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A 63-year-old man with a history of myocardial infarction and unstable angina is scheduled for coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB). A preoperative ethylenediaminetetraacetic acid (EDTA) anticoagulant sample is submitted to the blood bank for type and screen along with a request for crossmatch of four units of red blood cells (RBCs) in preparation for the surgery.

A 3-year-old girl is admitted to the emergency department with fever of 101.6°F accompanied by poor feeding over the prior 3 days and a persistent cough with dyspnea. Chest x-ray reveals left lower lobe pneumonia, and blood cultures are positive for Streptococcus pneumoniae. The child was born prematurely at 34 weeks by vaginal delivery and weighed 2.5 kg (current weight 12.4 kg). Laboratory values are as follows: white blood cells (WBC) 20.0 K/μL, hemoglobin (Hgb) 7.2 g/dL, hematocrit (Hct) 24%, platelet count 62 K/μL, lactate dehydrogenase (LDH) 800 U/L, prothrombin time (PT) 17.2 s, activated partial thromboplastin time (aPTT) 48.5 s, total bilirubin 5.0 mg/dL, and creatinine 4.2 mg/dL. An ethylenediaminetetraacetic acid (EDTA) anticoagulant sample is submitted to the blood bank for type and screen.

A 38-year-old male who underwent craniotomy surgery 2 months ago presents today for outpatient red blood cell (RBC) transfusion of two units for symptomatic anemia, hemoglobin (Hgb) level 7.4 g/dL. The patient had received multiple RBC transfusions during the craniotomy surgery and postoperatively in recovery; all of the RBC units were issued by immediate spin crossmatch. A type and crossmatch sample (ethylenediaminetetraacetic acid, EDTA anticoagulant) is submitted to the blood bank and two units are crossmatched by immediate spin and are transfused without incident.

A 55-year-old man with B-cell lymphoma and history of a warm autoantibody and a cold autoanti-I antibody reactive at 4 °C but no alloantibodies is admitted to the hospital for workup of fever of unknown origin. The patient has received red blood cell (RBC) and platelet transfusions in the hospital in the past but none in the prior 3 months. An ethylenediaminetetraacetic acid (EDTA) anticoagulant sample is submitted to the blood bank for type and screen along with a request for crossmatch of one irradiated RBC unit; the patient’s hemoglobin (Hgb) is noted to be 7.0 g/dL at the time of the request.

A 73-year-old man with immunoglobulin (Ig)G kappa multiple myeloma is referred for outpatient transfusion due to severe anemia with hemoglobin (Hgb) of 6.6 g/dL. The patient has a history of red blood cell (RBC) transfusion at your hospital 2 years ago at which time the antibody screen was negative. An ethylenediaminetetraacetic acid (EDTA) anticoagulant sample is submitted to the blood bank for type and screen along with a request for two units of irradiated RBCs.

A 59-year-old female, a self-described homemaker, and a mother to three children presents to the emergency department (ED) with acute-on-chronic anemia secondary to lower gastrointestinal (GI) bleeding (the patient is known to have a history of colonic diverticular bleeding) and iron deficiency. The patient takes iron and vitamin supplements at home. She additionally takes warfarin due to a history of atrial fibrillation. The patient’s hemoglobin (Hgb) level is 6.4 g/dL in the ED, and the patient appears pale with tachycardia (heart rate 110 beats/min) though her blood pressure is stable at 130/80 mmHg and her oxygen saturation is normal (98%) on room air. A type and screen sample (ethylenediaminetetraacetic acid [EDTA] anticoagulant) is submitted to the blood bank along with a request for crossmatch of two units of red blood cells (RBCs).

A 74-year-old man is admitted to hospital for workup of gastrointestinal (GI) bleeding; he is scheduled for colonoscopy the following day. An ethylenediaminetetraacetic acid (EDTA) anticoagulant sample is submitted to the blood bank for type and screen.

A 55-year-old man with a history of alcohol abuse and liver cirrhosis presents to the emergency department with upper gastrointestinal bleeding and symptomatic anemia related to acute blood loss (hemoglobin [Hgb] level 7.1 g/dL). A type and screen sample (ethylenediaminetetraacetic acid [EDTA] anticoagulant) along with an order for two units of red blood cells (RBCs) is submitted to the blood bank.

A 22-year-old man is brought into the emergency department (ED) after sustaining trauma resulting in a fracture of the right femur sustained during a skiing accident. An ethylenediaminetetraacetic acid (EDTA) anticoagulant sample is submitted to the blood bank for type and screen and crossmatch of four red blood cell (RBC) units. No transfusion history is given.

A 54-year-old woman with hepatitis C cirrhosis, status post deceased-donor orthotopic liver transplant 14 days ago, returns for outpatient follow-up with complaints of excessive fatigue, lightheadedness, and dyspnea on exertion. The patient had experienced an uneventful postoperative course and was discharged from the hospital in good condition on postoperative day #4. Laboratory studies show that the hemoglobin (Hgb) has decreased from 9.1 (hospital discharge) to 5.1 g/dL. A type and screen sample (ethylenediaminetetraacetic acid [EDTA] anticoagulant) and a request for two units of red blood cells (RBCs) are submitted to the blood bank.

A 51-year-old woman with breast cancer and a history of type 1 von Willebrand disease (VWD) is scheduled for a left total mastectomy. The patient relates a history of easy bruising, frequent nose bleeds, and menorrhagia; the patient successfully delivered a full-term baby at age 32 for which she had received prophylactic transfusions with cryoprecipitate. The patient has had no prior surgeries, but did have a wisdom tooth extraction as a teenager for which she received prophylactic desmopressin acetate (DDAVP, l-deamino-8-d-arginine vasopressin) injection and experienced only minor bleeding. A type and screen (ethylenediaminetetraacetic acid [EDTA] anticoagulant) sample is submitted to the blood bank.

An 8-year-old boy with congenital heart disease is admitted to the hospital for a planned mitral valve repair and revision. The patient has had multiple admissions to the hospital for surgery and complications relating to the congenital heart condition, most recently 1 month ago, and has required support with multiple transfusions of blood products over the years. His prior blood bank tests show that he is group A-positive with a negative antibody screen. A type and screen sample (ethylenediaminetetraacetic acid [EDTA] anticoagulant) is submitted to the blood bank along with a request for crossmatch of two units of red blood cells (RBCs).

A 36-year-old female, with no significant past medical history, is status post vaginal delivery of a baby at term pregnancy. Postdelivery hematocrit (Hct) is 30 % and patient weighs 65 kg. The patient is known to have received prenatal Rh immune globulin (RhIg) at 28 weeks, at which time the antibody screen was negative. A type and screen sample (ethylenediaminetetraacetic acid, EDTA anticoagulant) is submitted to the blood bank along with the cord blood sample from the baby and a request for postpartum RhIg.

A 32-year-old female presents to the obstetrical clinic at 8 weeks of pregnancy. A type and screen sample (ethylenediaminetetraacetic acid, EDTA anticoagulant) is submitted to the blood bank.

A 44-year-old female with sickle cell disease presents to the emergency department with acute pain crisis (pain in shoulders and upper back). The patient’s hemoglobin (Hgb) level is 7.2 g/dL, which is around her usual baseline Hgb. The patient received 2 red blood cell (RBC) units in the outpatient department of another hospital 4 days prior to admission (her Hgb level was 7.6 g/dL prior to transfusion at that time), and as per that hospital’s blood bank, the patient has an antibody history of warm autoantibody, anti-Fya, and anti-Jkb. Overnight in the emergency department, the patient’s blood pressure dropped to 90/56 mmHg, and the Hgb level dropped to 5.4 g/dL with total bilirubin (T-Bili) level 15.3 mg/dL and the lactate dehydrogenase (LDH) level 10,000 U/L. The patient is admitted to the medical intensive care unit (MICU) and a type and screen sample (ethylenediaminetetraacetic acid, EDTA anticoagulant) is submitted to the blood bank along with a request for two units of RBCs.

A 30-year-old female presents for outpatient transfusion of one unit of red blood cells (RBCs). The patient’s hemoglobin (Hgb) level is 7.5 g/dL and the platelet count is 25 K/µL (the patient is known to have a history of thrombocytopenia). A type and screen sample (ethylenediaminetetraacetic acid, EDTA anticoagulant) is submitted to the blood bank. The patient has no history of transfusion or pregnancy.

A 78-year-old male is brought to the emergency department after falling on ice and sustaining head trauma outside of his home. A computed tomography (CT) head scan shows intracerebral hemorrhage. The patient is noted to have a medical history significant for non-valvular atrial fibrillation for which he takes dabigratran etexilate anticoagulant medication. Coagulation laboratory studies show prothrombin time (PT) 13.1 s, activated partial thromboplastin time (aPTT) 62.0 s. A type and screen (ethylenediaminetetraacetic acid, EDTA anticoagulant) is submitted to the blood bank along with a request for four units of fresh frozen plasma (FFP).

A 31-year-old female is post uncomplicated vaginal delivery of a full term, healthy baby 1 day ago. According to the history from the patient’s obstetrician, the patient typed O-negative blood group, as tested from an outside laboratory, and received Rh immune globulin (RhIg) at 28 weeks of gestation. A type and screen sample (ethylenediaminetetraacetic acid, EDTA anticoagulant) from the mother and cord blood are submitted to the blood bank along with a request for postpartum RhIg.

A 70-year-old female of African American decent, with history of hypertension, type II diabetes mellitus, anemia, and congestive heart failure, is admitted because of symptomatic anemia (hemoglobin, Hgb level 7.2 g/dL). The patient has a history of red blood cell (RBC) transfusions and is known to have alloantibodies (anti-C, -K, and -Fya). The patient was last transfused two units of RBCs 2 weeks ago. Two RBC units are now requested, and a type and crossmatch sample (ethylenediaminetetraacetic acid, EDTA anticoagulant) is submitted to the blood bank.

A 72-year-old male with myelodysplastic syndrome, multiply transfused with a known history of anti-E and anti-c antibodies, presents to the outpatient transfusion service. He was transfused with 2 units of red blood cells (RBCs) 5 weeks ago. The patient’s hematocrit (Hct) is now 22 % and 1 unit of RBCs is requested for the patient. A type and crossmatch sample (ethylenediaminetetraacetic acid, EDTA anticoagulant) is submitted to the blood bank.

A 72-year-old male is admitted to the hospital with a presumptive diagnosis of acute myeloid leukemia. He is scheduled for bone marrow biopsy but has a platelet count of 7 K/µL. A type and screen sample (ethylenediaminetetraacetic acid, EDTA anticoagulant) is submitted to the blood bank along with a request for two units of apheresis platelets.

A 10-year-old male presents with a history of multiple recurrent infections including pneumonia, lymphadenitis, and osteomyelitis since the age of 2 months. The patient currently has a pulmonary mycetoma that is refractory to medical treatment and is scheduled for surgical resection. A type and screen sample (ethylenediaminetetraacetic acid, EDTA anticoagulant) is submitted to the blood bank with a request for two units of red blood cells (RBCs) for surgery.

A 58-year-old male presents to the hospital for knee replacement surgery. The patient has a history of transfusion (at another hospital) some years ago after gastrointestinal bleeding. A type and screen sample (ethylenediaminetetraacetic acid, EDTA anticoagulant) is submitted to the blood bank.

A 20-year-old female with a history of systemic lupus erythematosus and idiopathic (immune) thrombocytopenic purpura (ITP), who received intravenous Rh immune globulin (RhIg) 1 year ago for treatment of ITP and has no prior history of red blood cell (RBC) transfusion or pregnancy, is found to have a hematocrit (Hct) level of 15 %. The patient was referred to the emergency department by her primary care physician for stat RBC transfusion of two units. A type and crossmatch sample (ethylenediaminetetraacetic acid, EDTA anticoagulant) is submitted to the blood bank.

A 54-year-old female presents to the emergency department because of altered mental status. She has a history of hypertension and breast cancer and weighs 65 kg. The patient has no prior history of transfusion. Her laboratory values are significant for a hematocrit (Hct) level of 20 %, platelets 12 K/µL, lactate dehydrogenase (LDH) level 2500 U/L, and creatinine 2.3 mg/dL. The prothrombin time (PT) and activated partial thromboplastin time (aPTT) laboratory values are within normal range. A type and screen sample (ethylenediaminetetraacetic acid, EDTA anticoagulant) is submitted to the blood bank along with a request for two units of red blood cells (RBCs). In addition, urgent plasma exchange is requested.

A 53-year-old male with a history of coronary artery disease, hypertension, type 2 diabetes mellitus, and chronic anemia, presents with gangrenous left foot and is scheduled for amputation. The patient was transfused red blood cells (RBCs) at the hospital 3 years ago and most recently 6 months ago; the antibody screen was negative at those times. A type and screen sample (ethylenediaminetetraacetic acid, EDTA anticoagulant) is submitted to the blood bank.

A 66-year-old male is scheduled for an elective hip replacement surgery. A preadmission test sample (ethylenediaminetetraacetic acid, EDTA anticoagulant) is submitted to the blood bank for type and crossmatch of two red blood cell (RBC) units. No transfusion history is given.

A 52-year-old male with a history of hypertension, type 2 diabetes mellitus, and three-vessel coronary artery disease is admitted to the hospital for a coronary artery bypass graft surgery. An ethylenediaminetetraacetic acid (EDTA) anticoagulant sample is submitted to the blood bank for type and crossmatch of four red blood cell (RBC) units. No transfusion history is given.

A 16-year-old female with sickle cell disease now presents with aplastic crisis with a hematocrit (Hct) of 17 % (the patient’s baseline Hct is 28 %). The patient has been transfused many times with the last red blood cell (RBC) transfusion occurring 1 month ago. The patient has a known history of anti-E antibody. A sample (ethylenediaminetetraacetic acid, EDTA anticoagulant) is submitted to the blood bank for stat type and crossmatch of two RBC units.