Difference between Type&Cross and Type&Screen

[lsyorke, RN]

Type and screen determine Blood type, Rh, and any antibodies present in CASE you need blood. No blood is prepared for transfusion.

Type and cross-determine the same information but go one step further and get blood ready to be transfused based on that information.

[Archana Shrestha, BSN, RN]

These two are different in the hospital I work.

A type and screen are ordered if a blood transfusion is likely but not sure, while a crossmatch order indicates to the transfusion service that a blood transfusion is required.

Ordering a "type and screen" is a common approach to ensuring blood is available for patients requiring transfusion in a given medical or surgical setting. A type and screen order in the laboratory results in blood grouping (ABO and Rh typing) and antibody screening. If the screen is negative, a computer crossmatches can confirm compatibility if blood is required. Since this process takes only minutes, there is no need to prepare units in advance or tag units of blood for a specific patient. In this setting, if blood is required urgently, an ABO and Rh-compatible unit is selected by computer crossmatch, followed by labeling and issuing the blood for transfusion.

If the antibody screen is positive following the type and screen order, identification of the antibody, selection of antigen-negative donor units, and a serological crossmatch are required to ensure blood is available for transfusion.

For patients for whom a blood transfusion is intended, a crossmatch should be requested and indicate how many red cell units are required. For a patient with a crossmatch order, in addition to performing a type and screen, compatibility testing is performed along with preparation and labeling of red blood cell units for transfusion.

Compatibility testing may involve a computer (electronic) crossmatch if the antibody screen is negative or a serological crossmatch when an antibody has been identified.

[meownsmile, BSN, RN]

To my knowledge, a type and cross mean they type the blood and cross-match it for PRBC units. A kind and screen mean they type the blood and screen for antibodies that may cause a reaction to transfused blood. When they do a screen, they also have to match the available blood units antibodies to the patient's antibodies. The cross means they have the correct blood type available to infuse.

I know I have had to wait up to a couple of hours to receive blood from a neighboring town's blood bank because the patient had specific antibodies that made giving her a unit of what we had available impossible.

[km5v6r, EdD, RN]

At my hospital, they are pretty specific about the T&S vs. TCM. The T&S means the blood is checked, but a particular number of units of blood is not designated for that pt. The antibodies are limited, but PRBCs are not set aside for that pt. We are supposed to use this if a transfusion is possible but not necessarily going to happen. According to the lab, it would take another 15 mins to have blood in hand if ordered. A T&CM designates a certain number of units of PRBCs for that pt. They are labeled and set aside. This is used if giving blood is a definite or the additional 15 min wait is too long. If an emergency arises, the PRBCs from a T&CM designated for pt X can not be used for pt Y. With a T&S, all the preliminary work is done, but specific units are not assigned and available for anyone to use. We see this a lot working at a significant transplant/trauma center. The lab prefers for us to utilize the T&S whenever possible.

[Ann Fosque]

I know T&S may be ordered for OHS Cases if Cryoprecipitates are indicated to control bleeding by checking antibodies.