Massive Transfusion Protocol

(MTP)

Order sets

In EPIC there is an order set named “massive transfusion protocol” – this will activate necessary blood and lab orders to be carried out during the MTP.  The necessary orders are pre-selected and no modifications to the order set are needed, just sign.

 

Documentation

After signing the MTP order set there is no epic documentation needed intraoperatively. The only documentation taking place during the MTP is on paper using the MTP tally sheet which is located in the MTP cart.  This form is where the product number (blood bag sticker), time transfusion began, and dual signoff will be recorded.  Hence NO SCANNING.  Once the case is over select MTP button in your intraop anesthesia record (which is located under MORE, on left side of epic record).  Select the time when the blood transfusion started and you can document all units given under a single time selection.  The field which states “product #” only needs to be filled in if the massive transfusion protocol tally sheet is not kept as part of the medical record.

 

 

Standard Blood Transfusions

On the far left of the patients chart there is a button for “blood availability” which should reflect what blood is available in the blood bank for the patient.

 

Order set: Blood transfusion Adult, on this order set you can order a type and cross

  1. transfuse products – pick what product and how much you want to transfuse

  2. you can pick uncrossmatched in this order set

  3. there is also an option for crossmatch and hold – you will have to go back to this order set later to pick “transfuse products” later when you decide to transfuse

 

When you put this order in make sure to communicate with your nurse to release it and follow up with the blood bank.  If the nurse does not release it no one will see your order.  The lab may need a second sample of blood for crossmatching blood.

 

Documentation

Click the blood (standard tabs), then click on the product you are transfusing.  Epic will prompt you to enter the unit number and product code.  You can scan the blood for these numbers.  Then the blood will come up under assigned units and you can click on the unit and add it to your chart.  Once the transfusion is finished you can give the paper attached to the blood to the nurse with your signature.  You don’t need to fill in vitals on this piece of paper.  Just check the blood and sign off on starting and finishing the transfusion.

 

Rebooting the Blood Scanner

  1. Scan Code on the arem of the epic computer or right side of anesthesia machine

  2. Return Scanner to base

  3. Wait for scanner to beep

  4. Scanner should be ready to use

 

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