If blood is emergency released but all of it comes back and none is infused, is it necessary to keep the emergency release form signed by the ordering physician?

Thanks!

YES - but only my opinion.  I don't know that there is a standard but you have released the blood and that would be the documentation of why (even though you did get it back).

I was going to say I don't think you would have to keep it, if you dispensed it as Emergency Release and then returned it in your LIS (tracking). As David stated, it might be best to save it.

I think that you would need to keep it so that you have a full audit trail, if for no other reason.  The blood has, after all, left your possession, even though this may only be for a short time.

 

If non-emergency blood leaves the issues fridge and then comes back unused, this is recorded, for exactly the same reason - to show there has been no temperature excursion.

You all may be interested to know that our medical director decided to document this in our deviation from standard practice book and not to chase down a signature on the emergency release form.

Yes. For traceability of blood products. You never know what will come up in future. What if that patient did not make it and your risk & claim is investigating whole case!!!

Yes. For traceability of blood products. You never know what will come up in future. What if that patient did not make it and your risk & claim is investigating whole case!!!

Yes, save it, but I would not chase down a signature after the fact if the unit was not given.

IMO, I would keep it.  You issued blood without completion of pretransfusion testing.  If you didn't have the form, how would you show an inspector that is was an approved deviation?  Also we allocate the unit(s), issue and return them in the LIS with appropriate comments that this was an emergency release.   

AABB Std 5.25.5 requires "The records shall contain a signed statement from the requesting physician indicating that the clinical situation was sufficiently urgent to require release of blood before completion of compatibility testing or infectious disease testing".  

 

Notice that this requirement is not hinged on whether the patient actually gets transfused with the emergency released blood.  The fact that blood was requested prior to completion of testing requires the physician's signed statement, regardless of whether they end up transfusing it or not.   So yes, you need to keep the emergency release form with the physician signature.  If the form is returned with no signature, you should also chase the doctor down and get that signature, even if the blood was not given.   It can be a hassle, but those are the standards.

Thanks sgoertzen for the Standards Quote. Lesson learned, always check the standards.

This is also required by the CFR.

Would anyone be willing to share their emergency release form.  I tried seaching for the forms and found threads discussing them but not the forms themselves.

 

Kim