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