Emergency Release

[jojo808 45]

Some physicians are  requesting that our IT build an Emergency release XM test to avoid having to sign 'the paper' for it. It will be a normal crossmatch test with the understanding that it is uncrossmatched and 'emergency released' via the verbiage that will be attached to it. Does anyone know if that is not acceptable to any agency? I will definitely require that the phone call to blood bank still be in the process, this is not my choice but I feel being forced upon us. I feel I'm the only one who objects to these things. Thanks in advance for the comments.

[Neil Blumberg 246]

Sounds like a good plan. Reducing needless work is a great idea.  I find it absurd to require busy practitioners to attest to the urgency of a clinical request by installing bureaucratic obstacles.  It may be required by regulators and accreditation agencies, but it is bureaucratic nincompoopery (sic) to my mind, serving no real purpose. 

A discussion of the pros and cons of giving out red cells without an antibody screen should occur with every such request when time allows. Almost no one does a physical crossmatch these days anyway,  to my knowledge, except if alloantibodies are present.

This requirement is obsolete.  Documenting in the medical record what you did and why should be the priority, not filling out forms taking responsibility for that which one is obviously entirely responsible.  The transfusion service doesn't decide when to transfuse patients, so obviously a decision to urgently transfuse partially tested or untested blood is the responsibility of the ordering practitioner.  Duh.

[David Saikin 1,425]

I think that your institution may develop whatever means they feel appropriate for emergency release.  The only caveat I have is that the MD who is  ordering is documented on the request.  Many times computer generated orders only have the attending who is in the system.  Definitely keep the phone call.

[Kathyang 49]

  We have this with Epic and it does save time in an emergency or MTP. Also we don't have to worry about the paperwork, it is right in the EMR. We still ask for the call since we are the ones that are usually ordering the Emergency transfusion.

[slsmith 58]

We have a order for emergency uncrossmatch blood in EPIC and it has an electronic signature attached to the order so no other signature needed. How the IR department built it I don't know. And a phone call is still required as there are times the order was placed in error (darn residents) and the fact that when an order prints we don't necessarily jump to see what  just printed .

[applejw 89]

We have just implemented this in Epic.  Haven't gone through an inspection yet but I can't see that the FDA would have a problem with it as it is documenting a medical decision.