Type and Screen: Use and Effectiveness in Elective Surgery

During a 20- month evaluation period from July 1977 through February 1979, blood specimens from 6,656 patients were given a type and screen. One hundred and fifty-four (2.3%) of these patients required blood transfusions, and so type and screen requests were converted to crossmatch. Although irregular antibodies were detected on type and screen for five of the 154 patients, all blood transfusion outcomes were uneventful. In previous reports, a procedure to develop guidelines for ordering blood,and the efficacy and safety of the type and screen were described. For five years at the State University of New York, the type and screen has been successfully and safely used for elective-surgery patients who are unlikely to require transfusions, but for whom blood should be available on demand if needed for an unexpected hemorrhage. The type and screen is a safe, resource-conserving, practical alternative to the more expensive traditional two-unit crossmatch for surgical procedures usually not requiring a blood transfusion.