Kijabe Hospital Blood Sample Management

Authors: Britney Grayson, David Macharia

  • Written: 19 November 2021

  • Approved/Effective: 2021

  • Date of next review: PENDING

  • Version: 1

  • Targeted users: Theatre and laboratory staff who process blood samples and requests for patients undergoing surgical procedures.

Purpose: To ensure a timely process for receipt of urgent lab results and/or blood for blood transfusion when patients are undergoing surgical procedures.

Description: When a patient undergoing a surgical procedure needs serum lab values checked (for example, hemoglobin), an order is first placed by a physician (consultant anesthesiologist/surgeon or a trainee member of team). This order carries a STAT designation when appropriate. Next, blood is drawn by the anesthetist and taken to theatre reception where porters are available to carry it immediately to the lab. In the lab, the previously placed order identifies the sample as STAT when it is logged in, thus resulting in processing as quickly as possible. When the results are obtained, critical and alert values are called back to the ordering provider. All values are uploaded into HMIS immediately upon result.

  • When a patient undergoing a surgical procedure requires a blood transfusion, blood is obtained in one of several ways:

    • Often, the type and crossmatch is performed prior to theatre, with a ready time for the blood as requested by the surgical team. In this case, all orders have already been placed and when the blood is needed, the theatre staff walks to reception where a porter carries a cooler to the lab and can immediately pick up the blood.

    • If a type and crossmatch has NOT yet been performed, a STAT order is placed by a physician on the team, the blood sample is drawn by the anesthetist and taken immediately to the lab by the porters. In the lab, verbal handoff of the sample takes place, alerting the lab to the urgency or emergency of the situation.

    • If there is time for a full type and crossmatch, theatre reception can be called when the blood is ready and a porter sent back at that time.

    • If there is time for grouping of the blood only, an emergency request form is filled, the grouping test is done quickly, while the porter waits, and then type-specific blood is released after an emergency request form is filled.

    • If there is no time for any testing, a sample is not required. The emergency request form is filled and O negative blood is released immediately.

  • On nights and weekends, the porters are not available and the lab has more limited staff. Instead of the porters, any available member of the anesthesia or surgery team may carry the sample to the lab. If lab employees have stepped out, the monthly published call schedule contains the mobile number of the lab employee on call and/or the coverage nurse can assist in locating them quickly.