Would any one be willing to share their policy for issuing uncrossmatched blood? I am interested in the processes other facilities have in place for handling requests for the blood, identifying the patient (if a John Doe), tie tags or transfusion forms used, the forms for the physician to sign and where those forms are kept (i.e. in the chart or in the blood bank) and the age that is specified for "women of childbearing age" when deciding to use Rh negative vs Rh positive.

Thanks.

We have a form that we require to be brought to the lab with a tube of blood when requesting emergency release blood. It must have the physician's signature or at least a nurse's signature with us obtaining the physician signature after the emergency. We use Cerner millenium which will allow us to issue uncrossmatched blood to either a known or unknown patient and will print out a form to sign to issue the blood. The physican receives O neg blood at least initially. If we are short of O neg, we will ask our pathologist for permission to change to O pos if necessary, but never for women of child bearing age (we do not specify but I would assume we would use the same cut off we do for pregnancy tests for women having surgery, age 50). A copy of the emergency release form is then attached to our patient card (we are not paperless) and a copy for the Technical Specialist's files. The original is put on the patient chart. Hope this helps. If I need to clarify, just ask.

We issue emergency release blood for traumas, and any other situation that warrants it. We just require a page or phone notification for the request. If the patient has no ID available, we will not release the blood until registration enters the patient as a "No ID" and we have 2 forms of identification and a patient armband.

We use a hand-written emergency release form. A copy is retained in the blood bank, and the original is put in the patient's medical record. We also label all units with an "Uncrossmatched Blood" sticker.

We have recently modified our "women of childbearing age" limit to <50 years. Surely we're getting them all now!

Karen,

Not necesarily, there are now women in their 60's serving as surrogates.

Shelley

I had no idea! I thought I was old when I did it at 32!

Thanks for the info!

My question now is: How many women are doing this in their 60s? Is the risk high enough that I should consider revising the age limit? And if we do, will they just start doing it their 70s???

Play the odds and stick with >50 as your cut off. I think you'll be fine. We have no plans of changing here.

I have no plans on changing from <50 yrs. It's a rare occurrence and we can't over task our O neg supply any more than it already is just because someone in their 60's decides to do something that 99.999% of the female population would never even consider. Let mother nature do her job and 50 is a reasonable age.

We have the Meditech BB module, but keep a STAT box ready all the time. It contains two units of O neg RBCs, an emergency release form, paper ("downtime") unit tags, and a Typenex band. We complete the unit tags with all the unit info ahead of time, leaving the patient ID/date/time/location blank If we get a call in a true emergency we can grab the box and run to the location. At some point during this process the BB specimen is drawn, the patient is banded, and routine testing is then done. We are very rigid with our patient identification policies for crossmatched blood that we deem compatible, but in an emergency we will provide O neg as fast as we can, including to a John Doe. Additionally, those two O neg units are not considered "stock", so if that is all we have, then we consider ourselves out of O neg. Meditech has an "emergency release" protocol, but that info is typically documented after the fact. Our TAT is so fast that the only time we get requests for uncrossmatched blood is from the E.D. for some type of trauma. Once our other docs realized that they had to sign a form indicating that they took responsibility for transfusion of potentially incompatible blood, they decided they could wait.