The following protocol is the one I made for National Guard Health Affairs in Riyadh and has been updated to include the use of a blood bank computer system.
Medinfo has an emergency mode that facilitates release of blood components even if all the usual testing is not available
If Medinfo software is used, one can write a protocol based on the diagnosis of placenta previa to automatically allocate the blood and keep it on hold at all times.
- As soon as a patient with high-risk placenta previa is identified, order type and crossmatch for 4 units PRBCs.
- Immediately forward the specimen and its requisition to the blood bank for expedited processing. BE CERTAIN TO INDICATE ON THE FORM AND/OR IN THE COMPUTER SYSTEM THAT THIS IS A PLACENTA PREVIA CASE!!
- Send a new specimen for crossmatching every 3 days until delivery.
- Phone the blood bank immediately when blood is needed for the patient before coming to the Blood Bank. DO THIS BEFORE SENDING SOMEONE TO THE BLOOD BANK TO PICK UP THE BLOOD!
Blood Bank Responsibilities:
- Check the order comments for placenta previa.
- Handle all such requests as emergency or STAT.
- Enter a comment in the computer that this is a placenta previa case.
- Verify that the specimen has been properly collected and labelled.
- If the specimen is not acceptable, request new specimen.
- In emergencies, use emergency release/emergency mode in Medinfo.
- If specimen valid:
- Perform ABO/Rh typing and antibody screen if one is not available within the past 3 days.
- Check for previous history of ABO/Rh typing and antibodies—performed by blood bank computer system.
- Allocate 4 units, electronic crossmatch or full AHG as indicated by our rules.
- Provide antigen-matched units accordingly.
- When the ward calls that a placenta previa patient needs blood, immediately prepare the blood for release. This is an emergency request of the highest priority. VERBAL REQUESTS FOR BLOOD IN THESE CASES ARE ACCEPTABLE.
- Use emergency mode/emergency release in Medinfo if all the testing is not done or current.