Specimen Requirements

Storage

Blood may only be stored in specially monitored Transfusion Services refrigerators which are located in Transfusion Services or in blood coolers prepared by Transfusion Services. Do not store blood in area drug refrigerators.

Note: If blood has been issued and transfusion can not be started within 30 minutes, return unit to Transfusion Services on foot, not via computerized transport system (CTS).

 

Patient Preparation

Recipient must be identified with both a patient identification armband and a red 4-digit Transfusion Services armband. See Transfusion Services Recipient Armbands in Transfusion Services in Special Instructions for additional details. Both armbands must be put on patient before crossmatch specimen is drawn. These armbands must remain on patient until transfusions are complete.

 

Policy

Infusion of blood or blood components to Peninsula Regional Medical Center (PRMC) patients shall be under direct supervision of either a physician with privileges to practice at PRMC or a RN employed at PRMC. One of these individuals must be present at time of transfusion and take responsibility for transfusion and any/all related procedures. All individuals involved in blood transfusion shall have had appropriate instruction on PRMC’s transfusion policies and procedures.

 

Issue and Transport

Blood products will be issued from Transfusion Services via CTS or to any hospital employee when CTS is unavailable.

 

Anyone requesting issue of blood products via CTS tube system, must send Transfusion Services (CTS #104) a Blood Product Tube Transport Form (BPTF) with upper 1/3 of form completed. When product is received via CTS, individual taking product out of tube must complete bottom 1/3 of BPTF form and immediately return it via tube to station #104. This individual should immediately give product to nursing personnel who are directly responsible for patient’s care.

 

Anyone requesting to hand transport blood products from Transfusion Services, must present a printed patient’s label showing patient’s name, medical record number and recipient armband number. (No product will be issued to anyone not having a printed patient label that includes the recipient armband number.) Transporter must immediately transport product to appropriate nursing area. Product should be given to nursing personnel who are directly responsible for patient’s care.

 

If transfusion is not immediately started, it is the responsibility of receiving individual to transport product back to Transfusion Services immediately. All returns must be hand transported regardless of method of initial transport of the product.

Caution: Blood products may not be stored in nursing area refrigerators.

 

No individual who is not a member of Transfusion Services may transport units for more than 2 patients at any time.

 

Unit Receipt

Nurse receiving unit shall check unit label, unit tag, and patient’s armbands when comparing the following information:

1. Patient’s first and last name (unit tag and armband)

2. Medical record number (unit tag and armband)

3. Transfusion Service’s 4-digit recipient number (unit tag and red armband)

4. Unit number (unit tag and unit label)

5. ABO and Rh type of patient and unit (unit tag and unit label)

6. Compatibility results (unit tag)

7. Unit expiration date (unit label)

 

If type and Rh of patient and unit are not identical, unit tag should be stamped “Approved by  Pathologist.” All discrepancies should immediately be brought to attention of a Transfusion Service technologist.

 

Administration

All nursing procedures relating to transfusion of blood and blood products can be found in Policy Manager - Blood/Blood Product Administration Procedure (consult appropriate sections).

Caution: Before transfusion at patient’s bedside, 2 individuals, transfusionist and 1 other responsible adult, must double check all information, that is check unit tag against patient’s hospital armband. Check recipient number on patient against recipient number recorded on unit tag. Check unit label item for item against information on unit tag. All information must be exactly the same and numbers must be identical before unit can be transfused.

 

Medications

No medications may be added to blood during infusion. Sterile 0.9% saline is only solution which may be added to or run simultaneously with blood. This can only be done with a physician’s order.

 

Unit Numbers

Each blood product unit has it’s own unique identification number. These are assigned by drawing blood bank (Blood Bank of Delmarva or American Red Cross). 

 

Unit Tag

Each unit issued has a computerized unit tag securely attached to it. This tag contains all necessary unit and patient identification information, including patient’s full name (first and last), medical record number, blood type, Rh, recipient number, unit number, unit type, unit volume, results of testing and initials of technician. Unit tag must remain attached to unit until transfusion is completed.

 

Transfusion Record

The unit tag must be completely filled out by transfusionist. The following must be filled in:

1. Transfusion Service’s recipient number

2. Amount of blood given

3. Date and time of transfusion

4. Name of both transfusionists

5. Time of completion of transfusion

6. Checkmark if a reaction occurred

 

After transfusion, the unit tag is placed in patient’s chart.

 

Transfusion Reaction

If any of the signs or symptoms of a transfusion reaction occur, the steps outlined in Policy Manager - Blood/Blood Product AAdministration Procedure must be followed immediately. Contact Transfusion Services immediately and request an investigation of a suspected transfusion reaction. A Transfusion Reaction Form should be completed. The Transfusion Reaction Form along with a copy of the unit tag is then hand carried with blood bag and any attached sets to Transfusion Services either by a nurse or phlebotomist drawing blood specimens.

 

Specimen Required

Blood and urine are required.

 

Blood

Draw blood in a large, pink-top (K₂ EDTA) tube and a plain, red-top tube. Send 6 mL of K₂ EDTA whole blood and send 10 mL of clotted blood.

Note: Label specimen with 4-digit transfusion services red armband number, patient's first and last name, medical record number, time of collection and phlebotomist’s initials. Mark as “Transfusion Reaction” and appropriately (blood).

 

Urine

Submit first urine specimen voided by patient in a plastic urine container.

Note: Label specimen with patient's first and last name, medical record number, time of collection and collector’s initials. Mark as “Transfusion Reaction” and appropriately (urine).