BBKT

This may seem like a silly question but we are having a major disagreement with a trauma doc. Does anyone issue emergency release blood without having a patient name and MRN? If so, how do you track which blood goes where? We are a Class I trauma center where multiple traumas at one time is common. We have a system that works well with single traumas. Blood bank is included in the trauma page, we call ER get patient info and we deliver emergency release blood before the patient has even arrived. However, when there are multiple traumas at one time, the ER communication seems to break down - Pages aren't sent, phone calls aren't made etc etc. We tried an ER refrigerator but that was a nightmare. They could not comply with all of the regulations and it was removed after about 2 months and several attempts at retraining.

You will all find this interesting. We were sited on this issue just last month in my AABB inspection. The inspector stated - blood that is delivered to the floor (not in a cooler) is considered to be in a "ready for transfusion state" and therefore if it is returned to the blood bank the he blood needs to be verified upon return to be in the 1-6 degree C temperature range. (1-10 degree C range is for blood in transport state not "ready for transfusion state".) We kept the 30 minute guideline for nursing because we do not want them to rush through the proper patient identification steps. We have found that units out of the blood bank for more than 5-10 minutes exceed the allowable 6 degree C temp.

Word of warning. A few years back we tried to validate an infrared thermometer. (I don't remember what brand it was.) We found a big variance in temp readings depending on how far you held the unit away from the bag, what kind of angle you held it at, and which part of the bag you aimed the beam at.

In our computer system when the name is truncated on the label, the name is also truncated in the computer. Therefore the name on the tube matches the name in the computer and the name that prints on the crossmatch tags. I admit, not a good sytem, but at least the names match everywhere. We also use a tyenex armband so we have a third identifier to utilize.

"One of the benefits of getting into hot water is it keeps you clean."

We will be one interfaced system. (Cerner) It will be able to check for duplicate orders. We are moving from a "paper" system where requests come to the blood bank and we order everything in the computer ourselves to physician order entry. We are trying to figure out how to alert the blood bank when orders have been entered. (Always looking on a pending list is impractical.) We are also trying to figure out how nursing knows when a physician has written transfusion orders. Of course, we would love to reduce the amount of phone calls that come into the blood bank as well.

I'm looking for input from people who use Physician Order Entry for Blood Bank orders as well as transfusion orders. Can you give me a quick summary of the process beginning with the placement of the order by the physician to how transfusion orders arrive in the blood bank. Do most facilities have some kind of computer generated orders (for testing as well as transfusion orders) that prints in the blood bank? Thanks everyone.

Is anyone using this system to control access to obtaining blood from an ER refrigerator? I would appreciate any input, good or bad. We have attempted to store O neg units in an ER refrigerator in the past. We ended up removing the refrigerator after 3 short months because the ER just couldn't figure out how to get us accurate patient information in a timely manner when units were transfused. It really was a nightmare from a bood bankers perspective. :cries:Our ER is requesting a refrigerator again and I am reluctant to try without some kind of sytem that can control access into the refrigerator, record when units are removed, who the units are intended to be transfused to, as well as alert the BB when units are removed so we know to restock. Yes I want it all. This system seems to be the answer but it is relatively new.

We have recently moved from a stand alone blood bank computer system where we had complete control over patient information to a hospital wide system where Medical Records is now in charge of updating patient names and MRNs. I need input on how other institutions deal with issuing blood to a patient that has had patient information in the computer (for example when an assigned trauma name and MRN gets updated to the real patient name and different MRN) changed and your blood bank tube label no longer matches the patient information in the computer. I am "old school' and feel we need a new sample submitted on the patient labeled with the updated MRN/name. However, this poses typing problems if the patient has received uncrossmatched O negs, not to mention the fact that docs do not want to wait the additional hour for the new sample testing to be completed before they can have more blood. Plus, finance says we can't bill for the second Type and Cross. I am VERY uncomfortable with the idea of just accepting that Medical Records combined or updated the patient information correctly. Help!!!!

Can anyone recommend a high impact printer that is compatible with Cerner Millennium that will print a 3-part crossmatch tag relatively quickly?

Several years ago, we had a remote refrigerator at an outpatient cancer center. Our computer system allowed us to transfer blood to the remote location. We required an RN to call the blood bank to check out a unit of blood over the phone. We would dispense the unit to the RN during the phone conversation. This allowed us to track when blood was removed from the refrigerator and who the blood was issued to without having a paper log. We no longer have this remote location refrigerator but this process worked very well for many years.

Add me to the list of people who would like to see your checklist. We just completed our CAP inspecton with no deficencies. However, I know my AABB inspecors will be asking about this. Thanks for sharing. Trayk@usa.redcross.org

Anyone heard about this one? 21 CFR 606.121(e)(1)(ii) states that the anticoagulant must appear before the proper name of the product. With ISBT 128 standards, the anticoagulant appears below the proper name. Does this mean I will need to request a variance when we start using ISBT products and we relabel when dividing?