planned surgery).

• Any special requirements for components, for example: Irradiated.

• Signed declaration by the collector confirming that the patient was positively identified at the time of collection and that the samples were labelled before leaving the patient.

• Date and time of collection of blood sample.

The request form should also include:

• Clinical diagnosis and indication for transfusion.

• Record of any known previous transfusions or pregnancy within the last three months.

• Patient’s location.

• Gender.

• Date of surgical procedure (if applicable).

'''Note: ''' The actual prescription for the blood component is the charting of the blood by the attending Medical Officer in the patient’s medical record.

== Requirements for pre-transfusion testing ==
'''Important: ''' It is not possible to over-emphasise the importance of proper patient identification.

Most errors relating to transfusion practice arise from administrative and clerical error. These errors can have serious consequences for patients and are sometimes fatal.

=== '''Blood Products and Components Available''' ===
{| class="wikitable"
|'''Blood Products and Components'''
|'''Special Requirements'''
|-
|Red Cells Resuspended
|Irradiated Red Cells by special request
|-
|Fresh Frozen Plasma (FFP)
|
|-
|Platelet Concentrates
|Enquire about availability before requesting
|-
|Cryoprecipitate
|
|-
|Biostate (Recombinant Factor VIII also available)

Recombinant Factor IX available
|By special request
|-
|Privigen NZ

Alburex 5

Alburex 20

Rh(D) Immunoglobulin - VF

Hepatitis B Immunoglobulin - Neonatal Dose

Tetanus Immunoglobulin - VF

Beriplex NZ
|
|-
|Normal Immunoglobulin - VF

Hepatitis B Immunoglobulin - VF (Adult dose)

Zoster Immunoglobulin - VF

Hizentra NZ

Hizentra
|By special request

|}
A NZBlood Blood Bank Request Form is required for plasma products. Request the name of the product and quantity or dose required. The patient’s full details need to be included along with the date required and time if applicable.

=== '''Transfusion Therapy''' ===
Please refer to Blood Transfusion - [https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Minimum Orders Policy HBDHB/IVTG/626]

=== '''Procedures:''' ===

==== '''Antibody Screen (ABS)''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Blood Group''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cold Agglutinin Screen''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cord Blood Screen''' ====
Specimen required: 4mL Purple Top (EDTA) tube.

==== '''Crossmatch (X Match)''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

Use NZBlood Blood Bank Request Form.

• Fill in the areas on the form especially previous transfusions or pregnancies within the last 3 months and Clinical Details (Pre-op is not helpful!).

• Start date and time when blood may be required. Failure to supply any of this information may cause unnecessary delays.

• Crossmatched units will only be held for 24 hours except by special arrangement with the Transfusion Medicine Department.

• In the event of postponement or cancellation of surgery, please notify the Transfusion Medicine Department.

==== '''Direct Antiglobulin Test (DAT)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

==== '''Group, Screen and Hold (GSH)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

Use NZBlood Blood Bank Request Form.

==== '''Transfusion Reaction Investigations''' ====
{| class="wikitable"
|'''Specimens Required'''
|'''Consider Need For'''
|-
|6 mL Pink top (Crossmatch) tube
|Blood cultures if sepsis suspected
|-
|10 mL Red top (plain) tube
|Blood gases if respiratory distress present
|-
|4 mL Purple (EDTA) tube
|Urine to check for haemoglobinuria
|-
|4.5 mL Lithium heparin (Pale green top) tube
|Coagulation screen if bleeding
|-
|Blood unit(s) implicated in reaction investigation
|
|}
After hours - investigations are only generally performed if the reaction is considered serious and the laboratory is contacted.

=== '''Specimen Validity''' ===
Samples from patients for red cell transfusion are valid for 72 hours, 7 days or 21 days depending on transfusion history, pregnancy and information supplied on the request form.
{| class="wikitable"
|'''Clinical Situation'''
|'''Specimen Validity Time'''
|-
|Patient transfused with red cell, platelet or allogeneic HPC components in the last 3 months.
| rowspan="2" |

Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Patient is pregnant or has been pregnant within the last 3 months (excluding placental risk and planned caesarean sections - see below).
|-
|Patient with placental risk.
|Sample valid for 7 days unless patient transfused red cell or platelet components within the last 3 months.

Once transfusion occurs, units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.
|-
|Patient with planned caesarean section.
|Sample valid for 72 hours, however if the section is planned Monday, the sample may be collected on the preceding Friday and valid for 96 hours.
|-
|Transfusion request form does not clearly exclude transfusion or pregnancy within the last 3 months (i.e. history section of form not completed).
|Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the last 3 months.
|Sample valid for 7 days but only 72 hours after transfusion has commenced.
|-
|Elective procedures (pre-admission samples), where the transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the past three months and clearly indicates the date that blood transfusion could occur, is more than 7 days after sample collection.
|On request, the sample may be valid for up to 21 days provided history is validated (for example: the eTraceline transfusion file shows no evidence of transfusion in past 3 months).

Once transfusion occurs units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.

Plasma/serum will be separated as soon as possible (and no more than 7 days following collection) and frozen to 20°C or below.
|}
If unsure of the validity that will be applied in a specific scenario, contact Transfusion Medicine Department for advice.

== Contact ==
Transfusion Medicine (Blood Bank) Laboratory - (06) 878 1692 ext 2645

'''Tony Morgan''' (Head of Department) - ext 2629

== Related Links ==
[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/transfusion-medicine-handbook Transfusion Medicine Handbook]

[https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Blood Transfusion Minimum Orders (IVTG626)]

[https://www.clinicaldata.nzblood.co.nz/resourcefolder/index.php?dhbid=14 NZ Blood Service Resource Folder]

[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/clinical-newsletter/ NZ Blood Service Clinical Newsletters]

[https://www.nzblood.co.nz/ NZ Blood Service Website]

Transfusion Medicine Department Information

2025-08-06T02:30:06Z

Jmayes: /* Specimen Collection and Labelling */

== Specimens for pre-transfusion testing ==

=== '''Specimen''' ===
{| class="wikitable"
|Type
|6 mL Pink Top (Crossmatch)
|-
|Volume
|Normally 6mL. Greater volumes may be required for certain individuals.

Minimum 2mL (generally paediatric)
|-
|Haemolysis
|Sample must not be grossly haemolysed
|}

=== '''Specimen Collection and Labelling''' ===
'''Correctly identifying the patient before collection of the blood sample is essential.'''

• If the patient is in hospital and does not have a wristband, ask the ward staff to apply one before collecting the sample.

• '''At the time of sample collection''' ask the patient to state (if able) their family name, given name(s) and date of birth.

• '''If a wristband is not provided''' (for example: in an outpatient setting) ask the patient to state '''and spell''' (if able) their family name, given name(s) and date of birth.

• '''In an extreme emergency''' a Red Bracelet number with unique NHI may be used. This number must be copied from the patient’s wristband.

• In the case of an '''unconscious patient or person unable to comply with the request for information,''' copy the patient identification details from the patient’s wristband, and if possible confirm with a relative.

• '''Check all the information supplied''' (by patient or relative, on wristband and on request form) to ensure they match. '''DO NOT''' proceed with sample collection if there are discrepancies.

• The patient’s identity must be re-established if the collector leaves the patient’s location prior to initiating the blood collection procedure.

'''Sample tubes must not be labelled in advance of the sample collection.'''

'''The sample tubes must be accurately labelled BEFORE leaving the patient.   '''

'''DO NOT copy patient details from the patient’s notes or charts.'''

'''DO NOT apply a computer generated Bradma label to the sample.'''

Legible hand written patient details must be recorded on the sample tube(s) with pen.

'''The following information MUST be included on the sample tube(s):'''

   Surname (unabbreviated)

   First name (unabbreviated)

Date of Birth

   NHI Number

   Time and date of collection

   Signature of person who collected the sample

Failure to provide any of this information will result in the specimen being rejected for processing.

'''In an Emergency:'''

Unique ED Red Bracelet Identification Code Number may be used along with the Hospital Number allocated to this unique number. (This information should be attached to the patient, for example: wristband).

   Time and date of collection

Signature of person who collected the sample

'''Following specimen labelling:'''

• Check the request form and the sample tube have identical patient information.

• Complete Step 4: “Specimen Collector Declaration” on the request form with the time and date, your name and signature.

=== '''Completion of the NZ Blood Request for Blood Bank Tests & Blood Components or Products Form''' ===
Full and accurate completion of the request form is essential for ensuring that the right test or quantity of blood component or product, is available at the right place at the right time.

Patient details are to be recorded on NZ Blood Request for Blood Bank Tests & Blood Components or Products Form using preferably a computer generated label or legible handwriting.

The request form '''MUST''' contain the following patient information:

• Patient’s registered surname name and given name/s (unabbreviated).

• Hospital number (NHI) and/or date of birth.

• Name of patient’s consultant/practitioner.

• Name and signature of the person completing the request form. This may be a nurse on behalf of the requesting doctor.

• Details of tests required and/or indication of the quantity and time that blood components or products are required (such as date and type of planned surgery).

• Any special requirements for components, for example: Irradiated.

• Signed declaration by the collector confirming that the patient was positively identified at the time of collection and that the samples were labelled before leaving the patient.

• Date and time of collection of blood sample.

The request form should also include:

• Clinical diagnosis and indication for transfusion.

• Record of any known previous transfusions or pregnancy within the last three months.

• Patient’s location.

• Gender.

• Date of surgical procedure (if applicable).

'''Note: ''' The actual prescription for the blood component is the charting of the blood by the attending Medical Officer in the patient’s medical record.

== Requirements for pre-transfusion testing ==
'''Important: ''' It is not possible to over-emphasise the importance of proper patient identification.

Most errors relating to transfusion practice arise from administrative and clerical error. These errors can have serious consequences for patients and are sometimes fatal.

=== '''Blood Products and Components Available''' ===
{| class="wikitable"
|'''Blood Products and Components'''
|'''Special Requirements'''
|-
|Red Cells Resuspended
|Irradiated Red Cells by special request
|-
|Fresh Frozen Plasma (FFP)
|
|-
|Platelet Concentrates
|Enquire about availability before requesting
|-
|Cryoprecipitate
|
|-
|Biostate (Recombinant Factor VIII also available)

Recombinant Factor IX available
|By special request
|-
|Privigen NZ

Alburex 5

Alburex 20

Rh(D) Immunoglobulin - VF

Hepatitis B Immunoglobulin - Neonatal Dose

Tetanus Immunoglobulin - VF

Beriplex NZ
|
|-
|Normal Immunoglobulin - VF

Hepatitis B Immunoglobulin - VF (Adult dose)

Zoster Immunoglobulin - VF

Hizentra NZ

Hizentra
|By special request

|}
A NZBlood Blood Bank Request Form is required for plasma products. Request the name of the product and quantity or dose required. The patient’s full details need to be included along with the date required and time if applicable.

=== '''Transfusion Therapy''' ===
Please refer to Blood Transfusion - [https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Minimum Orders Policy HBDHB/IVTG/626]

=== '''Procedures:''' ===

==== '''Antibody Screen (ABS)''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Blood Group''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cold Agglutinin Screen''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cord Blood Screen''' ====
Specimen required: 4mL Purple Top (EDTA) tube.

==== '''Crossmatch (X Match)''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

Use NZBlood Blood Bank Request Form.

• Fill in the areas on the form especially previous transfusions or pregnancies within the last 3 months and Clinical Details (Pre-op is not helpful!).

• Start date and time when blood may be required. Failure to supply any of this information may cause unnecessary delays.

• Crossmatched units will only be held for 24 hours except by special arrangement with the Transfusion Medicine Department.

• In the event of postponement or cancellation of surgery, please notify the Transfusion Medicine Department.

==== '''Direct Antiglobulin Test (DAT)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

==== '''Group, Screen and Hold (GSH)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

Use NZBlood Blood Bank Request Form.

==== '''Transfusion Reaction Investigations''' ====
{| class="wikitable"
|'''Specimens Required'''
|'''Consider Need For'''
|-
|6 mL Pink top (Crossmatch) tube
|Blood cultures if sepsis suspected
|-
|10 mL Red top (plain) tube
|Blood gases if respiratory distress present
|-
|4 mL Purple (EDTA) tube
|Urine to check for haemoglobinuria
|-
|4.5 mL Lithium heparin (Pale green top) tube
|Coagulation screen if bleeding
|-
|Blood unit(s) implicated in reaction investigation
|
|}
After hours - investigations are only generally performed if the reaction is considered serious and the laboratory is contacted.

=== '''Specimen Validity''' ===
Samples from patients for red cell transfusion are valid for 72 hours, 7 days or 21 days depending on transfusion history, pregnancy and information supplied on the request form.
{| class="wikitable"
|'''Clinical Situation'''
|'''Specimen Validity Time'''
|-
|Patient transfused with red cell, platelet or allogeneic HPC components in the last 3 months.
| rowspan="2" |

Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Patient is pregnant or has been pregnant within the last 3 months (excluding placental risk and planned caesarean sections - see below).
|-
|Patient with placental risk.
|Sample valid for 7 days unless patient transfused red cell or platelet components within the last 3 months.

Once transfusion occurs, units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.
|-
|Patient with planned caesarean section.
|Sample valid for 72 hours, however if the section is planned Monday, the sample may be collected on the preceding Friday and valid for 96 hours.
|-
|Transfusion request form does not clearly exclude transfusion or pregnancy within the last 3 months (i.e. history section of form not completed).
|Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the last 3 months.
|Sample valid for 7 days but only 72 hours after transfusion has commenced.
|-
|Elective procedures (pre-admission samples), where the transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the past three months and clearly indicates the date that blood transfusion could occur, is more than 7 days after sample collection.
|On request, the sample may be valid for up to 21 days provided history is validated (for example: the eTraceline transfusion file shows no evidence of transfusion in past 3 months).

Once transfusion occurs units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.

Plasma/serum will be separated as soon as possible (and no more than 7 days following collection) and frozen to 20°C or below.
|}
If unsure of the validity that will be applied in a specific scenario, contact Transfusion Medicine Department for advice.

== Contact ==
Transfusion Medicine (Blood Bank) Laboratory - (06) 878 1692 ext 2645

'''Tony Morgan''' (Head of Department) - ext 2629

== Related Links ==
[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/transfusion-medicine-handbook Transfusion Medicine Handbook]

[https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Blood Transfusion Minimum Orders (IVTG626)]

[https://www.clinicaldata.nzblood.co.nz/resourcefolder/index.php?dhbid=14 NZ Blood Service Resource Folder]

[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/clinical-newsletter/ NZ Blood Service Clinical Newsletters]

[https://www.nzblood.co.nz/ NZ Blood Service Website]

Transfusion Medicine Department Information

2025-08-06T02:27:46Z

Jmayes: /* Blood Products and Components Available */

== Specimens for pre-transfusion testing ==

=== '''Specimen''' ===
{| class="wikitable"
|Type
|6 mL Pink Top (Crossmatch)
|-
|Volume
|Normally 6mL. Greater volumes may be required for certain individuals.

Minimum 2mL (generally paediatric)
|-
|Haemolysis
|Sample must not be grossly haemolysed
|}

=== '''Specimen Collection and Labelling''' ===
'''Correctly identifying the patient before collection of the blood sample is essential.'''

• If the patient is in hospital and does not have a wristband, ask the ward staff to apply one before collecting the sample.

• '''At the time of sample collection''' ask the patient to state (if able) their family name, given name(s) and date of birth.

• '''If a wristband is not provided''' (for example: in an outpatient setting) ask the patient to state '''and spell''' (if able) their family name, given name(s) and date of birth.

• '''In an extreme emergency''' a Red Bracelet number with unique NHI may be used. This number must be copied from the patient’s wristband.

• In the case of an '''unconscious patient or person unable to comply with the request for information,''' copy the patient identification details from the patient’s wristband, and if possible confirm with a relative.

• '''Check all the information supplied''' (by patient or relative, on wristband and on request form) to ensure they match. '''DO NOT''' proceed with sample collection if there are discrepancies.

• The patient’s identity must be re-established if the collector leaves the patient’s location prior to initiating the blood collection procedure.

'''Sample tubes must not be labelled in advance of the sample collection.'''

'''The sample tubes must be accurately labelled BEFORE leaving the patient.   '''

'''DO NOT copy patient details from the patient’s notes or charts.'''

'''DO NOT apply a computer generated Bradma label to the sample.'''

Legible hand written patient details must be recorded on the sample tube(s) with pen.

'''The following information MUST be included on the sample tube(s):'''

   Surname (unabbreviated)

   First name (unabbreviated)

Date of Birth

   NHI Number

   Time and date of collection

   Signature of person who collected the sample

Failure to provide any of this information will result in the specimen being rejected for processing.

'''In an Emergency:'''

Unique ED Red Bracelet Identification Code Number may be used along with the Hospital Number allocated to this unique number. (This information should be attached to the patient, for example: wristband).

   Time and date of collection

Signature of person who collected the sample

'''Following specimen labelling:'''

• Check the request form and the sample tube have identical patient information.

• Complete Step 4: “Specimen Collector Declaration” on the request form with the time and date, your name and signature.

=== '''Completion of the NZ Blood Request for Blood Bank Tests & Blood Components or Products Form''' ===
Full and accurate completion of the request form is essential for ensuring that the right test or quantity of blood component or product, is available at the right place at the right time.

Patient details are to be recorded on NZ Blood Request for Blood Bank Tests & Blood Components or Products Form using preferably a computer generated label or legible handwriting.

The request form '''MUST''' contain the following patient information:

• Patient’s registered surname name and given name/s (unabbreviated).

• Hospital number (NHI) and/or date of birth.

• Name of patient’s consultant/practitioner.

• Name and signature of the person completing the request form. This may be a nurse on behalf of the requesting doctor.

• Details of tests required and/or indication of the quantity and time that blood components or products are required (such as date and type of planned surgery).

• Any special requirements for components, for example: Irradiated.

• Signed declaration by the collector confirming that the patient was positively identified at the time of collection and that the samples were labelled before leaving the patient.

• Date and time of collection of blood sample.

The request form should also include:

• Clinical diagnosis and indication for transfusion.

• Record of any known previous transfusions or pregnancy within the last three months.

• Patient’s location.

• Gender.

• Date of surgical procedure (if applicable).

'''Note: ''' The actual prescription for the blood component is the charting of the blood by the attending Medical Officer in the patient’s medical record.

== Requirements for pre-transfusion testing ==
'''Important: ''' It is not possible to over-emphasise the importance of proper patient identification.

Most errors relating to transfusion practice arise from administrative and clerical error. These errors can have serious consequences for patients and are sometimes fatal.

=== '''Blood Products and Components Available''' ===
{| class="wikitable"
|'''Blood Products and Components'''
|'''Special Requirements'''
|-
|Red Cells Resuspended
|Irradiated Red Cells by special request
|-
|Fresh Frozen Plasma (FFP)
|
|-
|Platelet Concentrates
|Enquire about availability before requesting
|-
|Cryoprecipitate
|
|-
|Biostate (Recombinant Factor VIII also available)

Recombinant Factor IX available
|By special request
|-
|Privigen NZ

Alburex 5

Alburex 20

Rh(D) Immunoglobulin - VF

Hepatitis B Immunoglobulin - Neonatal Dose

Tetanus Immunoglobulin - VF

Beriplex NZ
|
|-
|Normal Immunoglobulin - VF

Hepatitis B Immunoglobulin - VF (Adult dose)

Zoster Immunoglobulin - VF

Hizentra NZ

Hizentra
|By special request

|}
A NZBlood Blood Bank Request Form is required for plasma products. Request the name of the product and quantity or dose required. The patient’s full details need to be included along with the date required and time if applicable.

=== '''Transfusion Therapy''' ===
Please refer to Blood Transfusion - [https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Minimum Orders Policy HBDHB/IVTG/626]

=== '''Procedures:''' ===

==== '''Antibody Screen (ABS)''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Blood Group''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cold Agglutinin Screen''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cord Blood Screen''' ====
Specimen required: 4mL Purple Top (EDTA) tube.

==== '''Crossmatch (X Match)''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

Use NZBlood Blood Bank Request Form.

• Fill in the areas on the form especially previous transfusions or pregnancies within the last 3 months and Clinical Details (Pre-op is not helpful!).

• Start date and time when blood may be required. Failure to supply any of this information may cause unnecessary delays.

• Crossmatched units will only be held for 24 hours except by special arrangement with the Transfusion Medicine Department.

• In the event of postponement or cancellation of surgery, please notify the Transfusion Medicine Department.

==== '''Direct Antiglobulin Test (DAT)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

==== '''Group, Screen and Hold (GSH)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

Use NZBlood Blood Bank Request Form.

==== '''Transfusion Reaction Investigations''' ====
{| class="wikitable"
|'''Specimens Required'''
|'''Consider Need For'''
|-
|6 mL Pink top (Crossmatch) tube
|Blood cultures if sepsis suspected
|-
|10 mL Red top (plain) tube
|Blood gases if respiratory distress present
|-
|4 mL Purple (EDTA) tube
|Urine to check for haemoglobinuria
|-
|4.5 mL Lithium heparin (Pale green top) tube
|Coagulation screen if bleeding
|-
|Blood unit(s) implicated in reaction investigation
|
|}
After hours - investigations are only generally performed if the reaction is considered serious and the laboratory is contacted.

=== '''Specimen Validity''' ===
Samples from patients for red cell transfusion are valid for 72 hours, 7 days or 21 days depending on transfusion history, pregnancy and information supplied on the request form.
{| class="wikitable"
|'''Clinical Situation'''
|'''Specimen Validity Time'''
|-
|Patient transfused with red cell, platelet or allogeneic HPC components in the last 3 months.
| rowspan="2" |

Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Patient is pregnant or has been pregnant within the last 3 months (excluding placental risk and planned caesarean sections - see below).
|-
|Patient with placental risk.
|Sample valid for 7 days unless patient transfused red cell or platelet components within the last 3 months.

Once transfusion occurs, units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.
|-
|Patient with planned caesarean section.
|Sample valid for 72 hours, however if the section is planned Monday, the sample may be collected on the preceding Friday and valid for 96 hours.
|-
|Transfusion request form does not clearly exclude transfusion or pregnancy within the last 3 months (i.e. history section of form not completed).
|Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the last 3 months.
|Sample valid for 7 days but only 72 hours after transfusion has commenced.
|-
|Elective procedures (pre-admission samples), where the transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the past three months and clearly indicates the date that blood transfusion could occur, is more than 7 days after sample collection.
|On request, the sample may be valid for up to 21 days provided history is validated (for example: the eTraceline transfusion file shows no evidence of transfusion in past 3 months).

Once transfusion occurs units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.

Plasma/serum will be separated as soon as possible (and no more than 7 days following collection) and frozen to 20°C or below.
|}
If unsure of the validity that will be applied in a specific scenario, contact Transfusion Medicine Department for advice.

== Contact ==
Transfusion Medicine (Blood Bank) Laboratory - (06) 878 1692 ext 2645

'''Tony Morgan''' (Head of Department) - ext 2629

== Related Links ==
[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/transfusion-medicine-handbook Transfusion Medicine Handbook]

[https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Blood Transfusion Minimum Orders (IVTG626)]

[https://www.clinicaldata.nzblood.co.nz/resourcefolder/index.php?dhbid=14 NZ Blood Service Resource Folder]

[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/clinical-newsletter/ NZ Blood Service Clinical Newsletters]

[https://www.nzblood.co.nz/ NZ Blood Service Website]

Transfusion Medicine Department Information

2025-08-06T02:18:21Z

Jmayes: /* Blood Products and Components Available */

== Specimens for pre-transfusion testing ==

=== '''Specimen''' ===
{| class="wikitable"
|Type
|6 mL Pink Top (Crossmatch)
|-
|Volume
|Normally 6mL. Greater volumes may be required for certain individuals.

Minimum 2mL (generally paediatric)
|-
|Haemolysis
|Sample must not be grossly haemolysed
|}

=== '''Specimen Collection and Labelling''' ===
'''Correctly identifying the patient before collection of the blood sample is essential.'''

• If the patient is in hospital and does not have a wristband, ask the ward staff to apply one before collecting the sample.

• '''At the time of sample collection''' ask the patient to state (if able) their family name, given name(s) and date of birth.

• '''If a wristband is not provided''' (for example: in an outpatient setting) ask the patient to state '''and spell''' (if able) their family name, given name(s) and date of birth.

• '''In an extreme emergency''' a Red Bracelet number with unique NHI may be used. This number must be copied from the patient’s wristband.

• In the case of an '''unconscious patient or person unable to comply with the request for information,''' copy the patient identification details from the patient’s wristband, and if possible confirm with a relative.

• '''Check all the information supplied''' (by patient or relative, on wristband and on request form) to ensure they match. '''DO NOT''' proceed with sample collection if there are discrepancies.

• The patient’s identity must be re-established if the collector leaves the patient’s location prior to initiating the blood collection procedure.

'''Sample tubes must not be labelled in advance of the sample collection.'''

'''The sample tubes must be accurately labelled BEFORE leaving the patient.   '''

'''DO NOT copy patient details from the patient’s notes or charts.'''

'''DO NOT apply a computer generated Bradma label to the sample.'''

Legible hand written patient details must be recorded on the sample tube(s) with pen.

'''The following information MUST be included on the sample tube(s):'''

   Surname (unabbreviated)

   First name (unabbreviated)

Date of Birth

   NHI Number

   Time and date of collection

   Signature of person who collected the sample

Failure to provide any of this information will result in the specimen being rejected for processing.

'''In an Emergency:'''

Unique ED Red Bracelet Identification Code Number may be used along with the Hospital Number allocated to this unique number. (This information should be attached to the patient, for example: wristband).

   Time and date of collection

Signature of person who collected the sample

'''Following specimen labelling:'''

• Check the request form and the sample tube have identical patient information.

• Complete Step 4: “Specimen Collector Declaration” on the request form with the time and date, your name and signature.

=== '''Completion of the NZ Blood Request for Blood Bank Tests & Blood Components or Products Form''' ===
Full and accurate completion of the request form is essential for ensuring that the right test or quantity of blood component or product, is available at the right place at the right time.

Patient details are to be recorded on NZ Blood Request for Blood Bank Tests & Blood Components or Products Form using preferably a computer generated label or legible handwriting.

The request form '''MUST''' contain the following patient information:

• Patient’s registered surname name and given name/s (unabbreviated).

• Hospital number (NHI) and/or date of birth.

• Name of patient’s consultant/practitioner.

• Name and signature of the person completing the request form. This may be a nurse on behalf of the requesting doctor.

• Details of tests required and/or indication of the quantity and time that blood components or products are required (such as date and type of planned surgery).

• Any special requirements for components, for example: Irradiated.

• Signed declaration by the collector confirming that the patient was positively identified at the time of collection and that the samples were labelled before leaving the patient.

• Date and time of collection of blood sample.

The request form should also include:

• Clinical diagnosis and indication for transfusion.

• Record of any known previous transfusions or pregnancy within the last three months.

• Patient’s location.

• Gender.

• Date of surgical procedure (if applicable).

'''Note: ''' The actual prescription for the blood component is the charting of the blood by the attending Medical Officer in the patient’s medical record.

== Requirements for pre-transfusion testing ==
'''Important: ''' It is not possible to over-emphasise the importance of proper patient identification.

Most errors relating to transfusion practice arise from administrative and clerical error. These errors can have serious consequences for patients and are sometimes fatal.

=== '''Blood Products and Components Available''' ===
{| class="wikitable"
|'''Blood Products and Components'''
|'''Special Requirements'''
|-
|Red Cells Resuspended
|Irradiated Red Cells by special request
|-
|Fresh Frozen Plasma (FFP)
|
|-
|Platelet Concentrates
|Enquire about availability before requesting
|-
|Cryoprecipitate
|
|-
|Biostate (Recombinant Factor VIII also available)

Recombinant Factor IX available
|By special request
|-
|Privigen NZ

Alburex 5

Alburex 20

Rh(D) Immunoglobulin - VF

Hepatitis B Immunoglobulin - Neonatal Dose

Tetanus Immunoglobulin - VF

Beriplex NZ
|
|-
|Normal Immunoglobulin - VF

Hepatitis B Immunoglobulin - VF (Adult dose)

Zoster Immunoglobulin - VF

Hizentra NZ

Hizentra
|By special request

|}
A NZ Blood Request for Blood & Blood Components or Products Form is required for plasma products. Request the name of the product and quantity required. The patient’s full details need to be included along with the date required and time if applicable.

=== '''Transfusion Therapy''' ===
Please refer to Blood Transfusion - [https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Minimum Orders Policy HBDHB/IVTG/626]

=== '''Procedures:''' ===

==== '''Antibody Screen (ABS)''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Blood Group''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cold Agglutinin Screen''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cord Blood Screen''' ====
Specimen required: 4mL Purple Top (EDTA) tube.

'''Crossmatch (X Match)'''

Specimen required: 6mL Pink Top (Crossmatch) tube.

Use NZ Blood Request for Blood & Blood Components or Products Form.

• Fill in the areas on the form especially previous transfusions or pregnancies within the last 3 months and Clinical Details (Pre-op is not helpful!).

• Start date and time when blood may be required. Failure to supply any of this information may cause unnecessary delays.

• Cross-matched units will only be held for 24 hours except by special arrangement with the Transfusion Medicine Department.

• In the event of postponement or cancellation of surgery, please notify the Transfusion Medicine Department.

==== '''Direct Antiglobulin Test (DAT)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

==== '''Group, Screen and Hold (GSH)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

Use NZ Blood Request for Blood & Blood Components or Products Form.

==== '''Transfusion Reaction Investigations''' ====
{| class="wikitable"
|'''Specimens Required'''
|'''Consider Need For'''
|-
|6 mL Pink top (Crossmatch) tube
|Blood cultures if sepsis suspected
|-
|10 mL Red top (plain) tube
|Blood gases if respiratory distress present
|-
|4 mL Purple (EDTA) tube
|Urine to check for haemoglobinuria
|-
|4.5 mL Lithium heparin (Pale green top) tube
|Coagulation screen if bleeding
|-
|Blood unit(s) implicated in reaction investigation
|
|}
After hours - investigations are only generally performed if the reaction is considered serious and the laboratory is contacted.

=== '''Specimen Validity''' ===
Samples from patients for red cell transfusion are valid for 72 hours, 7 days or 21 days depending on transfusion history, pregnancy and information supplied on the request form.
{| class="wikitable"
|'''Clinical Situation'''
|'''Specimen Validity Time'''
|-
|Patient transfused with red cell, platelet or allogeneic HPC components in the last 3 months.
| rowspan="2" |

Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Patient is pregnant or has been pregnant within the last 3 months (excluding placenta praevia and planned caesarean sections - see below).
|-
|Patient with placenta praevia.
|Sample valid for 7 days unless patient transfused red cell or platelet components within the last 3 months.

Once transfusion occurs, units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.
|-
|Patient with planned caesarean section.
|Sample valid for 72 hours, however if the section is planned Monday, the sample may be collected on the preceding Friday and valid for 96 hours.
|-
|Transfusion request form does not clearly exclude transfusion or pregnancy within the last 3 months (i.e. history section of form not completed).
|Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the last 3 months.
|Sample valid for 7 days but only 72 hours after transfusion has commenced.
|-
|Elective procedures (pre-admission samples), where the transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the past three months and clearly indicates the date that blood transfusion could occur, is more than 7 days after sample collection.
|On request, the sample may be valid for up to 21 days provided history is validated (for example: the eTraceline transfusion file shows no evidence of transfusion in past 3 months).

Once transfusion occurs units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.

Plasma/serum will be separated as soon as possible (and no more than 7 days following collection) and frozen to 20°C or below.
|}
If unsure of the validity that will be applied in a specific scenario, contact Transfusion Medicine Department for advice.

== Contact ==
Transfusion Medicine (Blood Bank) Laboratory - (06) 878 1692 ext 2645

'''Tony Morgan''' (Head of Department) - ext 2629

== Related Links ==
[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/transfusion-medicine-handbook Transfusion Medicine Handbook]

[https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Blood Transfusion Minimum Orders (IVTG626)]

[https://www.clinicaldata.nzblood.co.nz/resourcefolder/index.php?dhbid=14 NZ Blood Service Resource Folder]

[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/clinical-newsletter/ NZ Blood Service Clinical Newsletters]

[https://www.nzblood.co.nz/ NZ Blood Service Website]

Transfusion Medicine Department Information

2025-08-06T02:17:16Z

Jmayes: /* Blood Products and Components Available */

== Specimens for pre-transfusion testing ==

=== '''Specimen''' ===
{| class="wikitable"
|Type
|6 mL Pink Top (Crossmatch)
|-
|Volume
|Normally 6mL. Greater volumes may be required for certain individuals.

Minimum 2mL (generally paediatric)
|-
|Haemolysis
|Sample must not be grossly haemolysed
|}

=== '''Specimen Collection and Labelling''' ===
'''Correctly identifying the patient before collection of the blood sample is essential.'''

• If the patient is in hospital and does not have a wristband, ask the ward staff to apply one before collecting the sample.

• '''At the time of sample collection''' ask the patient to state (if able) their family name, given name(s) and date of birth.

• '''If a wristband is not provided''' (for example: in an outpatient setting) ask the patient to state '''and spell''' (if able) their family name, given name(s) and date of birth.

• '''In an extreme emergency''' a Red Bracelet number with unique NHI may be used. This number must be copied from the patient’s wristband.

• In the case of an '''unconscious patient or person unable to comply with the request for information,''' copy the patient identification details from the patient’s wristband, and if possible confirm with a relative.

• '''Check all the information supplied''' (by patient or relative, on wristband and on request form) to ensure they match. '''DO NOT''' proceed with sample collection if there are discrepancies.

• The patient’s identity must be re-established if the collector leaves the patient’s location prior to initiating the blood collection procedure.

'''Sample tubes must not be labelled in advance of the sample collection.'''

'''The sample tubes must be accurately labelled BEFORE leaving the patient.   '''

'''DO NOT copy patient details from the patient’s notes or charts.'''

'''DO NOT apply a computer generated Bradma label to the sample.'''

Legible hand written patient details must be recorded on the sample tube(s) with pen.

'''The following information MUST be included on the sample tube(s):'''

   Surname (unabbreviated)

   First name (unabbreviated)

Date of Birth

   NHI Number

   Time and date of collection

   Signature of person who collected the sample

Failure to provide any of this information will result in the specimen being rejected for processing.

'''In an Emergency:'''

Unique ED Red Bracelet Identification Code Number may be used along with the Hospital Number allocated to this unique number. (This information should be attached to the patient, for example: wristband).

   Time and date of collection

Signature of person who collected the sample

'''Following specimen labelling:'''

• Check the request form and the sample tube have identical patient information.

• Complete Step 4: “Specimen Collector Declaration” on the request form with the time and date, your name and signature.

=== '''Completion of the NZ Blood Request for Blood Bank Tests & Blood Components or Products Form''' ===
Full and accurate completion of the request form is essential for ensuring that the right test or quantity of blood component or product, is available at the right place at the right time.

Patient details are to be recorded on NZ Blood Request for Blood Bank Tests & Blood Components or Products Form using preferably a computer generated label or legible handwriting.

The request form '''MUST''' contain the following patient information:

• Patient’s registered surname name and given name/s (unabbreviated).

• Hospital number (NHI) and/or date of birth.

• Name of patient’s consultant/practitioner.

• Name and signature of the person completing the request form. This may be a nurse on behalf of the requesting doctor.

• Details of tests required and/or indication of the quantity and time that blood components or products are required (such as date and type of planned surgery).

• Any special requirements for components, for example: Irradiated.

• Signed declaration by the collector confirming that the patient was positively identified at the time of collection and that the samples were labelled before leaving the patient.

• Date and time of collection of blood sample.

The request form should also include:

• Clinical diagnosis and indication for transfusion.

• Record of any known previous transfusions or pregnancy within the last three months.

• Patient’s location.

• Gender.

• Date of surgical procedure (if applicable).

'''Note: ''' The actual prescription for the blood component is the charting of the blood by the attending Medical Officer in the patient’s medical record.

== Requirements for pre-transfusion testing ==
'''Important: ''' It is not possible to over-emphasise the importance of proper patient identification.

Most errors relating to transfusion practice arise from administrative and clerical error. These errors can have serious consequences for patients and are sometimes fatal.

=== '''Blood Products and Components Available''' ===
{| class="wikitable"
|'''Blood Products and Components'''
|'''Special Requirements'''
|-
|Red Cells Resuspended
|Irradiated Red Cells by special request
|-
|Fresh Frozen Plasma (FFP)
|
|-
|Platelet Concentrates
|Enquire about availability before requesting
|-
|Cryoprecipitate
|
|-
|Biostate (Recombinant Factor VIII also available)

Recombinant Factor IX available
|By special request
|-
|Privigen NZ

Alburex 5

Alburex 20

Rh(D) Immunoglobulin - VF

Hepatitis B Immunoglobulin - Neonatal Dose

Tetanus Immunoglobulin - VF

Prothrombinex - VF
|
|-
|Normal Immunoglobulin - VF

Hepatitis B Immunoglobulin - VF (Adult dose)

Zoster Immunoglobulin - VF

Hizentra NZ

Hizentra
|By special request

|}
A NZ Blood Request for Blood & Blood Components or Products Form is required for plasma products. Request the name of the product and quantity required. The patient’s full details need to be included along with the date required and time if applicable.

=== '''Transfusion Therapy''' ===
Please refer to Blood Transfusion - [https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Minimum Orders Policy HBDHB/IVTG/626]

=== '''Procedures:''' ===

==== '''Antibody Screen (ABS)''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Blood Group''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cold Agglutinin Screen''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cord Blood Screen''' ====
Specimen required: 4mL Purple Top (EDTA) tube.

'''Crossmatch (X Match)'''

Specimen required: 6mL Pink Top (Crossmatch) tube.

Use NZ Blood Request for Blood & Blood Components or Products Form.

• Fill in the areas on the form especially previous transfusions or pregnancies within the last 3 months and Clinical Details (Pre-op is not helpful!).

• Start date and time when blood may be required. Failure to supply any of this information may cause unnecessary delays.

• Cross-matched units will only be held for 24 hours except by special arrangement with the Transfusion Medicine Department.

• In the event of postponement or cancellation of surgery, please notify the Transfusion Medicine Department.

==== '''Direct Antiglobulin Test (DAT)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

==== '''Group, Screen and Hold (GSH)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

Use NZ Blood Request for Blood & Blood Components or Products Form.

==== '''Transfusion Reaction Investigations''' ====
{| class="wikitable"
|'''Specimens Required'''
|'''Consider Need For'''
|-
|6 mL Pink top (Crossmatch) tube
|Blood cultures if sepsis suspected
|-
|10 mL Red top (plain) tube
|Blood gases if respiratory distress present
|-
|4 mL Purple (EDTA) tube
|Urine to check for haemoglobinuria
|-
|4.5 mL Lithium heparin (Pale green top) tube
|Coagulation screen if bleeding
|-
|Blood unit(s) implicated in reaction investigation
|
|}
After hours - investigations are only generally performed if the reaction is considered serious and the laboratory is contacted.

=== '''Specimen Validity''' ===
Samples from patients for red cell transfusion are valid for 72 hours, 7 days or 21 days depending on transfusion history, pregnancy and information supplied on the request form.
{| class="wikitable"
|'''Clinical Situation'''
|'''Specimen Validity Time'''
|-
|Patient transfused with red cell, platelet or allogeneic HPC components in the last 3 months.
| rowspan="2" |

Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Patient is pregnant or has been pregnant within the last 3 months (excluding placenta praevia and planned caesarean sections - see below).
|-
|Patient with placenta praevia.
|Sample valid for 7 days unless patient transfused red cell or platelet components within the last 3 months.

Once transfusion occurs, units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.
|-
|Patient with planned caesarean section.
|Sample valid for 72 hours, however if the section is planned Monday, the sample may be collected on the preceding Friday and valid for 96 hours.
|-
|Transfusion request form does not clearly exclude transfusion or pregnancy within the last 3 months (i.e. history section of form not completed).
|Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the last 3 months.
|Sample valid for 7 days but only 72 hours after transfusion has commenced.
|-
|Elective procedures (pre-admission samples), where the transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the past three months and clearly indicates the date that blood transfusion could occur, is more than 7 days after sample collection.
|On request, the sample may be valid for up to 21 days provided history is validated (for example: the eTraceline transfusion file shows no evidence of transfusion in past 3 months).

Once transfusion occurs units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.

Plasma/serum will be separated as soon as possible (and no more than 7 days following collection) and frozen to 20°C or below.
|}
If unsure of the validity that will be applied in a specific scenario, contact Transfusion Medicine Department for advice.

== Contact ==
Transfusion Medicine (Blood Bank) Laboratory - (06) 878 1692 ext 2645

'''Tony Morgan''' (Head of Department) - ext 2629

== Related Links ==
[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/transfusion-medicine-handbook Transfusion Medicine Handbook]

[https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Blood Transfusion Minimum Orders (IVTG626)]

[https://www.clinicaldata.nzblood.co.nz/resourcefolder/index.php?dhbid=14 NZ Blood Service Resource Folder]

[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/clinical-newsletter/ NZ Blood Service Clinical Newsletters]

[https://www.nzblood.co.nz/ NZ Blood Service Website]

Main Page

2025-08-06T02:14:32Z

Jmayes: /* Key Contacts */

__NOTOC__
[[File:IANZLogo small.jpg|thumb|link=https://www.ianz.govt.nz/]]
Welcome to the Te Whatu Ora Te Matau a Māui Hawke's Bay Laboratory services Manual and test guide. Departmental information, guidance documents, and policies can be found in the sidebar on the left (desktop only).

The lab test guide can be searched in the search bar below, or at any time from the search bar at the top of the page. Alternatively a full list of available tests is available here: [[:Category:Tests|'''Full test list here (click)''']]

=== '''Search tests here:''' ===
Tests not listed here will be referred to our reference laboratory Canterbury Health Laboratories (CHL) - [https://www.chl.co.nz/test-manager/ Click here]
{| class="wikitable"
!<inputbox>
type=create
break=no
type=search
type=fulltext
width = 30
placeholder=Enter test name here
</inputbox>
|}

=== '''Search entire manual here:''' ===
{| class="wikitable"
|+
!<inputbox>
type=create
break=no
type=search
type=fulltext
width = 30
placeholder=Enter search term here
namespaces=Main**,File**,Tests**
</inputbox>
|}

===Information for Patients===
- Patient Rights:

Patient Consent - [https://hawkesbaylabmanual.co.nz/wiki/images/1/16/Patient_Consent_Information.pdf Click here]

Code of Rights - [https://www.hdc.org.nz/your-rights/about-the-code/code-of-health-and-disability-services-consumers-rights/ Click here]

- Collection Site Open Hours:

{| class="wikitable"
!Hawke's Bay Hospital Laboratory
!Central Hawke's Bay Health Centre Laboratory
|-
|
Lab open hours: 24/7

Phlebotomy hours at Villa 8:
Mon – Fri 0800 – 1700

Ph 8781308 ext 2452

Disabled access is via the courtyard by Zac's Cafe and toilets are available within Villa 8.
|
Lab open hours: Mon - Fri 0730-1700

Phlebotomy hours:
Mon – Fri 0730 – 1600

Ph 06 8587797 ext 5553

Disabled access and toilets are available within the Central Hawke's Bay Health Centre.
|-
!Napier Health Centre Laboratory
!Wairoa Hospital Laboratory
|-
|
Lab open hours: Mon – Fri 0800 – 1700

Phlebotomy hours:
Mon – Fri 0800 – 1700

Ph 06 8341815 ext 4142

Disabled access and toilets are available within Napier Health Centre.
|
Lab open hours: Mon – Fri 0730 – 1630

Phlebotomy hours:
Mon – Fri 0730 – 1500

Ph 06 8389710 ext 4859

Disabled access is through the main door to the Wairoa Health Centre.

Use the lift to go down to the basement where the Laboratory service is located.

Toilets are available within the Wairoa Health Centre.
|}

- Feedback Channels:

If you would like to provide feedback after a Blood Collection procedure, please complete a Patient Satisfaction Survey form - [https://rb.gy/psbq8v click here].

If you have a specimen specific enquiry, please [mailto:laboratory.office@hbdhb.govt.nz click here]. We will typically acknowledge and respond to your email within 2 working days.

If you would like to provide a service feedback or concern to the laboratory, please [mailto:feedback@hbdhb.govt.nz click here]. The Hawke's Bay Hospital Consumer Engagement Team will acknowledge your feedback within 20 working days.

===Key Contacts===
{| class="wikitable"
|+
!Name
!Position
!Internal ext
!Ext Ph
|-
|Andrew Burns
|Clinical Director
|
|027 243 1754
|-
|Tim Aitken
|Laboratory Manager
|
|022 122 0645
|-
|Pam Russell
|Quality Manager
|2538
|
|-
|Grace Lim
|HOD Haematology
|6249
|
|-
|Mari-Sann van Aardt
|HOD Biochemistry
|2449
|
|-
|Lynne Morgan
|HOD Pre-Analytical
|2603
|
|-
|Tony Morgan
|HOD Transfusion Medicine (Blood Bank)
|2629
|
|-
|Neil Campbell
|HOD Microbiology
|2630
|
|-
|Jade Chetty
|HOD Histology
|2485
|
|-
|Rebecca Warwick
|POCT Quality Manager
|2453
|027 246 6724
|}

[[File:Labnet Logo.jpg|none|thumb]]
[[File:CHL-Logo.png|none|thumb|link=https://www.chl.co.nz/test-manager/]]
Website by Chris Greenwood 2022

Reviewed April 2025

Transfusion Medicine Department Information

2024-12-16T20:53:10Z

Jmayes: /* Blood Products and Components Available */

== Specimens for pre-transfusion testing ==

=== '''Specimen''' ===
{| class="wikitable"
|Type
|6 mL Pink Top (Crossmatch)
|-
|Volume
|Normally 6mL. Greater volumes may be required for certain individuals.

Minimum 2mL (generally paediatric)
|-
|Haemolysis
|Sample must not be grossly haemolysed
|}

=== '''Specimen Collection and Labelling''' ===
'''Correctly identifying the patient before collection of the blood sample is essential.'''

• If the patient is in hospital and does not have a wristband, ask the ward staff to apply one before collecting the sample.

• '''At the time of sample collection''' ask the patient to state (if able) their family name, given name(s) and date of birth.

• '''If a wristband is not provided''' (for example: in an outpatient setting) ask the patient to state '''and spell''' (if able) their family name, given name(s) and date of birth.

• '''In an extreme emergency''' a Red Bracelet number with unique NHI may be used. This number must be copied from the patient’s wristband.

• In the case of an '''unconscious patient or person unable to comply with the request for information,''' copy the patient identification details from the patient’s wristband, and if possible confirm with a relative.

• '''Check all the information supplied''' (by patient or relative, on wristband and on request form) to ensure they match. '''DO NOT''' proceed with sample collection if there are discrepancies.

• The patient’s identity must be re-established if the collector leaves the patient’s location prior to initiating the blood collection procedure.

'''Sample tubes must not be labelled in advance of the sample collection.'''

'''The sample tubes must be accurately labelled BEFORE leaving the patient.   '''

'''DO NOT copy patient details from the patient’s notes or charts.'''

'''DO NOT apply a computer generated Bradma label to the sample.'''

Legible hand written patient details must be recorded on the sample tube(s) with pen.

'''The following information MUST be included on the sample tube(s):'''

   Surname (unabbreviated)

   First name (unabbreviated)

Date of Birth

   NHI Number

   Time and date of collection

   Signature of person who collected the sample

Failure to provide any of this information will result in the specimen being rejected for processing.

'''In an Emergency:'''

Unique ED Red Bracelet Identification Code Number may be used along with the Hospital Number allocated to this unique number. (This information should be attached to the patient, for example: wristband).

   Time and date of collection

Signature of person who collected the sample

'''Following specimen labelling:'''

• Check the request form and the sample tube have identical patient information.

• Complete Step 4: “Specimen Collector Declaration” on the request form with the time and date, your name and signature.

=== '''Completion of the NZ Blood Request for Blood Bank Tests & Blood Components or Products Form''' ===
Full and accurate completion of the request form is essential for ensuring that the right test or quantity of blood component or product, is available at the right place at the right time.

Patient details are to be recorded on NZ Blood Request for Blood Bank Tests & Blood Components or Products Form using preferably a computer generated label or legible handwriting.

The request form '''MUST''' contain the following patient information:

• Patient’s registered surname name and given name/s (unabbreviated).

• Hospital number (NHI) and/or date of birth.

• Name of patient’s consultant/practitioner.

• Name and signature of the person completing the request form. This may be a nurse on behalf of the requesting doctor.

• Details of tests required and/or indication of the quantity and time that blood components or products are required (such as date and type of planned surgery).

• Any special requirements for components, for example: Irradiated.

• Signed declaration by the collector confirming that the patient was positively identified at the time of collection and that the samples were labelled before leaving the patient.

• Date and time of collection of blood sample.

The request form should also include:

• Clinical diagnosis and indication for transfusion.

• Record of any known previous transfusions or pregnancy within the last three months.

• Patient’s location.

• Gender.

• Date of surgical procedure (if applicable).

'''Note: ''' The actual prescription for the blood component is the charting of the blood by the attending Medical Officer in the patient’s medical record.

== Requirements for pre-transfusion testing ==
'''Important: ''' It is not possible to over-emphasise the importance of proper patient identification.

Most errors relating to transfusion practice arise from administrative and clerical error. These errors can have serious consequences for patients and are sometimes fatal.

=== '''Blood Products and Components Available''' ===
{| class="wikitable"
|'''Blood Products and Components'''
|'''Special Requirements'''
|-
|Red Cells Resuspended
|Irradiated Red Cells by special request
|-
|Fresh Frozen Plasma (FFP)
|
|-
|Platelet Concentrates
|Enquire about availability before requesting
|-
|Cryoprecipitate
|
|-
|Biostate (Recombinant Factor VIII also available)

Recombinant Factor IX available
|By special request
|-
|Privigen NZ

Alburex 5

Alburex 20

Rh(D) Immunoglobulin - VF

Hepatitis B Immunoglobulin - Neonatal Dose

Tetanus Immunoglobulin - VF

Prothrombinex - VF
|
|-
|Normal Immunoglobulin - VF

Hepatitis B Immunoglobulin - VF (Adult dose)

Zoster Immunoglobulin - VF

Hizentra NZ
|By special request

|}
A NZ Blood Request for Blood & Blood Components or Products Form is required for plasma products. Request the name of the product and quantity required. The patient’s full details need to be included along with the date required and time if applicable.

=== '''Transfusion Therapy''' ===
Please refer to Blood Transfusion - [https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Minimum Orders Policy HBDHB/IVTG/626]

=== '''Procedures:''' ===

==== '''Antibody Screen (ABS)''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Blood Group''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cold Agglutinin Screen''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cord Blood Screen''' ====
Specimen required: 4mL Purple Top (EDTA) tube.

'''Crossmatch (X Match)'''

Specimen required: 6mL Pink Top (Crossmatch) tube.

Use NZ Blood Request for Blood & Blood Components or Products Form.

• Fill in the areas on the form especially previous transfusions or pregnancies within the last 3 months and Clinical Details (Pre-op is not helpful!).

• Start date and time when blood may be required. Failure to supply any of this information may cause unnecessary delays.

• Cross-matched units will only be held for 24 hours except by special arrangement with the Transfusion Medicine Department.

• In the event of postponement or cancellation of surgery, please notify the Transfusion Medicine Department.

==== '''Direct Antiglobulin Test (DAT)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

==== '''Group, Screen and Hold (GSH)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

Use NZ Blood Request for Blood & Blood Components or Products Form.

==== '''Transfusion Reaction Investigations''' ====
{| class="wikitable"
|'''Specimens Required'''
|'''Consider Need For'''
|-
|6 mL Pink top (Crossmatch) tube
|Blood cultures if sepsis suspected
|-
|10 mL Red top (plain) tube
|Blood gases if respiratory distress present
|-
|4 mL Purple (EDTA) tube
|Urine to check for haemoglobinuria
|-
|4.5 mL Lithium heparin (Pale green top) tube
|Coagulation screen if bleeding
|-
|Blood unit(s) implicated in reaction investigation
|
|}
After hours - investigations are only generally performed if the reaction is considered serious and the laboratory is contacted.

=== '''Specimen Validity''' ===
Samples from patients for red cell transfusion are valid for 72 hours, 7 days or 21 days depending on transfusion history, pregnancy and information supplied on the request form.
{| class="wikitable"
|'''Clinical Situation'''
|'''Specimen Validity Time'''
|-
|Patient transfused with red cell, platelet or allogeneic HPC components in the last 3 months.
| rowspan="2" |

Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Patient is pregnant or has been pregnant within the last 3 months (excluding placenta praevia and planned caesarean sections - see below).
|-
|Patient with placenta praevia.
|Sample valid for 7 days unless patient transfused red cell or platelet components within the last 3 months.

Once transfusion occurs, units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.
|-
|Patient with planned caesarean section.
|Sample valid for 72 hours, however if the section is planned Monday, the sample may be collected on the preceding Friday and valid for 96 hours.
|-
|Transfusion request form does not clearly exclude transfusion or pregnancy within the last 3 months (i.e. history section of form not completed).
|Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the last 3 months.
|Sample valid for 7 days but only 72 hours after transfusion has commenced.
|-
|Elective procedures (pre-admission samples), where the transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the past three months and clearly indicates the date that blood transfusion could occur, is more than 7 days after sample collection.
|On request, the sample may be valid for up to 21 days provided history is validated (for example: the eTraceline transfusion file shows no evidence of transfusion in past 3 months).

Once transfusion occurs units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.

Plasma/serum will be separated as soon as possible (and no more than 7 days following collection) and frozen to 20°C or below.
|}
If unsure of the validity that will be applied in a specific scenario, contact Transfusion Medicine Department for advice.

== Contact ==
Transfusion Medicine (Blood Bank) Laboratory - (06) 878 1692 ext 2645

'''Tony Morgan''' (Head of Department) - ext 2629

== Related Links ==
[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/transfusion-medicine-handbook Transfusion Medicine Handbook]

[https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Blood Transfusion Minimum Orders (IVTG626)]

[https://www.clinicaldata.nzblood.co.nz/resourcefolder/index.php?dhbid=14 NZ Blood Service Resource Folder]

[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/clinical-newsletter/ NZ Blood Service Clinical Newsletters]

[https://www.nzblood.co.nz/ NZ Blood Service Website]

Transfusion Medicine Department Information

2023-10-08T23:21:12Z

Jmayes: Updated sample labelling requirements. Intragam P to Privigen NZ and Evogam to Hizentra NZ. Added hyperlinks.

== Specimens for pre-transfusion testing ==

=== '''Specimen''' ===
{| class="wikitable"
|Type
|6 mL Pink Top (Crossmatch)
|-
|Volume
|Normally 6mL. Greater volumes may be required for certain individuals.

Minimum 2mL (generally paediatric)
|-
|Haemolysis
|Sample must not be grossly haemolysed
|}

=== '''Specimen Collection and Labelling''' ===
'''Correctly identifying the patient before collection of the blood sample is essential.'''

• If the patient is in hospital and does not have a wristband, ask the ward staff to apply one before collecting the sample.

• '''At the time of sample collection''' ask the patient to state (if able) their family name, given name(s) and date of birth.

• '''If a wristband is not provided''' (for example: in an outpatient setting) ask the patient to state '''and spell''' (if able) their family name, given name(s) and date of birth.

• '''In an extreme emergency''' a Red Bracelet number with unique NHI may be used. This number must be copied from the patient’s wristband.

• In the case of an '''unconscious patient or person unable to comply with the request for information,''' copy the patient identification details from the patient’s wristband, and if possible confirm with a relative.

• '''Check all the information supplied''' (by patient or relative, on wristband and on request form) to ensure they match. '''DO NOT''' proceed with sample collection if there are discrepancies.

• The patient’s identity must be re-established if the collector leaves the patient’s location prior to initiating the blood collection procedure.

'''Sample tubes must not be labelled in advance of the sample collection.'''

'''The sample tubes must be accurately labelled BEFORE leaving the patient.   '''

'''DO NOT copy patient details from the patient’s notes or charts.'''

'''DO NOT apply a computer generated Bradma label to the sample.'''

Legible hand written patient details must be recorded on the sample tube(s) with pen.

'''The following information MUST be included on the sample tube(s):'''

   Surname (unabbreviated)

   First name (unabbreviated)

Date of Birth

   NHI Number

   Time and date of collection

   Signature of person who collected the sample

Failure to provide any of this information will result in the specimen being rejected for processing.

'''In an Emergency:'''

Unique ED Red Bracelet Identification Code Number may be used along with the Hospital Number allocated to this unique number. (This information should be attached to the patient, for example: wristband).

   Time and date of collection

Signature of person who collected the sample

'''Following specimen labelling:'''

• Check the request form and the sample tube have identical patient information.

• Complete Step 4: “Specimen Collector Declaration” on the request form with the time and date, your name and signature.

=== '''Completion of the NZ Blood Request for Blood Bank Tests & Blood Components or Products Form''' ===
Full and accurate completion of the request form is essential for ensuring that the right test or quantity of blood component or product, is available at the right place at the right time.

Patient details are to be recorded on NZ Blood Request for Blood Bank Tests & Blood Components or Products Form using preferably a computer generated label or legible handwriting.

The request form '''MUST''' contain the following patient information:

• Patient’s registered surname name and given name/s (unabbreviated).

• Hospital number (NHI) and/or date of birth.

• Name of patient’s consultant/practitioner.

• Name and signature of the person completing the request form. This may be a nurse on behalf of the requesting doctor.

• Details of tests required and/or indication of the quantity and time that blood components or products are required (such as date and type of planned surgery).

• Any special requirements for components, for example: Irradiated.

• Signed declaration by the collector confirming that the patient was positively identified at the time of collection and that the samples were labelled before leaving the patient.

• Date and time of collection of blood sample.

The request form should also include:

• Clinical diagnosis and indication for transfusion.

• Record of any known previous transfusions or pregnancy within the last three months.

• Patient’s location.

• Gender.

• Date of surgical procedure (if applicable).

'''Note: ''' The actual prescription for the blood component is the charting of the blood by the attending Medical Officer in the patient’s medical record.

== Requirements for pre-transfusion testing ==
'''Important: ''' It is not possible to over-emphasise the importance of proper patient identification.

Most errors relating to transfusion practice arise from administrative and clerical error. These errors can have serious consequences for patients and are sometimes fatal.

=== '''Blood Products and Components Available''' ===
{| class="wikitable"
|'''Blood Products and Components'''
|'''Special Requirements'''
|-
|Red Cells Resuspended
|Irradiated Red Cells by special request
|-
|Fresh Frozen Plasma (FFP)
|
|-
|Platelet Concentrates
|Enquire about availability before requesting
|-
|Cryoprecipitate
|
|-
|Biostate (Recombinant Factor VIII also available)

Recombinant Factor IX available
|By special request
|-
|Privigen NZ

Albumex 4

Albumex 20

Rh(D) Immunoglobulin - VF

Hepatitis B Immunoglobulin - Neonatal Dose

Tetanus Immunoglobulin - VF

Prothrombinex - VF
|
|-
|Normal Immunoglobulin - VF

Hepatitis B Immunoglobulin - VF (Adult dose)

Zoster Immunoglobulin - VF

Hizentra NZ
|By special request

|}
A NZ Blood Request for Blood & Blood Components or Products Form is required for plasma products. Request the name of the product and quantity required. The patient’s full details need to be included along with the date required and time if applicable.

=== '''Transfusion Therapy''' ===
Please refer to Blood Transfusion - [https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Minimum Orders Policy HBDHB/IVTG/626]

=== '''Procedures:''' ===

==== '''Antibody Screen (ABS)''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Blood Group''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cold Agglutinin Screen''' ====
Specimen required: 6mL Pink Top (Crossmatch) tube.

==== '''Cord Blood Screen''' ====
Specimen required: 4mL Purple Top (EDTA) tube.

'''Crossmatch (X Match)'''

Specimen required: 6mL Pink Top (Crossmatch) tube.

Use NZ Blood Request for Blood & Blood Components or Products Form.

• Fill in the areas on the form especially previous transfusions or pregnancies within the last 3 months and Clinical Details (Pre-op is not helpful!).

• Start date and time when blood may be required. Failure to supply any of this information may cause unnecessary delays.

• Cross-matched units will only be held for 24 hours except by special arrangement with the Transfusion Medicine Department.

• In the event of postponement or cancellation of surgery, please notify the Transfusion Medicine Department.

==== '''Direct Antiglobulin Test (DAT)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

==== '''Group, Screen and Hold (GSH)''' ====
Specimen required: 6 mL Pink Top (Crossmatch) tube.

Use NZ Blood Request for Blood & Blood Components or Products Form.

==== '''Transfusion Reaction Investigations''' ====
{| class="wikitable"
|'''Specimens Required'''
|'''Consider Need For'''
|-
|6 mL Pink top (Crossmatch) tube
|Blood cultures if sepsis suspected
|-
|10 mL Red top (plain) tube
|Blood gases if respiratory distress present
|-
|4 mL Purple (EDTA) tube
|Urine to check for haemoglobinuria
|-
|4.5 mL Lithium heparin (Pale green top) tube
|Coagulation screen if bleeding
|-
|Blood unit(s) implicated in reaction investigation
|
|}
After hours - investigations are only generally performed if the reaction is considered serious and the laboratory is contacted.

=== '''Specimen Validity''' ===
Samples from patients for red cell transfusion are valid for 72 hours, 7 days or 21 days depending on transfusion history, pregnancy and information supplied on the request form.
{| class="wikitable"
|'''Clinical Situation'''
|'''Specimen Validity Time'''
|-
|Patient transfused with red cell, platelet or allogeneic HPC components in the last 3 months.
| rowspan="2" |

Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Patient is pregnant or has been pregnant within the last 3 months (excluding placenta praevia and planned caesarean sections - see below).
|-
|Patient with placenta praevia.
|Sample valid for 7 days unless patient transfused red cell or platelet components within the last 3 months.

Once transfusion occurs, units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.
|-
|Patient with planned caesarean section.
|Sample valid for 72 hours, however if the section is planned Monday, the sample may be collected on the preceding Friday and valid for 96 hours.
|-
|Transfusion request form does not clearly exclude transfusion or pregnancy within the last 3 months (i.e. history section of form not completed).
|Transfusion must be commenced within 72 hours of the sample being taken.
|-
|Transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the last 3 months.
|Sample valid for 7 days but only 72 hours after transfusion has commenced.
|-
|Elective procedures (pre-admission samples), where the transfusion request form clearly excludes a history of transfusion, current pregnancy or pregnancy within the past three months and clearly indicates the date that blood transfusion could occur, is more than 7 days after sample collection.
|On request, the sample may be valid for up to 21 days provided history is validated (for example: the eTraceline transfusion file shows no evidence of transfusion in past 3 months).

Once transfusion occurs units not commenced within 72 hours or before the expiry time of the sample (whichever is earlier) shall be subjected to pretransfusion testing on a new sample.

Plasma/serum will be separated as soon as possible (and no more than 7 days following collection) and frozen to 20°C or below.
|}
If unsure of the validity that will be applied in a specific scenario, contact Transfusion Medicine Department for advice.

== Contact ==
Transfusion Medicine (Blood Bank) Laboratory - (06) 878 1692 ext 2645

'''Tony Morgan''' (Head of Department) - ext 2629

== Related Links ==
[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/transfusion-medicine-handbook Transfusion Medicine Handbook]

[https://ourhub.hawkesbay.health.nz/assets/HUB-Policies-Procedures/Organisation-wide-Policies/IVTG/5ee50e30d6/Blood-Transfusion-Minimum-Orders-IVTG626.pdf Blood Transfusion Minimum Orders (IVTG626)]

[https://www.clinicaldata.nzblood.co.nz/resourcefolder/index.php?dhbid=14 NZ Blood Service Resource Folder]

[https://www.nzblood.co.nz/healthcare-professionals/transfusion-medicine/clinical-newsletter/ NZ Blood Service Clinical Newsletters]

[https://www.nzblood.co.nz/ NZ Blood Service Website]