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This document applies to all Covenant and AHS sites. Regional Laboratory Services Transfusion Medicine 2 13 Form G: AHS Edmonton Zone Prothrombin Complex Concentrate (PCC) (OptiPlex or Triplex) Request
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How to fill out prothrombin complex concentrate request
How to Fill Out Prothrombin Complex Concentrate Request:
01
Obtain the request form from the appropriate medical personnel or department. This form may be specific to your healthcare facility, so make sure you have the correct one.
02
Fill in the patient's personal information, including their full name, date of birth, and patient identification number. This is crucial for accurate identification and record-keeping.
03
Provide the relevant medical information, such as the reason for requesting prothrombin complex concentrate (PCC) and any specific details regarding the patient's condition or medical history that may be important for the healthcare provider.
04
Indicate the dosage and administration instructions for the PCC. This may involve specifying the dose in international units (IU) or following any specific guidelines provided by the prescribing physician or healthcare facility.
05
Include the date and your signature as the person requesting the PCC. This verifies that the request is authorized and ensures accountability.
06
Submit the completed request form to the appropriate department or personnel responsible for processing and fulfilling PCC requests.
Who Needs Prothrombin Complex Concentrate Request:
01
Patients with bleeding disorders: Prothrombin complex concentrate is often prescribed for patients with bleeding disorders that affect their blood clotting ability. This may include conditions such as hemophilia or acquired coagulation factor deficiencies.
02
Surgical or trauma patients: In certain surgical procedures or traumatic injuries, there may be a need for prothrombin complex concentrate to help control or prevent excessive bleeding.
03
Patients on anticoagulant therapy: Individuals who are on anticoagulant therapy, such as warfarin or direct oral anticoagulants, may require prothrombin complex concentrate as an antidote in cases of severe bleeding or the need for urgent surgery.
Remember to always consult with your healthcare provider or medical team for specific guidelines and recommendations regarding the use of prothrombin complex concentrate and completing the request form accurately.
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What is prothrombin complex concentrate request?
Prothrombin complex concentrate request is a form requesting the administration of a medication that helps with blood clotting.
Who is required to file prothrombin complex concentrate request?
Prothrombin complex concentrate request should be filed by a healthcare provider or medical professional.
How to fill out prothrombin complex concentrate request?
To fill out prothrombin complex concentrate request, one must provide patient information, medical history, reason for request, and dosage needed.
What is the purpose of prothrombin complex concentrate request?
The purpose of prothrombin complex concentrate request is to ensure the timely administration of medication to aid in blood clotting.
What information must be reported on prothrombin complex concentrate request?
On the prothrombin complex concentrate request, one must report patient details, medical history, reason for request, dosage needed, and any relevant test results.
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