Clerical Check
Any time a transfusion reaction is suspected on clinical grounds, the first obligation of the Blood Bank is to ensure that the patient has not suffered acute intravascular hemolysis.
With that goal in mind, it shouldn't be too hard to see why the first screening test is the Clerical Check.
The clerical check is usually quite simple. Both the Blood Bank and the transfusing location look at the documentation surrounding the transfusion to ensure that this was truly the patient who was supposed to be transfused, and that this particular unit of blood was the one intended for him. It sounds simple, I know, but unfortunately, the majority of fatal acute hemolytic reactions occur as a result of a screwup of the most basic process imaginable: Getting the right unit to the right patient (Those of you who are tempted to make a derogatory comment about the skill of nurses or clinicians, beware! Many of these are Blood Bank errors, too!).
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