Order Blood Products—Transfusions

• If you haven't already:

1. Select the patient.

2. Click Write (ALT+W).

3. Click Blood Products (ALT+B).

4. Click Transfuse (ALT+T).

• Complete the form

1. Select a blood product from the Product list. If Other, type the product name and click OK (ALT+O).

• Other IV treatments must be ordered as Medications

• For Rabies Immune Globulin, read administration recommendations when presented. For additional information, click CDC Recommendations (ALT+C) to open the Morbidity and Mortality Weekly Report on Use of a Reduced (4-Dose) Vaccine Schedule for Postexposure Prophylaxis to Prevent Human Rabies (PDF file). Click OK to close the message.

2. To order available modifications, select from the Modifier list.

• The IV option for Immune Globulin and the Prothrombin Complex Concentrate (4 factor) option for Clotting Factor are restricted products that require approval from Transfusion Medicine. See the Partners Handbook Clinical Topic, Transfusion Medicine (MGH).

• Click Continue (ALT+O) to acknowledge the reminder. Contact the Blood Transfusion Services physician for review.

• See also Guidelines for use of 4-factor Prothrombin Complex Concentrate (4-factor PCC) at MGH (PDF file).

3. Enter the amount and units:

• If needed, change the default units on the amount. The availability of different units depends on the product and modifier selected, as well as the patient's age.

• Type the amount.

For weight-based units (for example, mg/kg), you can enter either a weight-based Amount (ALT+A), or a Total Amount (ALT+T). The corresponding value is calculated automatically.

4. If appropriate, type a time in the Duration field.

This field is only available (with appropriate units) for applicable products. The duration is pre-filled for some products.

5. To note the rationale for transfusion, click Reasons (ALT+E). Click an option (or press the corresponding letter). If Other, type the reason. Click OK (ALT+O).

The Reasons button is disabled if an explanation is not required.

6. Select from the Priority drop-down list (Routine, STAT, Emergency Release, During Dialysis, In AM, Pre-Procedure, or Other).

7. To request transfusion restrictions:

• Click Restrictions (ALT+R).

• To display information from Blood Transfusion Services (BTS) about restrictions that do not require approval from a BTS MD, click the associated More button.

• Click the CAS icon in the taskbar at the bottom of the screen to bring Order Entry to the front without closing the information window; click the icon for the information window to toggle back.

• Click to close the information window.

• Click a checkbox or press the letter corresponding to an option to select one or more restrictions from the available list.

• Click OK (ALT+O).

8. Type instructions as needed.

9. Click OK (ALT+O).

• Write additional orders as needed, then sign the session.