Happy 2024! In our large tertiary care hospital, we require all requests for blood components/products to be faxed to the blood bank to ensure accuracy of information. However, we recently had an incident where the fax was not being received which delayed the issuing of the blood in an emergent situation. How many of you accept verbal orders for blood components/products? Would you accept verbal orders for emergency blood only? If so, do you have a specific form that is filled out at the time of the request? 

We have a form the Dr. must sign.  It includes the unit number/numbers, the Dr.s signature time and date, the tech involved signature time and date.  if the unit is O negative or type specific.  (We try to give type specific if possible and limit uncrossmatched blood to 2 units.. try)  We are a small rural hospital.  The ER calls the request to us.  on a rare occasion surgery will request emergency release blood.  same thing they call us.

Edited January 4, 20241 yr by milesd3

MTP and Emergency release is a verbal phone call to the blood bank with a signed form during the event.  Routines need an order faxed from the provider or orders placed into Epic.  Happy New Year! 

We accept verbal requests but should be followed by an order for emergency released (RBC, WB or plasma) placed in Epic. We issue blood with a triplicate form and require a physician's signature and a copy returned to the Blood Bank.  The form documents the units that were issued, product type, attestation statement, diagnosis, and issue information including a visual inspection of the product, person picking up the product, date/time for issue and the employee ID of the person issuing the product(s)

In our 25 bed critical access hospital, uncrossmatched blood orders are always verbal to the Blood Bank and all LIS entries are made by the Blood Bank Tech thereafter.  If the patient is registered (true name or John Doe), we perform the Emergency Release Routine in Meditech (otherwise we resort to paper back up procedures).  This routine assigns the unit to the patient, and allows us to choose whether or not to add to a specimen in use or create a new specimen order.  This same screen documents the issue of the unit to the patient.  An Issue/Transfusion card prints and is attached to the unit. A Practitioner's request for uncrossmatched blood form is filled out.  The unit is delivered to the care area by the Tech but not handed to the nurse until a provider signs the request form.  A nurse can sign but the provider must countersign when time permits. This form is immediately brought back to the Lab and additional units can be added to it need be.  The completed form, after review, is scanned into the EMR. The form has space for communicating any antibody history or other special transfusion requirements.

In emergencies, we always accept verbal orders for transfusion.  These should be followed up by a request documented in our electronic medical record, but that's after the fact.  If you have a paper system, then the followup order is documented that way.  There is a regulatory/accreditation requirement, which I consider bureaucratic, obstructive and useless,  that these emergency requests require a signed release from the ordering practitioner, if the transfusion is not fully tested for the recipient.