Consent/Ordering
Can telephone consent from an authorized representative be used?
Yes--it must be verified by a witness.
What is checked before obtaining blood product from blood bank?
Requisition and consent completion, IV access in place, VS within about 20 minutes of start time, any pre-medications.
Only 0.9% normal saline
What symptoms should a patient report during blood transfusion?
Rash/hives, itching, flushed feeling, chills, shortness of breath, chest/back pain.
Nursing should also observe for those and n/v, dyspnea/bronchospasm, tachycardia, leg/abdominal pain, sudden increase of temper 2 degrees Fahrenheit or more, significant increase/decrease >= 30mmHG in BP, hypoxemia with bilateral pulmonary infiltrates.
Where can I find the Emergency Blood Pathway that will help me to differentiate what I may need?
Laminated sheet on the nursing ring in each procedure room and in the Blood Admin notebook.
Who obtains blood consent from the patient or authorized representative?
MD or APP must document consent or refusal of blood or products on the consent form. A hospital employee or patient's authorized rep must withness the patient signature.
Maximum time from Blood bank cold storage completion should be how long?
No more than 4 hours and it should be hung and started within 30 minutes of leaving blood bank.
What must be documented when the blood reaches the patient?
"Start"
If a suspected reaction is happening, who gets informed?
Charge, blood bank, and MD/APP
True or False:
Fast Blood cannot be upgraded to MTP.
False, it can be upgrades anytime to an MTP.
True or False:
I must have an MD or APP order for blood and transfuse the blood per their order.
True
How do I obtain the blood requisition for blood bank?
By releasing the unit at a printer-connected computer. When you release the unit, it will automatically print the requisition. Remember, only release 1 unit at a time!
VS are obtained at what increments of the infusion?
Baseline prior to starting, 15 minutes from "Start", 60 minutes from "Start", completion of unit, or if there are changes in patient status.
What steps are there to a transfusion reaction?
1. Stop the transfusion
2. Re-verify unit
3. Report to blood bank, MD/APP
4. Document!!!
5. Follow MD/APP/Blood bank's orders.
Emergency Blood will get you __________.
1 unit of uncross-matched blood, an emergency release form, and a transfusion record to document on.
True or False:
I must order, sign, and acknowledge the blood order set.
True.
What is verified before blood is hung?
Full name, MRN, blood bank armband number, patient's blood type/Rh type, compatibility of blood, special requirements, Donor unit ID#, Donor type/Rh, unit expiration date.
The first 15 minutes of a whole blood or PRBC's transfusion should be ____--___ ml/hr.
60-120ml/hr.
Where and how do you stop and complete a unit of blood?
Under Blood Admin Flowsheet, place "0" in the rate box. Check your volume infusion, click "accept and complete." This Completes and removes the unit from view!
Fast Blood Blood will get you _________.
4 units of O Pos or O Neg RBC and 2 Thawed Plasma in a one-time cooler set, Emergency release form, MTP record sheet to document.
Lab should be ordered/collected ASAP.
What happens if your informed consent is incomplete?
Blood bank will consider this an Emergency Release.
Make sure your consent if filled out completely before retrieving your product. If it is incomplete, contact provider.
How many verifying signatures are required for blood transfusion?
2
For what reasons would a blood transfusion be stopped?
Emergency, suspected transfusion reaction, IV site failure
When the blood bag is empty, what do we do next?
Open Saline for at least 30ml more of saline. The transfusion is complete when the tubing is clear!
Obtain VS.
Mass Transfusion Protocol will get you ________.
4 units of RBC's and 2 Thawed Plasma set in a cooler--ON REPEAT UNTIL CANCELLED, emergency release form, MTP record sheet, LOTS OF FRIENDS!