Trauma issuing when the patient is not in the hospital

[labguru]

A victim fell off a cliff and was mangled on rocks below.  Medflight and EMT squad arrive on scene.  Medflight will not take victim because there is no pulse. EMT take victim and perform CPR while enroute to hospital and they get a pulse.  Hospital is notified that patient will be picked up at helipad (since there is a pulse) to fly him to a bigger hospital with Level 1 trauma and have 2 units of O neg waiting.

 

My question is: Has anyone ever been presented with something like this?  The victim was never admitted to hospital, no name, no info.  According to Physician on Medflight there was mass amounts of internal bleeding and they needed the blood as a life saving measure and the victim wouldn't make it to the next hospital without it.

 

What would you do in this case?  Or what should be done?

[David Saikin]

this happens to us rarely on an ambulance transport from far Northern NH to the tertiary care facility south of us. Hasn't happened in quite a while - I'd bill the ambulance company and let them pass the charges along. You should contact them afterwards to find out if the blood was infused and get the pt info for records at least. Sometimes you have to eat the charges.

Interesting topic.

[labguru]

What would legally need to be done on our end to satisfy the governing bodies?  Are you allowed to give out blood without all the policies being followed.  With no ability to get a blood bank tube or anything?

[SMILLER]

This has happened here once as well.  I believe we used our BB system to "ship" the units to the final destination hospital.  Making them responsible for all of the transfusion records.

 

Scott

[BankerGirl]

This has happened here once as well.  I believe we used our BB system to "ship" the units to the final destination hospital.  Making them responsible for all of the transfusion records.

 

Scott

 

This was my thought as well.

[tbostock]

You would eventually be able to get some type of ID on the patient and even though not admitted, we would be able to "admit" a patient in our LIS just to get the tracking information in there so we would know where those units went.

[AMcCord]

We would transfer the units to the receiving hospital, but would also try to determine who the patient was and whether or not the units were infused en route. Saving the life would be more important than pretty paperwork.

Edited November 18, 2015 by AMcCord

[Mabel Adams]

Our helicopter stocks 2 O negs.  They sometimes transfer a patient from a distant hospital that is not in our system to a bigger hospital that is also not in our system.  We have a contract with the helicopter company to sell them blood and they infuse it and document it according to their protocols.  They give us paperwork whenever they give it. Usually we have the patient to be able to assign all of the documentation to the patient.  When we don't get the patient, we get patient and unit information from them and are able to put the patient into the BB computer so we can track final disposition of the units. If they don't hang the blood en route the receiving hospital won't accept it.

 

If your computer doesn't allow entering patients like this, then be sure to assign final distribution as being issued/shipped/transferred to the helicopter team.  If there is a recall they should at least be able to look up all the patients that they transported that day to identify the recipient.  I am sure that they can't look things up by unit number in their system unless it has a Google-like search function so the correct date would be important.

 

As for not getting a specimen, you would use the same policies that you use if a patient dies after receiving uncrossmatched blood and you never got a sample, I'd say.