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STAT REFERRALBLOOD PRODUCT TRANSFUSION ORDER FORM PATIENT INFORMATION Last Name: ___ First Name: ___ MI___ DOB:___ HT: ___ in WT: ___ kg Birth Sex :( ) Male ( ) FemaleAllergies: ( ) NKDA, (Or):______
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How to fill out blood product transfusion order
How to fill out blood product transfusion order
01
Obtain the patient's name, date of birth, and medical record number.
02
Specify the blood product needed (e.g. packed red blood cells, platelets, plasma).
03
Indicate the quantity of the blood product required.
04
Provide the reason for the blood product transfusion order (e.g. low hemoglobin levels, active bleeding).
05
Include any special instructions or considerations (e.g. crossmatching, blood type compatibility).
06
Obtain the attending physician's signature and date of order.
Who needs blood product transfusion order?
01
Patients who are anemic or experiencing significant blood loss may require a blood product transfusion order.
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What is blood product transfusion order?
The blood product transfusion order is a form that authorizes the administration of blood products to a patient.
Who is required to file blood product transfusion order?
A licensed healthcare provider such as a physician or nurse is required to file the blood product transfusion order.
How to fill out blood product transfusion order?
The blood product transfusion order should be completed with the patient's information, the type and amount of blood product to be administered, and the provider's signature.
What is the purpose of blood product transfusion order?
The purpose of the blood product transfusion order is to ensure that the correct blood products are given to the right patient in a safe and timely manner.
What information must be reported on blood product transfusion order?
The blood product transfusion order must include the patient's name, medical record number, blood product type, amount, transfusion start time, and provider's signature.
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