4.7: Pre-transfusion blood sampling
Misidentification at blood sampling may lead to fatal ABO-incompatible blood transfusion, especially if the patient has not previously had their blood group documented. Inadequately or mislabelled samples carry a significantly increased risk of containing blood from the wrong patient. Risk of misidentification may be reduced by electronic systems, but all sampling should be carried out in line with the following principles by trained and competent staff:
- Patients must be positively identified and their details must match those on the request form.
- All inpatients must wear an identity band (or risk-assessed equivalent).
- Collection of the sample and labelling of the sample tubes must be performed as one uninterrupted process involving one member of staff and one patient.
- Sample tubes must never be pre-labelled.
- The sample tube label must contain the minimum patient identifiers (exactly matching those on the request form and identity band), date and time of sampling and identity of person taking the sample.
- Labels printed away from the patient (e.g. addressograph labels) must not be used on the transfusion sample but labels printed ‘on demand’ and applied to the tube next to the patient, as used in some electronic ID systems, are acceptable.
- All handwritten labels must be legible.
- BCSH guidelines recommend that laboratories have a ‘zero tolerance’ policy for rejecting samples that do not meet the above minimum requirements.