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simret

Emergency Released RBC

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Do you keep the emergency release form that was issued as an emergency, but then the blood was never transfused and the form was never signed by the physician and returned to the Blood Bank?

Thank you,

Simret G

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It would behoove you to keep it. Reason being, a unit in your care was issued before all required testing was performed. Even if the blood was returned, you need to keep the documentation as to why it was released from your electronic inventory record.

Now, say you issue a cooler full of an MTP pack and as the nurse is walking away, they cancel the MTP. The nurse returns the cooler, it doesn’t even make it to the floor, and you haven’t sent the slip for the physician’s signature yet. In that case, it could be a little redundant to make them sign a form for a nonexistent MTP, so I would just leave documentation of a variance from SOP document in the event of inspection with the documentation that an emergency release was initiated at the request of the physician and was canceled so you did not send a form.

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19 hours ago, Oniononorion said:

It would behoove you to keep it. Reason being, a unit in your care was issued before all required testing was performed. Even if the blood was returned, you need to keep the documentation as to why it was released from your electronic inventory record.

Now, say you issue a cooler full of an MTP pack and as the nurse is walking away, they cancel the MTP. The nurse returns the cooler, it doesn’t even make it to the floor, and you haven’t sent the slip for the physician’s signature yet. In that case, it could be a little redundant to make them sign a form for a nonexistent MTP, so I would just leave documentation of a variance from SOP document in the event of inspection with the documentation that an emergency release was initiated at the request of the physician and was canceled so you did not send a form.

Exactly!

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Thank you all for sharing your thoughts. Much appreciated!

Simret G.

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21CFR606.151(e) states "Standard operating procedures for compatibility testing shall include the following: Procedures to expedite transfusion in life-threatening emergencies. Records of all such incidents shall be maintained, including complete documentation justifying the emergency action, which shall be signed by a physician."

We keep them regardless of whether or not the units are transfused.

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Does anyone utilize the physician notes that mention the need for blood and are electronically signed in the EMR to satisfy the documentation required for emergency release of units?

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They certainly do in many hospitals within the UK where Biomedical Scientists have been empowered to so do.

I should point out that blood is never withheld in an emergency situation, there will most certainly be an investigation after the event.

Edited by Malcolm Needs

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We require a signature on an Emergency Release document, but we don't require that signature prior to the release of product, just a verbal. If the ED provider requested the release he/she is usually available to sign once the patient has been turned over to the surgeon/transferred/admitted. In some cases the form may get mailed to the surgeon's office the next day for signature or wait a few days until the ED provider is on duty again.

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Our issue is that the ED providers find a paper form archaic and say that the patients electronically signed EMR note should give enough indication for the product need prior to compatibility testing.

No...blood is never withheld in an emergency situation. This EMR review would be retrospecitve.

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