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Issuing Emergency Release/MTP Packs


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In an emergent situation, when a verbal order is given for an emergency release unit(s) or for the first pack of MTP blood does the person picking up the units need patient identifiers?  Can they just come to the window and say "I am here for the Emergency release units!".  I had always assumed that the protocol would allow for the RN, etc who may not have time to get a form, to skip this step as they will be identifying at the bedside.  Can some one give me some direction?

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Minimum requirement is to present the patients name and MR# in writing. This ensures there is no confusion as to who the blood is for as there could be other emergent situations occurring. In this type of situation written can be on the RN's hand, glove, post-it note etc. If patients name and MR# not brought with them in a written form they call for the info, write it down and present to tech.

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I agree with the above post. Case in point: We had someone call for emergency release blood and then someone came to get emergency release for a different patient. Thinking it was the patient they had called about, the tech issued the blood. It gets worse (nobody died) but suffice it to say that this went to risk management and the results were not pretty for the employees! A few days later, the nurse got upset because a different tech would not give her any emergency release blood without a name and DOB. They want it both ways! This final case was dropped as the tech was correct.

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They need a minimum of two identifiers. There are cases when there is a newborn or unidentified person requiring blood. It is NOT the Blood Banks responsibility to identify the patient, but we are required to have two identifiers. Nursing should have a process to apply aliases to those patients that are not registered or have not had their identities verified.

Imagine a motor vehicle accident with 4 or more people needing blood at the same time. We need to have 100% traceability of those units. A lookback is an important reason as to why we need to have 100% traceability. 

We've had a similar problem and it is a difficult task to get nursing educated on their requirement to identify patients with an alias and another identifier or whatever system they deem appropriate. 

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This is why, after our shooting incident in Roseburg in 2015, we will be sending a tech down to the ED to hand out the blood to the nurses and make sure they grab a label to document who got which units.  The ED tech who took a box of 4 OP and 4 ON was just handing them out like Halloween candy!  We never did get verification on where all the units went.  We do send out emergency release occasionally before a patient arrives if it is a chainsaw accident.

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I've had up to 12 John/Jane Does in the ER at one time.  We require patient identifiers.  We updated our MTP protocol to release 2 group O's; while these are delivered we get our MTP package together and it allows the p/u person to return with the patient ids.

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Some places are willing to issue uncrossmatched type-specific blood (type done but screen not finished yet).  We frown on it greatly but if that has to be done, all patient ID steps must be followed. An example would be a bleeding OB patient who is A neg at one of our smaller hospitals.  I would rather they issued uncrossmatched A neg after they have used up all O negs than give her O pos, but they have to follow patient ID rules.

We now use pre-registered trauma names for all of our full traumas so there should always be ID available.  There are rare exceptions like a newborn.

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