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UWHC,UWMF,

Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Order Sets,Inpatient,Hospital-wide

IP - Blood Transfusion - Pediatric - Supplemental [1267]

IP - Blood Transfusion - Pediatric - Supplemental [1267] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Hospital-wide


IP - Blood Transfusion - Pediatric - Supplemental [1267]
Tests
Tests [100542]
TYPE AND SCREEN [HCTS] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine, As good clinical practice and for patient safety, the
Transfusion Service will automatically crossmatch 2 packed
RBCs on all patients with antibodies to ensure blood would be
available in the event it is needed. If you would like to opt out
of this automatic order for this patient please contact the
Blood Bank at (608) 263-8367.
Tests [100543]
TYPE AND SCREEN, NEONATAL [HCNTS] STAT - RN COLLECT, Starting today For 1 Occurrences,
Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
Blood Products
Blood Products [12026]
Red Blood Cells (Adult) [BLB0006] Starting today, Routine
Reason for Order:
Blood Product Need (It will take approximately 30 to 60
minutes from the time nursing notifies the Blood Bank to
prepare the products):
Date Product Needed:
Uncrossmatched **WARNING** Requesting MD verifies that
the clinical situation is sufficiently urgent to require release of
blood before completion of compatibility testing and agrees to
hold UWHC harmless for any and all liability for any injuries
resulting from release of blood before such testing:
Irradiated (See Blood Product Guidelines) (May be pre-
selected based on history):
Indication for Irradiated Blood:
CMV Negative (Heart/Lung Transplant and Neonates up to 4
Months Only) (May be pre-selected based on history):
Has consent been obtained?
Date Consent Obtained (Valid for 1 year):
Patient Weight
No data found for Wt
All cellular products are leukocyte-reduced (CMV safe)
1 Red Blood Cell Unit ~ 350 mL.
Plasma (Adult) [BLB0003] Starting today, Routine
Reason for Order:
Blood Product Need (It will take approximately 30 to 60
minutes from the time nursing notifies the Blood Bank to
prepare the products):
Date Product Needed:
Has consent been obtained?
Date Consent Obtained (Valid for 1 year):
Patient Weight
No data found for Wt
1 Plasma Unit ~ 200 mL.
NURSING REMINDER: Call Blood Bank at 263-8367 30-60
minutes before transfusion to prepare products.
Platelets (Adult) [BLB0004] Starting today, Routine
Reason for Order:
Blood Product Need (It will take approximately 30 to 60
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Copyright © 2015 University of Wisconsin Hospital and Clinics Authority


minutes from the time nursing notifies the Blood Bank to
prepare the products):
Date Product Needed:
Irradiated (See Blood Product Guidelines) (May be pre-
selected based on history):
Indication for Irradiated Blood:
CMV Negative (Heart/Lung Transplant and Neonates up to 4
Months Only) (May be pre-selected based on history):
Has consent been obtained?
Date Consent Obtained (Valid for 1 year):
Patient Weight
No data found for Wt
For refractory patients, call Blood Bank at 263-8367.
1 Single Donor Unit ~ 200-250 mL.
All platelet products are leukocyte-reduced (CMV safe).
NURSING REMINDER: Call Blood Bank at 263-8367 30-60
minutes before transfusion to prepare products.
Cryoprecipitate (Adult) [BLB0005] Starting today, Routine
Reason for Order:
Blood Product Need (It will take approximately 30 to 60
minutes from the time nursing notifies the Blood Bank to
prepare the products):
Date Product Needed:
Has consent been obtained?
Fibrin Glue, mLs Needed:
Date Consent Obtained (Valid for 1 year):
Patient Weight
No data found for Wt
Cryoprecipitate is stored frozen as 5 pooled units (approx
120mL). Standard adult dose = 10 units. Suggested dose =
1 unit/10 kg.
Individual cryoprecipitate units are also available for fibrin
glue (approx 10-15 mL each).
NURSING REMINDER: Call Blood Bank at 263-8367 30-60
minutes before transfusion to prepare products.
Blood Product [12027]
Red Blood Cells (Pediatric) [BLB0013] Starting today, Routine
If ordering < 1 unit specify the Total Volume to be transfused
(mL):
Reason for Order:
Blood Product Need (It will take approximately 30 to 60
minutes from the time nursing notifies the Blood Bank to
prepare the products):
Date Product Needed:
Uncrossmatched **WARNING** Requesting MD verifies that
the clinical situation is sufficiently urgent to require release of
blood before completion of compatibility testing and agrees to
hold UWHC harmless for any and all liability for any injuries
resulting from release of blood before such testing:
Irradiated (See Blood Product Guidelines) (May be pre-
selected based on history):
Indication for Irradiated Blood:
CMV Negative (Heart/Lung Transplant and Neonates up to 4
Months Only) (May be pre-selected based on history):
Volume-Reduced (May be pre-selected based on history):
Has consent been obtained?
Date Consent Obtained (Valid for 1 year):
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Patient Weight
No data found for Wt
All cellular products are leukocyte-reduced (CMV safe).
1 Red Blood Cell Unit ~ 350 mL. Suggested dose: 10 mL/kg
body weight.
Plasma (Pediatric) [BLB0010] Starting today, Routine
If ordering < 1 unit specify the Total Volume to be transfused
(mL):
Reason for Order:
Blood Product Need (It will take approximately 30 to 60
minutes from the time nursing notifies the Blood Bank to
prepare the products):
Date Product Needed:
Has consent been obtained?
Date Consent Obtained (Valid for 1 year):
Patient Weight
No data found for Wt
1 Plasma Unit ~ 200 mL. Suggested dose: 10-15 mL/kg body
weight.
NURSING REMINDER: Call Blood Bank at 263-8367 30-60
minutes before transfusion to prepare products.
Platelets (Pediatric) [BLB0011] Starting today, Routine
If ordering < 1 unit specify the Total Volume to be transfused
(mL):
Reason for Order:
Blood Product Need (It will take approximately 30 to 60
minutes from the time nursing notifies the Blood Bank to
prepare the products):
Date Product Needed:
Irradiated (See Blood Product Guidelines) (May be pre-
selected based on history):
Indication for Irradiated Blood:
CMV Negative (Heart/Lung Transplant and Neonates up to 4
Months Only) (May be pre-selected based on history):
Volume-Reduced (May be pre-selected based on history):
Has consent been obtained?
Date Consent Obtained (Valid for 1 year):
Patient Weight
No data found for Wt
For refractory patients, call Blood Bank at 263-8367.
Suggested dose = 10-20 mL/kg body weight for neonatal and
pediatric patients. For patients greater than 60 kg, suggested
dose is 1 Single Donor Unit. 1 Single Donor Unit = 200-250
mL. All platelet products are leukocyte-reduced (CMV safe).
NURSING REMINDER: Call the Blood Bank at 263-8367 30-
60 minutes before transfusion to prepare products.
Cryoprecipitate (Pediatric) [BLB0012] Starting today, Routine
Reason for Order:
Blood Product Need (It will take approximately 30 to 60
minutes from the time nursing notifies the Blood Bank to
prepare the products):
Date Product Needed:
Has consent been obtained?
Date Consent Obtained (Valid for 1 year):
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Patient Weight
No data found for Wt
1 Cryoprecipitate Unit ~ 10-20 mL. Suggested dose: 1 Unit/10
kg body weight. If patient weighs less than 10 kg, give 1 Unit.
NURSING REMINDER: Call Blood Bank at 263-8367 30-60
minutes before transfusion to prepare products.
Transfusion
Transfusion [12028]
If ordering to transfuse a product, make sure the product is or has already been ordered.
Transfuse Red Blood Cells (Adult) [NURTRT0021] Starting today, Routine, Patient Weight
No data found for Wt
All cellular products are leukocyte-reduced (CMV safe)
1 Red Blood Cell Unit ~ 350 mL.
Run Each Unit Over:
Transfuse Plasma (Adult) [NURTRT0031] Starting today, Routine, Patient Weight
No data found for Wt
1 Plasma Unit ~ 200 mL.
NURSING REMINDER: Call Blood Bank at 263-8367 30-60
minutes before transfusion to prepare products.
Run Each Unit Over:
Transfuse Platelets (Adult) [NURTRT0030] Starting today, Routine, Patient Weight
No data found for Wt
1 Single Donor Unit ~ 200-250 mL.
NURSING REMINDER: Call Blood Bank at 263-8367 30-60
minutes before transfusion to prepare products.
Run Each Unit Over:
Transfuse Cryoprecipitate (Adult) [NURTRT0032] Starting today, Routine, Patient Weight
No data found for Wt
Cryoprecipitate is stored frozen as 5 pooled units (approx
120mL). Standard adult dose = 10 units. Suggested dose =
1 unit/10 kg.
Individual cryoprecipitate units are also available for fibrin
glue (approx 10-15 mL each).
NURSING REMINDER: Call Blood Bank at 263-8367 30-60
minutes before transfusion to prepare products.
Run Each Unit Over:
Fibrin Glue, mLs Needed:
Transfusion [12029]
If ordering to transfuse a product, make sure the product is or has already been ordered.
Transfuse Red Blood Cells (Pediatric) [NURTRT0035] Starting today, Routine, Patient Weight
No data found for Wt
All cellular products are leukocyte-reduced (CMV safe).
1 Red Blood Cell Unit ~ 350 mL. Suggested dose: 10 mL/kg
body weight.
Run Over:
If ordering < 1 unit specify the Total Volume to be transfused
(mL):
Transfuse Plasma (Pediatric) [NURTRT0037] Starting today, Routine, Patient Weight
No data found for Wt
1 Plasma Unit ~ 200 mL. Suggested dose: 10-15 mL/kg body
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Copyright © 2015 University of Wisconsin Hospital and Clinics Authority


weight.
NURSING REMINDER: Call Blood Bank at 263-8367 30-60
minutes before transfusion to prepare products.
Run Over:
If ordering < 1 unit specify the Total Volume to be transfused
(mL):
Transfuse Platelets (Pediatric) [NURTRT0036] Starting today, Routine, Patient Weight
No data found for Wt
1 Single Donor Unit ~ 200-250 mL. Suggested dose = 10-20
mL/kg body weight for neonatal and pediatric patients. For
patients greater than 60 kg, suggested dose is 1 Single Donor
Unit.
NURSING REMINDER: Call Blood Bank at 263-8367 30-60
minutes before transfusion to prepare products.
Run Over:
If ordering < 1 unit specify the Total Volume to be transfused
(mL):
Transfuse Cryoprecipitate (Pediatric) [NURTRT0038] Starting today, Routine, Patient Weight
No data found for Wt
1 Cryoprecipitate Unit ~ 10-20 mL. Suggested dose: 1 Unit/10
kg body weight. If patient weighs less than 10 kg give 1 unit.
NURSING REMINDER: Call Blood Bank at 263-8367 30-60
minutes before transfusion to prepare products.
Run Over:
Medications - Pre-medications - NOTE: Order for patients with previous reaction to
transfusion
Analgesics [16447]
acetaMINOPHEN alcohol free (TYLENOL) oral
suspension - NOTE: Suggested dose 15 mg/kg/dose
(Maximum 650 mg/dose) [800005]
15 mg/kg, Oral
NOTE: Suggested dose 15 mg/kg/dose (Maximum 650
mg/dose)
Antihistamines (Single Response) [16449]
diphenhydramine (BENADRYL) injection - NOTE:
Suggested dose 0.5-1 mg/kg/dose (Maximum 25
mg/dose) [750044]
0.5-1 mg/kg, Intravenous, ONCE For 1 Doses, for 1 Minutes
NOTE: Suggested dose 0.5-1 mg/kg/dose (Maximum 25
mg/dose)
diphenhydramine (BENADRYL) elixir - NOTE:
Suggested dose 0.5-1 mg/kg/dose (Maximum 25
mg/dose) [36793]
Oral, ONCE For 1 Doses
NOTE: Suggested dose 0.5-1 mg/kg/dose (Maximum 25
mg/dose)
Steroids (Single Response) [16450]
hydrocortisone sod suc in sodium chloride 0.9% injection
- NOTE: Maximum Dose = 100 mg [800189]
1 mg/kg, Intravenous, ONCE For 1 Doses
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Copyright © 2015 University of Wisconsin Hospital and Clinics Authority