Resources

Transfuse (Emergent) PRBCs

Message
Performed in Blood Bank.  Emergent- urgently need RBCs RIGHT NOW and will accept the safest product as determined by Blood Bank.  Physician must sign, taking responsibility for the order.


Test Code
ETRBC


Alias/See Also
Uncrossmatched Blood
Set Up (Emergent) RBCs
Emergency Release of Blood


Preferred Specimen
Pink 6.0 mL tube
Collection of specimen prior to initiating emergent transfusion of the blood products is preferred.  Special Blood Bank Identification process is required for specimens collected for Type and Cross testing.  For more information on sample collection requirements, refer to Transfuse PRBCs (Type and Cross).


Other Acceptable Specimens
Lavender 6.0mL.
Red top tubes are NOT the specimen of choice.  Please contact the Blood Bank for samples collected in these tubes.


Instructions
Prior to Issue of Blood (can be done in any order):
  • Place the "Transfuse (Emergent) PRBCs" order. 
  • Collect patient sample (6.0mL pink top) and label appropriately, including BBID (Blood Bank may already have a sample).
  • Call Blood Bank to inform them of the emergent order.
If unable to order "Transfuse (Emergent) PRBCs", call the Blood Bank to inform them of the request for emergent blood.  Tell them that "I need blood now" and provide the number of units, type of product needed, patient name, patient MRN and/or BBID, ordering Physician, patient location, transport method, and contact information.  An appropriately completed Blood Bank Dispense Form to pick up blood is only required in absence of the "Transfuse (Emergent) PRBCs" order.

The authorization for emergency release is built into the "Transfuse (Emergent) PRBCs" order.  However, if the order is NOT placed for the emergent transfusion, an Emergency Transfusion Request form must be signed by the physician to authorize the emergency release of blood.  A nurse may sign on behalf of a named physician.  The physician MUST sign as soon as possible.  The signature is required by regulatory agencies, even if blood is not transfused.


Setup Schedule
STAT
Blood Bank will provide the best RBCs available in 10 minutes.  Call the Blood Bank as soon as the need for emergent RBC's has been identified.  Procedures on how to transfuse are located on the Banner Intranet.  


Clinical Significance
Blood Bank will call as soon as the crossmatch testing has been completed.  If the blood products that were released uncrossmatched are found to be incompatible, Blood Bank will notify the Nursing Unit and/or physician immediately. 

INDICATIONS FOR USE:

Detailed information on recommendations for transfusion can be found in the "AABB Circular of Information for the Use of Human Blood and Blood Components" located on the AABB web site (link below).
http://www.aabb.org/tm/coi/Pages/default.aspx

Transfusion of Red Blood Cells:
  • Symptomatic anemia (Generally Hgb<7 or Hct<21)
  • Hypovolemia (Estimated blood loss >1000cc)
  • Acute Bleeding (estimated 15% blood loss)
Leuko-reduced Red Blood Cells:
All hospital sites use leuko-reduced red cell products. This is a better overall product, helps reduce the number of febrile transfusion reactions, and is considered CMV safe.




The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.