I need to know how other Trauma facilities deal with changing the patient's name. We use the Secureline band system The band says "Trauma, Joe". At some point when the patient hits ICU, the patient's name is changed. Our computer system (Soft) alerts us to the name change, and we accept it in the computer. At that time, we expect another specimen to be drawn to have the band reflect the current name. Trauma wants us to change this practice. Ideas???

Also, when you receive a trauma with a mixed field typing, and you can verify with another hospital that they did transfuse O cells, would you go ahead and call the patient the presumed blood type?

We maintain a lifetime medical record number for our patients in a 3 hospital system, but Traumas get a new MR at admit and it can't be merged with their original # until discharge. We don't use any blood bank wristband system.

We don't put any names on the BB wristband. Our thinking was, whoever is wearing the band is compatible with the unit, as long as the numbers match. The patient identifiers goes with the hospital ID band, which must be present on all draws, including trauma's.

Dingalls2,

So you have a unique trauma number that stays with the patient throughout the stay. What is your other identifier? Do they get a trauma name too? Does the name change? Thanks! Dar

Lcsmrz,

What other identifier stays the same on your specimen? You have your BB bracelet & what else? Is your specimen itself labeled with a pre-printed label? Thanks! Dar

Our BB band is a specimen identifier, while the hospital band is the patient identifier. We reband the patient with each draw and cut off the old band.

BB patients have three identifiers: Name, MRN, BBID. If a sample has these three plus date/time/initials, we accept the sample for BB work, even if the Meditech label says CBC.

We use the Typenex bands at our hospital; we are a busy level II trauma center. All trauma patients get a band, whether or not they are conscious or have ID on them (we've had kids with fake IDs...what a nightmare when you call the wrong parents!). If the band is "ABC1234", patient registration registers the patient with a new MR#, puts their name in as ABC1234,Trauma. This way we are complying with the two identifier reg. As soon as their real name is verified (we wait until they are out of OR, and there is family here to confirm the identity), the name is changed to their real name. If they have been to our hospital previously and have an old medical record number, it is merged after discharged.

In the case of a crime victim, where we want to keep their identity private, we leave their name as ABC1234,Trauma until they are discharged.

Terri,

Do you require a new specimen when the name changes, or do you just use the typenex number & your Med Rec# as your identifiers??

Oh, sorry...I forgot to add that part...

When we see their name updated in the computer, we send someone up to ID them. Preferably, we try to get the same phlebotomist who collected the original specimen. They go to the patient's bedside and check that their ABC1234 Typenex band is still on, and then we look at their "new" band with their real name. If they are alert, we ask them to verify their name and DOB to make sure the right band was placed on them. We have a logbook in the Lab where the phleb then initials that she performed the ID. So in that case, we can still use the original specimen because we have a cross-reference.

If the phleb goes up and someone has removed the Typenex band, we start from scratch and recollect the specimen.

We deliver blood to the ED in a trauma situation, they ring, we bring!! Just like the pizza guy!

To issue uncrossmatched O= or O+ cells we use the emergency release in HCLL, 2.9.3. In the BB we give the patient the name of Trauma,000123 (the 000123 is the HCLL system assigned number).

When a sample is received it comes with a Hollister label on the tube. We do testing on the sample with the real pt name. When everything is completed and the "trauma" is over we merge the Trauma,000123 pt with the real pt in HCLL.

If the pt is a victim of violence admitting assigns a predetermined alias name. When the victim of violence is d/c from the hospital we receive an ADT name change message across the HCLL interface.

We then change the admission on the HCLL side to reflect the pt real name. We use name, MR# and DOB when doing the registration modification in HCLL. HCLL tracks each step of the process by throwing exceptions when critical fields are modified.

It sounds complicated but based on how our Registration and ED trauma process flows it works for us.