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Block Release Protocol
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Transfusion Medicine Service Block Release Protocol

Further Information Is Available By Contacting The Medical Director Of Transfusion Medicine Service: Zbigniew.M.Szczepiorkowski, MD or the Blood Bank Medical Director, Nancy Dunbar M.D.

  1. This protocol is designed to enhance current Emergency Release procedures of uncrossmatched, Group O Rh Negative or Group O Rh Positive Red Blood Cells for immediate blood replacement requirements of patients in the ED, OR, OSC (Outpatient Surgery Center), ICU, BP, DHART, or any patient location experiencing acute and massive hemorrhage.

  2. The Blood Bank Laboratory will maintain four blocks, each with three units of Group O Negative Red Blood Cells and appropriate forms, and two blocks, each with three units of Group O positive Red Blood Cells, available for rapid release at all times. In addition, two blocks of 3 units of O negative red blood cells are maintained in a refrigerator in the DHART hangar for DHART use. A minimum of 3 units can be immediately released upon request.

  3. To activate this protocol, call the Blood Bank, (5-7207), request a Block Release of RBC's (or ask for units of uncrossmatched O Red Blood Cells). Provide the full patient name, DHMC Medical Record Number, and Date of Birth. Indicate the number of blocks requested (3 units per block). Notify the Blood Bank if the units are needed in the Outpatient Surgery Center (OSC) so arrangements can be made to meet the courier. The Transfusion Medicine Physician will be notified by the Blood Bank that the protocol has been activated and will become involved as needed.

  4. Enter and sign the electronic orders for a RBC block release(s) via eD-H. Select: "Block Release of RBC's". The ordering provider's signature is required by federal law (FDA regulation) for all uncrossmatched units of RBCs, whether they are transfused or returned to the Blood Bank.

  5. Block Releases will contain the "Block Release of Emergency Uncrossmatched Red Blood Cells" Form H-1554 (white and yellow copies) identifying the patient and red blood cell unit numbers in the block release. Documentation is completed on the paper block release form.

  6. Prior to any infusion of units to the patient, a blood specimen MUST be collected and prepared for transmittal to the Blood Bank. If the patient has never been typed at DHMC before, a second ABO recheck specimen will be requested. Once this specimen is collected, transfusion with uncrossmatched units can occur as needed. The specimen collected is to be sent to the Blood Bank for testing so that the true Blood Group and Type of the patient can be determined and conversion to that Blood Group and Type made if deemed appropriate by the Transfusion Medicine Physician in concert with the patient's primary physician. This specimen will also be used to complete other compatibility testing as may be required.

  7. The transfusionist will complete the Block Release Form: sign and write the date and time each unit of blood in the Block is transfused in the appropriate space on the form. The person confirming will also sign the Block Release Form. Units not transfused will be lined or crossed out on the form. Units not transfused are to be returned to the Blood Bank expeditiously with the same cold packs sent with the units.

  8. The original (white copy) of the Block Release Form must be completed by the transfusionist and placed in the patient's chart. DHART only: The yellow copy must be sent back to the Blood Bank with or without any unused units.

    Blood lock devices will not be used with emergency release of Group O Rh Negative or Group O Rh Positive RBC components. Proper identification of intended recipient with blood components must still occur.

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