Ordering
Blood Components
General Information
A MIS generated order is necessary for blood components unless a
medical emergency makes it impossible. In this case telephone requests
are honored but must be followed by a MIS order as soon as feasible.
Please note: Routine surgical blood orders should be placed
a minimum of 24 hours in advance of the scheduled procedure.
A complete crossmatch takes at least one hour from the time the
patient's blood sample is received in the laboratory. In urgent
situations a ten minute abbreviated (immediate spin) crossmatch
can be performed or uncrossmatched blood released. Please relay
this request by phone at 6-8335. Be prepared to state the patient's
full name, medical record #, number of units of RBC requested, your
name and the name of the requesting physician. A subsequent follow
up report will be required.
Blood specimens may be used for crossmatching until midnight of
the third day following collection. Before ordering red blood cells
it is important to know if a current acceptable specimen is already
available in DTM. This is determined by viewing current blood bank
orders for type and screen that display the specimen outdate or
by checking the patient's arm for a Typenex bracelet dated within
three days of the desired transfusion. Requesting a new specimen
be drawn when a sample is already available significantly delays
the availability of blood for the patient. Standing orders for type
and screen should be placed for Q4 day collection frequency to take
advantage of the maximum life of the specimen.
If excessive intraoperative blood loss is anticipated please contact
the DTM physician on call for a consultation prior to surgery so
that we can assure adequate inventory is available.
MIS Orders for Blood Components
From the Physician's Master Menu Choose:
Transfusion Medicine (Apheresis, BL BK, Hep, HLA)
Verify date that Consent for Blood Components was signed and obtain
a new consent if over 12 months ago.
Blood Components
Next screen gives the option of viewing current DTM orders, last
CBC results, or DTM Special Messages. Special messages display a
history of transfusion reactions and transfusion restrictions such
as irradiation.
Pre-Op Blood Orders (MSBOS)
This option allows one to access the maximum surgical blood order
system whereby an order for a type and screen or a predetermined
number of RBC is generated depending on the surgical procedure selected.
1. Irradiated Blood Products by Diagnosis (If the patient has one
of the diagnoses displayed select the diagnosis to order irradiated
blood components).
2. No Irradiated Blood Products Needed (If the patient's diagnosis
is not listed choose this option)
For non-surgical blood orders choose:
1. RBC (Also allows selection of irradiated blood by diagnosis)
2. Autologous RBC (if applicable)
3. Directed Donor RBC (if applicable)
FFP, cryoprecipitated AHF, and platelets are ordered through a
similar pathway.
Note: All components must also have infusion orders entered
prior to transfusion.
Ordering Virology, HLA, or RBC Serology Tests in MIS
1. Transfusion Medicine
2. Tests -Blood Bank (Hepatitis/HIV, HLA, Needle-sticks)
3. Transfusion Medicine Tests
a. Blood Bank Tests (Includes Type and Screen, Direct Coombs,
etc.)
b. Hepatitis/HIV Testing
c. Needle-stick/Blood Exposure
d. HLA testing
Computer Downtime Orders
Orders for routine blood bank and viral testing may be placed
using the form NIH
2353-1, Clinical Laboratory Ordering Record (Requires Adobe
Acrobat Reader®). Urgent requests for blood components during
MIS downtimes should be relayed by phone to 301-496-8334. Please
be prepared to state patient's full name, ID #, and the number and
type of components needed.
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