What does your policy say if consent for blood/blood products cannot be obtained in an emergency.

The attending MD makes the call if consent cannot be obtained due to patient condition/consciousness/etc.

The physician has to be at the bedside to evaluate the emergency, has to state in the medical record:

The nature of the emergency

That the patient cannot consent

That the health care proxy is not able to consent

Also, they have to check the chart for any advance directive that may have been signed by the patient that refuses blood products.

We have to see proof of this documentation in the Blood Bank before we can release the blood.

Our institution uses the "implied" consent for emergencies.

In our transfusion service, we don't see any of this (implied or signed for) for any transfusions. We leave that up to the Quality Care Managment department to audit.

Linda Frederick

This is all handled outside of the blood bank. The emergency physician must make the call and check for any directives either on the chart or from the patient's family. We get the physician's signature before any blood is released on the blood bank's emergency release form or we'll get the signature from the physician after the emergency is over. Any other consent for transfusion is obtained by nursing.

Us too. We are only concerned with physician signature on emergency release paperwork.

Our policy allows for the physician to sign after the crisis has passed.

If I was laying in the trauma room coding, I think (assuming I could think at the time) that I would appreciate that the physician was focused on me, rather than on an emergency release form.

There's always time to sign afterwards, and there's always ample documentation in the chart about how critical the patient's condition was.

Just to clarify my response above, we also wait until after the crisis to obtain the necessary paperwork.