We have 2 O Pos and 2 O Neg units all labeled and written on Emergency Issue and Blood Cooler forms ahead of time. Segments are also set aside for these units. When a full trauma is paged (we have full and partial traumas in our Level II Trauma Center), we call to find out the age and gender of the patient. We then pack up the appropriate units in a blood cooler. For most of our full traumas, someone comes from the ED to pick up the cooler. Sometimes they call first, and sometimes someone just appears at the blood bank window for the blood. These units are usually taken to the ED prior to the patient's arrival.
If the patient is an inpatient, the courier comes to pick up the units and brings patient identification. Orders are not usually in the computer prior to picking up the units. If a type and screen has been completed, we can quickly do an electronic crossmatch and have the units available. If it has been necessary for us to put the order for the packed cells in the computer, we complete a sheet for verbal orders that the physician signs later.
If an MTP is needed, that order is place in the computer. We prepare the first pack, and then blood bankers order any additional packs that are needed. Since this is an approved protocol, we don't need additional signatures from the physician.