Blood bank identification bands for neonates 

A blood bank colleague's hospital in Central California is currently using a commercial patient ID banding system for identification of all patients who require blood bank testing (in addition to a routine hospital ID band), except for neonates. Neonates are currently banded only with a routine hospital ID band. She would like information regarding commercial or custom blood bank ID banding systems, if they exist, for neonates. In order to reduce both the complexity of neonatal pre-transfusion testing and the risk of ABO-incompatible transfusion to their neonates, the practice at her hospital is to transfuse only group O, Rh specific RBCs for neonates requiring red cell transfusions.

Other considerations for this hospital are that umbilical cord blood samples are collected by a physician and labeled by a nurse at the time of collection. Currently the umbilical cord blood specimens are collected into a 7ml EDTA and a 7ml clot tube. The cord blood specimen tubes are labeled with the baby's account number, Medical Record Number (MR#), Last name, Gender, Mother's MR#, Mother's Blood Type, Collection Date & Time, and the name of the Doctor who collected the specimen. The neonate's mother is identified by her hospital ID Band that is verified by a verbal check at the time of a blood sample draw. If the mother requires blood bank testing, an additional commercial BB ID band is placed on the mother's arm at the time the specimen is drawn. It has the following information: Name, MR#, date & time of draw, and the initials of the person drawing the blood. Most of the mothers who are routinely drawn for blood bank testing have a Clot on Hold, in case additional testing (ABO/Rh/antibody screen and/or crossmatch) becomes necessary, and these specimens are good for 3 days, after which the mother needs to be redrawn. A mother's specimen can be used for serological testing for her neonate, in the event that the neonate needs an RBC transfusion.

She states that one of their biggest problems is with neonates who are transferred to their facility or when a neonate's mother is no longer an inpatient. In those cases they may not have a mother's sample for testing, in which case they need to rely on a neonatal sample, and their neonates are not labeled with the commercial blood bank ID system. Usually when neonates are transferred to them, the neonate arrives with a sample of their mother's blood and a sample of their cord blood. However such samples present a challenge in that one cannot be certain that they have been correctly labeled at the referring facility, and even if they were, the sample labeling may with a different system.

Finally, if a neonate is banded with a commercial or custom blood bank ID band, what is the procedure for labeling that band? Should the band show both the ID of the mother and the neonate? Then comes the problem of keeping the band on the neonate. Nursing staff in the Intensive Care Nursery have told the inquiring colleague that some neonates are just too small for any kind of ID band. Also, due to the sensitivity of the neonate's skin, bands must be frequently removed and replaced.

The following comments have been received

ADDENDA Dec. 15, 2004

1. A representative of a company that makes a blood recipient verification system reports that they have worked with hospitals that treat pediatric patients, and that many of these hospitals place alpha-numeric labels directly on a child's incubator, on related files and on the patient's paperwork.

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