University of Colorado Hospital

Fundamentals of Blood Administration

The content that will be covered in this module includes:

Blood Component Therapy Ordering Tests Ordering Blood Components Releasing Blood Components Transfusions

Blood Component Therapy

Blood/Blood Component Definitions

Blood is defined by its source: Blood/blood components are fractions of separated whole blood. Blood derivatives are pooled blood products which usually are obtained from pharmacy. For example, albumin, gamma globulin, factors, some vaccinations, etc.

Blood/Blood Component Definitions

Allogeneic blood is blood collected from a volunteer human donor. Compatibility testing is done. Designated or directed blood is collected from a donor designated by the intended recipient. Compatibility testing is required. Autologous blood is blood collected from the intended recipient in advance of the need for blood.

Does a patient need to consent to blood component therapy?

YES! Consent must be performed by a physician. Although
nurses and other health care professionals may assist, it is the physician who must perform the consent. A signed blood consent form must be on file prior to a transfusion, except in the case of an emergency. The form to be used is Consent to Medical Procedure (Surgery, Diagnostic, Therapeutic, Blood, Sedation, Anesthesia). https://pnp.uch.edu/file.aspx?pvdID=1791 Consents are needed for blood/blood components. Consents are not needed for blood derivatives unless the patient refuses blood/blood components and agrees to derivatives only.
https://pnp.uch.edu/file.aspx?pvdID=2215

How long is a blood component consent good?

The first consent for blood/blood component administration is valid the entire inpatient hospitalization. Consent must be obtained for each inpatient admission. For example, if an outpatient becomes an inpatient, a new consent must be obtained to cover the inpatient stay. An outpatient consent is good for 1 year.

What if the patent refuses blood component therapy?

The nurse admission screening in the EHR includes the question Does Pt Refuse Blood?. Documenting Yes applies a Blood Refusal FYI on the patients EHR banner. Attempting to order blood products on a patient with an active Blood Refusal FYI generates a BPA alert saying Please review this decision with the patient or family before proceeding with this order.. Nurses must notify the attending physician or requesting physician when a patient refuses blood products. The requesting physician discusses the refusal with the patient, providing information within the context of Informed Consent. If the patient refuses blood/blood components, the physician must also ask if the patient will agree to receive blood derivative products.

If the patient continues to refuse blood and/or blood derivative products, physicians must complete the Refusal to Permit Administration of Blood/Blood Components form and the BLUE No Blood band must be applied to the patient.

Blood Bank Tests Explained

Type and Screen: Determines the patients blood type (e.g., A positive) and screens for any antibodies pertinent to transfusion (this is an indirect anti-globulin test). EVERY patient receiving RBCs must be typed and screened. Prints on Zebra label as: ABORH & 3_CELL NOTE: This test does NOT order blood products. Type and Crossmatch: Type and screen testing that includes an order for units of RBCs to be crossmatched to the patient. Prints on Zebra label as ABORH, 3_CELL, XM IS Crossmatch: Used to order RBCs to be crossmatched to a patient using the patients current sample in the Blood Bank. This CANNOT be ordered if the patient does not have a current 3-day Type and Screen!
Only ordered as an add-on order. Should NOT print a Zebra label! A printout will go directly to the Blood Bank.

Blood Bank Tests Explained

ABORh Type: Determines the patients blood type (e.g., A positive). Prints on Zebra label as: ABORH. A patient with ONLY an ABORh result is not eligible to receive RBCs. Antibody Screen (indirect antiglobulin test, indirect Coombs test): Screens for antibodies relevant to transfusion in the patients blood Prints on Zebra label as: 3_CELL. A patient with ONLY an ABSC done is not eligible to receive RBCs.

NOTE: TS AUTO = ABORH + 3_CELL

Both of these tests must be done in order for a patient to receive RBCs.

Blood Bank Tests Explained

Blood Bank Hold (BBHOLD): A way to keep a specimen tube in the blood bank in the event that testing on the sample becomes necessary. NO testing is done on a Blood Bank Hold! Prints on Zebra label as: BBHOLD. DAT (direct antiglobulin test, direct Coombs test): Detects antibodies already bound to the surface of the patients RBCs that cause red cell destruction and anemia. This test is not part of standard pre-transfusion testing. Prints on Zebra label as: I DAT, AB DAT PHS. NOTE: Two zebra labels will print for this test, but only 1 pink tube is necessary!

Blood Bank Tests Explained

RhIG EVAL (RhoGAM evaluation): Determines if a mother needs a vial of RhoGAM due to potential Rh-incompatibility between the mother and baby. Testing includes a type and screen and a fetal screen (fetal screen is only done when the mother is 28 weeks pregnant and there is indication of a bleed). Prints on Zebra label as: ABORH, ABSC PHS, FETAL SC. RhoGAM can NOT be ordered on a patient unless the entire RhIG eval is done (just an ABORH will not suffice). There are exceptions to this rule for the ED: contact Blood Bank for more information.
NOTE: Be sure to include gestational age where indicated for this test.

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Blood Bank Tests Explained

NNP EVAL: Testing on a fetal sample, either from cord blood or another source to determine eligibility for blood products. Prints on Zebra label as: NNP EVAL. CORD: Testing on a newborn sample, either from cord blood or another source.
Prints on Zebra label as: ABORH NB, AB DAT PHS, I DAT CORD. NOTE: There are special, more stringent, requirements for labeling CORD blood samples. The babys specimen must be double-initialed and the bag must have an initialed maternal label on the outside. Reference http://hub.uch.edu/pdf/NICU_guideline_C3NN.pdf NOTE: Please include the mothers blood type on the external maternal label.

In this chapter you learned.

Meaning of definitions relating to blood components

Ins and outs of consents for blood component therapy

Steps to follow when a patient refuses blood component therapy

Definitions of all Blood Bank test options

Review Question #1 Which of the following is NOT considered to be a blood derivative? 1. Gamma globulin 2. Interferon 3. Fresh frozen plasma (Correct Answer) Rationale: Gamma globulin, interferon, and vaccines are blood derivatives. Fresh frozen plasma is a blood component.

Review Question #2 Which of the following will NOT print a Zebra label if ordered correctly in EPIC? 1. Type and Screen 2. Crossmatch (Correct Answer) 3. DAT Rationale: A crossmatch is an add-on order to crossmatch RBCs to a Type & Screen sample already in the Blood Bank. A Zebra label indicates that a new sample needs to be drawn. A Type & Crossmatch is what you would order if you had no current sample already in the Blood Bank.

How to Order RBC Blood Products and Testing

1. How to order testing 2. How to order RBCs

3. How to obtain a sample for the Blood Bank

4. How to order other blood components

How to Order Tests/ Components in EPIC

How to order all testing/blood components in EPIC:
FIRST: In Epic, under Order Entry, search for the order set Blood Administration: Inpatient and Emergency Department. Accept and open the order set.

Always start with the blood order set!

How to Order Testing (no blood product) in EPIC

In Epic, under Order Entry search for the Blood Administration: Inpatient and Emergency Department order set. Accept and open the order set. Click to expand open the Individual Blood Bank and Lab Orders section.

Check the box that indicates which lab youd like to order, indicate the priority and frequency, and click Accept.

How to Order Testing (no blood product) in EPIC

Testing can be added on to a current sample in the Blood Bank by choosing the Add-On Last Lab priority (this will print ONLY in the Blood Bank and will NOT generate a specimen label).
Make sure the patient has a sample in the Blood Bank. Example add-on tests: Convert Blood Bank Hold, Crossmatch (added to a type and screen), DAT, NNP eval.

Ordering RBCs
In order to obtain RBCs for a patient, the patient must have a current 3-day Type and Screen sample in the Blood Bank. If you need uncrossmatched RBCs emergently, call the Blood Bank (84444) and verbally order trauma
units, being sure to indicate that it is an emergency.

How to Order RBCs in EPIC

In Epic, under Order Entry search for the Blood Administration: Inpatient and Emergency Department order set. Accept and open the order set. Check whether the patient has a current type and screen. Results Review is the best place in Epic to see if theres a current type and screen result. Another option is to click the Click HERE to see if there is an active type and screen box. Samples are valid for 3 days after draw until midnight of the third day. Check the appropriate Order Red Blood Cells box based on whether or not the patient has a current type and screen (clot). Choosing the wrong order box will cause a delay in patient care - call the Blood Bank (84444) if you cant find out if the patient has a current clot.

How to Order Tests/RBC Components in EPIC

When ordering blood 1 products, ALWAYS check BOTH the order for testing AND the transfuse product order. The first order goes to the Blood Bank and the second order goes to the nurse.
***Not checking one of these boxes makes the preparation and transfusion impossible to complete in Epic.

How to Order Tests/RBC Components in EPIC

Check the first box underneath the order This order goes to the blood bank. Be sure to indicate the number of RBCs you are ordering. Give as much information as possible about the patient and why they need ordered products to avoid unnecessary phone inquiries. Choose the applicable transfusion indications (i.e., active bleeding, perioperative). If other is chosen and there is no special comment made, the Blood Bank will likely call for more information. Also choose the applicable special requirements (i.e., irradiated, leukoreduced, etc.).
NOTE: If you need uncrossmatched RBCs emergently, call the Blood Bank and verbally order trauma units, being sure to indicate that it is an emergency.

Dont be afraid to add a comment!

How to Order Tests/RBC Components in EPIC

Check the 2nd box (Transfuse RBC) underneath the order. This order goes to the nurse. Without this, the nurse CANNOT release the unit from the Blood Bank. Any special notes for transfusion for the nurse can be added here. Be sure that the number of units to transfuse matches the number of units ordered. NOTE: If you need uncrossmatched RBCs emergently, call the Blood Bank and verbally order trauma units, being sure to indicate that it is an emergency.

With all blood component orders, there are TWO boxes to check one for the lab and one for the nurse!

Obtaining Blood Sample

Positively identifying your patient and properly labeling the Blood Bank sample at the bedside is the first and most important step to assure a safe transfusion.
continued

Obtaining Blood Sample

The Health Care Provider obtains a pink top tube, and a bar-coded Zebra label with patient identification. Verify the patients name at the bedside (hospital identification bracelet) by comparing information to the prepared specimen collection label. If possible, ask the patient to state his/her name. Use two patient identifiers.
continued

Obtaining Blood Sample

The person drawing the specimen should: Draw sample in a pink top tube. Invert 10 times to mix. While still in the presence of the patient, label the sample with the barcoded identification sticker.
IMMEDIATELY initial the specimen clearly with your initials and the initials of the second-check in the room drawing with you.

continued

Obtaining Blood Sample

Before leaving the bedside, be sure to complete the READ-BACK VERIFICATION.

A second person must verify with the phlebotomist that the patient identifiers on the hospital identification bracelet match those on the blood specimen and the pink requisition, if used. Both persons initial the specimen tube and, if used, the requisition form.
The specimen will be rejected if it is not double-initialed and legible!

(keep in mind that some pens tend to smear on the labels. If in doubt, put a piece of tape over the initials to preserve them) All information on the patients hospital identification bracelet, the sample, and Blood Bank requisition (downtime) must match.

Dont forget to double initial!

continued

Obtaining Blood Sample

Send the specimen to the Blood Bank via pneumatic tube station #531 or #631. Dont forget the requisition, if used.
(Please do not send to Tube #132, as it can be lost or delay testing)

A requisition is only necessary if: the specimen is a 7-day pre-op sample products are needed for a different day the testing was not ordered via Epic (downtime only) there is no Zebra label on the specimen (label printer broken, etc.)

When Downtime Occurs

If downtime occurs, and you are unable to use EPIC, please refer to Downtime Protocol and the RED Downtime Binder within your unit.

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 A blood bank sample is valid on a patient for 3 days from the date it was drawn. After that time, a new specimen must be drawn to receive Crossmatched blood/blood components. All red cell components must be crossmatched. In an emergency, RBCs may be transfused before the crossmatch is complete. This uncrossmatched blood is called trauma blood. Call the Blood Bank to verbally order these products and tell them you are ordering blood for an emergent situation (8-4444).

Additional Blood Components

Crossmatching is not required for some blood components (e.g. FFP, platelets, and cryoprecipitate). The blood bank must have typed the patients blood during the current admission or have a historical record of the patients blood type.

Ordering Blood Components from Blood Bank

In Epic, under Order Entry search for the Blood Administration: Inpatient and Emergency Department order set. Accept and open the order set.

Scroll down to the Plasma, Platelets, or Cryoprecipitate category and click the arrow to open the category.

Ordering Blood Components from Blood Bank

1. Click the order button for the component you would like to order. This order goes to the blood bank. 2. Indicate the number of products you are ordering.

3. Choose the applicable transfusion indications (i.e. active bleeding, preoperative). If other is chosen and there is no special comment made, the Blood Bank will likely call for more information.
4. Also choose the correct special requirements (i.e., irradiated, leukoreduced, etc.)
NOTE: Only O.R. may order 2 platelets for a patient at one time, and even then platelets will be given one at a time (as needed) and a post-count may be requested in between units.

Dont be afraid to add a comment in this box!

Dont forget to also place the transfuse order!

Ordering Blood Components from Blood Bank

1 2

Upon checking the Transfuse box, the order details screen opens.
This order goes to the nurse.

Be sure that the number of units to transfuse matches the number of units ordered.

See a pattern? With all blood component orders, there are TWO boxes to check one for the Blood Bank and one for the nurse!

Ordering Additional Products

If the Blood Bank has a current sample, additional products may be ordered.

If ordering electronically:
For RBCs: In Epic, under Order Entry search for the Blood Administration: Inpatient and Emergency Department order set. Accept and open the order set. Choose the Order Red Blood Cells (If active Type & Screen (clot) in system) option and order as outlined earlier.

For other blood components:

Order as you would normally order these components (outlined earlier); no special steps required.

In this chapter you learned.

The steps to take in obtaining a crossmatch blood sample How long crossmatched blood/blood components remain good Which blood products need a crossmatch blood sample What to do for those additional blood components not requiring a crossmatch How to obtain blood components from the Blood Bank

Review Question #2
True or False: A patient must have current (3-day) type and screen testing done to receive crossmatched RBCs. True Rationale: There must be a current sample for the blood bank to be able to crossmatch RBCs. This is not true of all blood components; just a historical type is needed for FFP, platelets and cryoprecipitate. Uncrossmatched blood may be requested in an emergent situation by calling the Blood Bank.

Requesting Blood Products via Pneumatic Tube System (PTS)

From the Blood Bank To the Patient

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Obtaining Blood Components from Blood Bank

Verify in Epic that blood product is ready by opening Results Review tab Under laboratory results, choose the Blood Bank section. There will be a row for the patients Type (ABORH) and Screen (ANTIBODY SCREEN), where you can see the specimens expiration date (specimens expire at 2359 of that day).

- In the further columns, blood product availability can be seen. *Each row represents a different product order.

Obtaining Blood Components from Blood Bank

When RBCs are ready, the Crossmatch row will display COMPAT and the number of units ready will be listed underneath.
NOTE: The red cells may be listed in multiple columns from one order If the item is eligible to be sent via the PTS, the pneumatic tube row will say YES.

If this row says NO, the unit must be physically picked up at the Blood Bank (AIP2, 2nd floor).

Obtaining Blood Components from Blood Bank

When other blood products are ready, the PREPARE PRODUCT row will say READY and the number of units ready will be listed below it.
NOTE: others may be listed in multiple columns from one order

When Blood Bank has Blood Products Ready to Transfuse

Once verified in Results Review in Epic that the blood is ready, the next step is: Release the blood product via Epic:
Under the Doc Flowsheets tab, search for the Blood Product Administration flowsheet. In the upper right corner, there will be a box with a Transfuse Orders (Remaining) hyperlink. Click on this hyperlink. Note: The infusionist must check the chart for a signed Blood Consent Form prior to release and transfusion of blood/blood components.

When Blood Bank has Blood Products Ready to Transfuse

The Transfuse Orders (Remaining) screen will open. Click ONCE on the Release #/# hyperlink to release one unit for transfusion. If this screen is not available, the Transfuse order was likely not ordered with the testing/prepare order (order set not used, both boxes not checked).

NOTE: Click each hyperlink ONLY ONCE or else multiple units will be released!

ATTENTION: NEVER release products until they and you are ready!

Blood Product Pneumatic Tube Transport Request

Pneumatic tube Carriers will hold:
1 unit RBC 1-2 units FFP 1 unit of Platelets 5 10 units Pooled Cryoprecipitate

DO NOT release in EPIC and/or request more than one product on one PTS Transport Request (except 2 FFP)

Receiving the Blood from PTS

Blood product will be sent via PTS, along with a verification form. 1. To accept the blood from the PTS, enter security code
4444.

2.

Verify that the blood product is intact by checking YES or NO to record the condition of the blood received.
Note: If product arrives damaged in any way, call the Blood Bank immediately. Do Not send damaged product back through the tube.

1 2

3. Sign the form and indicate time of receipt. 4. Return the form to the Blood Bank (tube station 531/631). 5. You are now ready to transfuse!

Dont forget to fill out all fields of the bottom half of the form and to send it back!

Other Options
You may also come personally to the Blood Bank on the 2nd Floor -AIP 2 to pick up Blood (Bring a patient sticker with the Patients Name, MRN, Type and Quantity of product you are picking up.) If multiple units are required in a very short time, units will be packed in a Blood Bank Cooler and will have to be picked up.
Note: Please return the cooler to Blood Bank after the last unit is transfused.

Coolers are good for 8 hours. If the blood is to be in the cooler for longer than this, the cooler must be returned and re-packed by the Blood Bank

In this chapter you learned.

The correct way to order blood products using EPIC. Where to find downtime protocols when EPIC is not working. How to properly fill out the Blood Product Pneumatic Tube Transport Request. Steps to follow once the Blood Bank sends the blood product through the PTS. Other options for picking up blood.

Review Question #3
Once the Blood Bank sends you the blood product through the pneumatic tube, as a nurse, what are your next steps? (Choose all that apply.) 1. 2. 3. 4. Verify that the blood product is intact. Sign the verification form. For Blood Transport Request form, complete the lower half of the form. Return the form back to the blood bank before you transfuse the patient.

All of the above are correct.

Transfusions

Transfusion Procedure
The infusionist must check the chart for a signed Blood Consent Form prior to release and transfusion of blood/blood components.

Blood not transfused must be returned to the Blood Bank or a monitored blood storage refrigerator (in OR only) within 20 minutes.

Transfusion Procedure
RN opens the patients chart, then Doc Flowsheets, then Blood Product Administration flowsheet, and clicks in the product Rate row field (the syringe icon displays).

Transfusion Procedure
Steps to initiating transfusion:
1. RN scans the patients armband. 2. RN scans blood product label barcode. 3. Screen opens showing the blood product and unit number that was scanned.
A variation: If a screen with two unit number options pops up: select the option with the unit number beginning with **, Click ACCEPT

Youll get a Select a Blood Unit screen: RN clicks on the product unit number that matches whats on the blood product label, then clicks the Accept button.

Transfusion Procedure
If LDAs have been documented, the Link Line screen opens. RN clicks on a listed LDA and clicks the Link button. Administration by Barcode screen opens, the blood product Unit Number displays. REQUIRED!: RN clicks in the Rate field, enters a rate.

Recommended: Chart vital signs.

- Alternatively, the RN or

CNA can chart VS in the Vitals flowsheet prior to or after these blood administration steps.

Click Accept button

Transfusion Procedure
Dual Sign Off Summary screen displays
Second RN Clicks the Verify button, and enters User ID and Password in User Authentication Screen.

Transfusion Procedure
RN is returned to Blood Administration flowsheet. Status indicates Transfusing next to the unit number and product code. LDA is listed along with rate.
IMPORTANT! When transfusion is completed, RN enters a 0 (zero) in the Rate field and a total quantity in the Volume field, then clicks File.

The status indicates Stopped next to the unit number and product code.

Transfusion Procedure
Once ALL the ordered units of a product have been documented as transfused in full, open the Blood Product Administration flowsheet, click on the Blood Product Administration hyperlink and click each of the Complete hyperlinks that correspond with of the units that were transfused. Clicking the Complete hyperlink completes the Transfuse orders. This cleans up the list of active orders in Order Review. DO NOT click before all units are transfused or else you will lose the necessary active transfuse orders.

Transfusion Procedure
If any administration warnings are received at any time saying that unit numbers do not match: Review all patient and product identifiers again. If no explanation can be found for the mismatch, do not transfuse the unit. Call the Blood Bank. Since all transfusion documentation is completed in Epic, blood transfusion tags may be discarded in the red biohazard bins along with the blood bags and tubing.
Note: An exclusion to this would be if a patient has transfusion reaction symptoms and the blood was not given in an emergency situation (trauma, massive protocol, or code white).

Patients who receive blood must be observed for an appropriate amount of time after transfusion is completed prior to discharge. Discharge teaching instructions should be given to the patient/family. https://pnp.uch.edu/file.aspx?pvdID=2711

Suspected Transfusion Reaction

Stop the transfusion and replace set with standard administration set and NS at a keep open rate. Notify physician. Follow transfusion reaction guidelines that are provided on the bottom of the transfusion record tag. RN must document the suspected transfusion reaction in the Blood Product Administration flowsheet under Suspected Transfusion Reaction.

Transfusion Reaction
-Call the Blood Bank (8-4444) to notify that there had been a transfusion reaction. -MD places a Transfusion Reaction Investigation order, draw a pink top tube of blood, label & double-initial. - Walk down to Transfusion Services with the original blood bag and tubing, transfusion pink record tag completed (transcribe from Epic), and the requisition form for transfusion reaction investigation. - A Safety Intelligence (SI) should be submitted regarding the transfusion reaction. ***DO NOT send via pneumatic tube system.

When do I change blood IV tubing?

Multiple blood components may be transfused with the same tubing. Tubing must be changed every 4 hours unless decreased patency is noted. All blood products should be transfused with NS.

Massive Transfusion & Code White Blood Administration situations defined

Massive transfusion protocol (MTP):
Red Blood Cell replacement approximating or exceeding the patients blood volume within a 24 hour interval.

Criteria for calling MTP:

Physicians may call for MTP for patients with active bleeding, hemodynamic instability, patients requiring greater than 4 units packed red blood cells in 4 hours, or patients likely to receive greater than 10 units of RBCs in 12 hours.

Blood Bank will set up blood products

Cooler #1 will contain 5 units of PRBCs. A unit of apheresis platelets will accompany the cooler but are not placed in the cooler at any time. (5 units of FFP will be thawing for the 2nd cooler.) Cooler #2 will contain 5 units of PRBCs and 5 units of FFP. Cooler #3 will contain 5 units PRBCs and 5 units FFP. A unit of apheresis platelets will accompany the cooler but are not placed in the cooler at anytime. Note: Blood Bank will continue alternating coolers #2 and #3 until the MTP is deactivated. https://pnp.uch.edu/file.aspx?pvdID=1952

Massive Transfusion & Code White Blood Administration situations defined

Code White: Code White is called when there is a severe, uncontrolled obstetrical hemorrhage not responding to initial measures and assistance from multiple departments is required. An RN, physician, CRNA or CNM may call a Code White for uncontrolled hemorrhage (greater than 1000 mL blood loss for a vaginal delivery and greater than 1500 mL blood loss for a cesarean delivery) that is not responding to medication. This call should be made from the site by personnel doing a direct assessment of the patient. Blood bank will set up blood products
Cooler #1 will contain 5 units of PRBCs. A unit of apheresis platelets will accompany the cooler but are not placed in the cooler at any time. (5 units of FFP will be thawing for the 2nd cooler.) Cooler #2 will contain 5 units of PRBCs and 5 units of FFP. Cooler #3 will contain 5 units PRBCs and 5 units FFP. A unit of apheresis platelets will accompany the cooler but are not placed in the cooler at anytime. NOTE: Blood bank will continue alternating coolers #2 and #3 until the Code White is deactivated or stopped per medical services.

https://pnp.uch.edu/file.aspx?pvdID=1934

 Call the Blood Bank ASAP to notify and order products

Do not place any blood product orders into the system since products are to be ordered emergently via phone call to the Blood Bank.

Massive Transfusion & Code White Blood Administration situations

After the patient has been fully stabilized and phone-ordered products have been transfused in full, the MD needs to place one of the following orders, as relevant:
Massive Transfusion Protocol Code White Emergent Blood Administration The transfusing RN documents on the paper transfusion tags and MUST return the pink copy of the tag to the Blood Bank ASAP. The transfusing RN must then document the total blood product intake in Epic.

In this chapter you learned.

Steps to requesting blood products Steps in giving a transfusion Important items needing to be documented relating to giving a transfusion What to do if there is a transfusion reaction How frequently to change blood IV tubing

Review Question #4
True or False

A transfusion must always be tested for compatibility before it can be given. False Rationale: Transfusions may be given in emergent situations that have not been tested for compatibility. However, the MD must authorize this in the designated area of the transfusion record tag.

Transporting Blood Components with the Patient

Transporting Blood Components with the Patient

The FDA requires that the location of blood components is accounted for and documented at all times. When a patient is transported to UCH with a blood component transfusing, notify Transfusion Services with the unit number on the product. When a patient arrives at UCH with blood components in a box, notify Transfusion Services and immediately transport the box of components to Transfusion Services. Do not open the box or transfuse. In an emergency, request trauma blood.

Transporting Blood Components with the Patient Transportation of coolers from the OR to the ICUs can only happen in EMERGENT situations
In this situation, call the blood bank to let them know you have the cooler (8-4444)

Whenever possible, the cooler should always be returned after surgery is completed in the OR