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Blood products for OR


pbaker

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What is your process for issuing blood to patients in OR?  Are there any special "exemptions" when the surgeon feels this is an emergent need?  Do you require patient ID when issuing products?  What patient information is required?

We are being told that we are "killing the patient" because we have so many rules.  Just gathering information from other institutions.

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  We treat the OR patient like any other patient that gets blood. They can ask for an emergency release but we still require them to bring a piece of paper with patient's name, medical record number, date of birth, and Blood Bank ID if the patient has a BBID wrist band. They may bring a chart sticker down to get blood since it has all but the BBID number on it. The BBID number must be written on the piece of paper. They don't always like this process but we need to know which patient since they will probably have more than one patient. It is our way to cover for legality purposes.

  

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We have a "pick-up" slip for any time the anesthesiologist is monitoring the blood. This slip must have a chart label attached (name, dob, mr#), the BBID wrist band number, and how many units are requested. We NEVER, EVER give out blood, even emergency release, without them bringing some type of patient identification with them. What if there were 2 patients needing blood? We use SoftBank and we print out a transfusion slip for the anesthesiologist who scribbles "see anesth. report on it rather than filling it in and we issue it from our side into SoftBank as issued. My feeling is that the fewer "exemptions" the safer the process is. I also suspect that some physicians would capitalize on the "exemption" and push it past the limit.

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On 1/31/2019 at 8:32 AM, Kathyang said:

  We treat the OR patient like any other patient that gets blood. They can ask for an emergency release but we still require them to bring a piece of paper with patient's name, medical record number, date of birth, and Blood Bank ID if the patient has a BBID wrist band. They may bring a chart sticker down to get blood since it has all but the BBID number on it. The BBID number must be written on the piece of paper. They don't always like this process but we need to know which patient since they will probably have more than one patient. It is our way to cover for legality purposes.

  

We do much the same, except we don't use the BBID numbers.

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The OR runner or nurse brings a "patient label" which has the  full name, MR #, Acct# and DOB.

If blood is needed emergently and there is no Type an Screen the doctor places the order "prepare  emergent blood" for how many units they want. The way the order was built includes a electronic signature so no high risk form needs to be sent

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We use a blood cooler for PCs and FFP taken to the OR.  The units are logged onto a log sheet that accompanies the cooler.  The log sheet has a sticker with patient ID.  When we deliver the cooler, the person we hand off to has to have something with the patient ID and we check two identifiers before giving them the cooler.  We also issue the units to the patient so the OR folks can use BCTA (barcode-enabled transfusion administration) to transfuse the products -- only one nurse and the computer verify the units.

Like the others, if emergency blood is needed, we prepare the uncrossmatched units - writing the information on the cooler log sheets -- and deliver those units to the OR along with the paper for the physician to sign taking responsibility if anything happens.

 

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