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TRM.41350 Compatibilty Label/Tag

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Help!! 

We are revising our emergency blood release process (including MTP)..  For those of you who are CAP - how do you comply with this in emergency situations?  I've gotten some feedback in a few posts, but nothing that we can use to work for us as of yet. 

It seems trauma specimens only require one identifier, but products need 2.   I've also included a response from CAP regarding my inquiry.  Thank you for any feedback :) 

"For blood products, even for trauma patients, there must be two identifiers as stated in TRM.41350. Typically emergency rooms use pre-defined "temporary" patient identification numbers that are later merged with the real patient medical record number once established. The CAP does not dictate the process for the temporary identifiers as long as the facility keeps them unique for the patients in question."

Thank you for your inquiry,
Lilly Petkovic, MT(ASCP)SBB
Laboratory Accreditation Program

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I think you need to follow the advice in the CAP response.  How does your ER ID patients when they come through the door?  They should already have downtime procedures for patient ID (as well as a John Doe ID procedure).  I believe our registration system assigns a new MR (Medical Record) number if there is no other admission on the system.  For John (or Jane) Doe names, we simply use a system that reflects the year and "Doe" number (Doe2018-14, John).  So our two identifiers are at the minimum the name and MR number.  Practically, we require a birth date for history purposes as well as date/time, etc.

I would think that you may want to start with ER and find out what they are doing down there for ID on these types of patients.  In the US, you MUST h ave two Identifiers for everything. 

Scott

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26 minutes ago, SMILLER said:

I think you need to follow the advice in the CAP response.  How does your ER ID patients when they come through the door?  They should already have downtime procedures for patient ID (as well as a John Doe ID procedure).  I believe our registration system assigns a new MR (Medical Record) number if there is no other admission on the system.  For John (or Jane) Doe names, we simply use a system that reflects the year and "Doe" number (Doe2018-14, John).  So our two identifiers are at the minimum the name and MR number.  Practically, we require a birth date for history purposes as well as date/time, etc.

I would think that you may want to start with ER and find out what they are doing down there for ID on these types of patients.  In the US, you MUST h ave two Identifiers for everything. 

Scott

Thanks Scott!  Currently, ED shows up with a 'Tag number' that is then used as the patient's Financial Number (or visit number).  I'm not sure at what point they are given an actual medical record number/name.  We do not have a refrigerator in ED - so we release a lot of coolers before the patient arrives.  The Tag Number is currently being used as an identifier on the specimen tube (which is OK per CAP in trauma situations, strangely.....) 

Which LIS do you use?  Do you wait and print unit tags once product is requested or are they pre-labeled with all info except patient?

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We are using Mediware's HCLL in the BB.  In general, ER will know through field triage what is coming so that they can use the registration system and give us a name/MR before the patient arrives.  It takes about 10  minutes to  order and print tags for a "initial resuscitation" cooler of 2 O neg RBCs and 2 AB FFPs. 

We are a level 2 trauma center so it is important that a patient can be registered before they arrive.  Like many facilities, we always have at least two AB thawed units of AB plasma on hand along with a 5-pack of plts, in addition to the O neg RBCs.

Scott

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