The Blood Bank
Samples and requests
Let's ensure that the right sample from the right patient is sent to the Blood Bank
Before a blood transfusion, a blood group is always confirmed with a new sample to ensure the patient's safety. The results from the sample are used to select the correct blood products. The correct sample is therefore vital for the patient.
In the case of predetermined surgery, where a patient has not been blood typed, it is best, with regard to his/her safety, to:
send one sample and one request for blood sorting in preparation
send another sample and request when he/she comes in for surgery
Healthcare professionals with access to Saga/Orbit and Heilsugátt can view a patient's blood group in "Interinfo". Staff at other locations must call the Blood Bank to see if a patient has been blood grouped.
Blood group antibodies are always screened at the first blood grouping and a healthcare centre/institution is notified if a patient is diagnosed with blood group antibodies. In such circumstances, more preparation is needed, e.g. sending two samples to confirm antibodies and cross-matching of selected units.
In order to ensure the safety of patients before blood transfusion, the new blood group is always compared to the known blood group. When samples are taken at the same time, the safety gained by this comparison is reduced.
If a patient has been blood grouped and is not found to have a blood group antibody (see "Interinfo" available to staff through Saga/Orbit and Heilsugátt), it is sufficient to send one sample with a request. You can take a the sample when the patient is being admitted to the hospital but you must check to see if you can request an extension if the operation is not due until some days later.
The reliability of blood tests and safe transfusions depends on the quality of the samples. In order to ensure patient safety, the policy of the Blood Bank is not to grant exemptions where the quality, labelling and/or traceability of samples is unacceptable.
The goal of sample and request marking is to ensure that the Blood Bank receives the correct samples for examination.
The sample and request shall be marked with the name and ID number of the patient in question.
Requests must always be accompanied by a sample to the Blood Bank. It should include information on the patient, what is to be examinated and who orders the examination in question. The Icelandic Blood Bank will not conduct the requested examination if personal identification of the staff is lacking.
Further informations on the sampling procedure are in the Blood Banks quality manual at Landspítali's website.
Personal identification is a very important part of secure blood banking services. The personal identification shall be the responsibility of the person taking the sample for ensuring that the sample is taken from the correct patient.
The correct patient should be confirmed when sampling is carried out. The patient himself/herself provides his/her full name and ID number, unless his/her condition prevents this, in which case the user shall use an ESR. If a patient does not have a badge, another staff member, who knows the identity of the patient, must be provided with the badge to confirm that the patient is correct.
The signature of the employee taking the sample is equivalent to the responsibility of the sample being from the correct individual, cf. "The undersigned took an attached sample from the individual listed on the tube and request".
The Blood Bank will not conduct the requested study if personal identification is lacking.
Study | Blood samples | To scrutiny |
|---|---|---|
ABO/RhD grouping and screening for blood group antibodies | 1x 4 mL EDTA | Always send 2 tubes from patients with blood group antibody |
BAS/BKS test | 1x 4 mL EDTA | Always send 2 tubes from patients with blood group antibody - further information on blood recipients under 4 months at the bottom |
Determination of blood group antibodies and titration of blood group antibodies | 2x 4 mL EDTA | |
Direct Coomb's test (DAT) | 1x 4 mL EDTA | |
Screening for cold sensitive antibodies | 1x 4 mL EDTA | |
Adverse reactions in blood transfusions | 1x 4 mL EDTA | Fill in a Blood Bank Request - Adverse Reactions and Events and send it with the sample |
Infant blood grouping | Microtube 1ml EDTA | Infant samples are samples from children under 4 months of age |
Blood grouping of umbilical cord blood | 4-10 ml EDTA | |
HPA-1 classification | 1 x 4 ml EDTA | Done on Blood sample from mother when NAIT is suspected |
Search for a living kidney donor | 4x 4 ml EDTA 1x 4 ml of whole blood, non-adjuvant-gel |
|
Search for a cadaveric donor | 4x 4 mL EDTA 1x 4 ml whole blood, non-adjuvanted |
|
Search for a stem cell donor | 1x 4 mL EDTA | |
HLA antibody screening | 1 x 4 ml EDTA 1x 4 ml whole blood, non-adjuvanted |
|
HLA-B27 | 1x 4 mL EDTA |
|
HLA-DR | 1x 4 mL EDTA | |
CD34+ | 1x 2ml EDTA | |
Other | Contact the Blood Bank |
Blood recipients younger than 4 months.
Only one infant sample from infants younger than 4 months is required for blood transfusion.
When blood components are ordered for the first time, a sample from the mother must be included with a sample from the infant.
If the mother does not have blood group antibodies and the child's Coomb's test is negative, the child's BKS test is extended until 4 months of age, and then a sample is not needed again until the child is older than 4 months.
Blood group is not confirmed as children of this age receive all AB negative plasma and O negative red blood cell concentrate (unless the mother's blood group antibodies cause a different blood group to be chosen).
Note that the Blood Bank does not accept electronic requests for laboratory services.
All requests for the Blood Bank are in the Blood Bank's quality manual on Landspítali's website. It also contains information on filling in requests.