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Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Order Sets,Inpatient,Neonatal

IP – Blood Transfusion – Neonatal – Supplemental [5033]

IP – Blood Transfusion – Neonatal – Supplemental [5033] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Neonatal


SmartSet: IP - BLOOD TRANSFUSION - NEONATAL - SUPPLEMENTAL (ID:5033)
General Information
Display name: IP - Blood Transfusion - Neonatal - Supplemental
Type: General
Merge priority:
Version comment:
Content source:
Synonyms: 1. NICU
2. Neonate
3. .NICU
4. .NEONATE
SmartSet notes:
Description:
Web information: Title URL
1.
Questionnaire:
Configuration
Patient Care Orders
Nutrition
NPO during blood transfusion ONCE For 1 Occurrences
Non-Categorized Patient Care Orders
Glucose, POC SEE COMMENTS, Starting S, Routine, Glucose, POC should
always be ordered in conjunction with orders for
hypoglycemia management and monitoring as indicated in the
Hypoglycemia Management (Adult) panel.
If Conditional, What Condition?
Check blood glucose half way through transfusion and then 2
hours post transfusion.
Intravenous Therapy
Insert and Maintain Peripheral IV CONTINUOUS, Routine
Peripheral IV Size: RN Discretion
Does this need to be inserted/placed? Yes
Medications
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Copyright © 2016 University of Wisconsin Hospitals and Clinics Authority
 

Medications
furosemide (LASIX) intraVENOUS 1 mg/kg, Intravenous, ONCE For 1 Doses
Laboratory
Laboratory
TYPE AND SCREEN, NEONATAL STAT - RN COLLECT For 1 Occurrences, Routine
If add on test, what should lab do if unable to add test to
previous specimen?
If Conditional, What Condition?
CBC WITH DIFFERENTIAL STAT - RN COLLECT 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
Red Blood Cells (Neonatal) < 1 UNIT For 1 Occurrences, 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:
Consent Status:
Total Volume to be transfused (mL):
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): Yes
Indication for Irradiated Blood: S1 Patients during the first four
months of life
CMV Negative (Heart/Lung Transplant and Neonates up to 4
Months Only) (May be pre-selected based on history): Yes
Volume-Reduced (May be pre-selected based on history):
Patient Weight
No data found for Wt
All cellular products are leukocyte-reduced (CMV safe).
1 Red Blood Cell Unit ~ 350 mL.
Plasma (Neonatal) < 1 UNIT For 1 Occurrences, 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:
Consent Status:
Total Volume to be transfused (mL):
Patient Weight
No data found for Wt
REMINDER: Call Blood Bank at 263-8367 30-60 minutes
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Copyright © 2016 University of Wisconsin Hospitals and Clinics Authority
 

before transfusion to prepare products.
1 Plasma Unit ~ 200 mL
Platelets (Neonatal) < 1 SINGLE DONOR UNIT For 1 Occurrences, 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:
Consent Status:
Total Volume to be transfused (mL):
Irradiated (See Blood Product Guidelines) (May be pre-
selected based on history): Yes
Indication for Irradiated Blood: S1 Patients during the first four
months of life
CMV Negative (Heart/Lung Transplant and Neonates up to 4
Months Only) (May be pre-selected based on history): Yes
Volume-Reduced (May be pre-selected based on history):
Patient Weight
No data found for Wt
For refractory patients, call UWHC Blood Back at (608) 263-
8307 or The American Center Lab at (608) 234-6600 as
appropriate 30-60 minutes (at UWHC) or 2-3 hours (at The
American Center) before transfusion to prepare products.
Suggested dose = 10-20 mL/kg body weight for neonatal and
pediatric patients. For patients greater than 40 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 UWHC Blood Bank at (608) 263-
8367 or The American Center Lab at (608) 234-6600 as
appropriate 30-60 minutes (at UWHC) or 2-3 hours (at The
American Center) before transfusion to prepare products.
Cryoprecipitate (Neonatal) 1 UNIT For 1 Occurrences, 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:
Consent Status:
Total Volume to be transfused (mL):
Patient Weight
No data found for Wt
REMINDER: Call Blood Bank at 263-8367 30-60 minutes
before transfusion to prepare products.
Cryoprecipitate is stored frozen as individual units
(approximately 10-15mL) or as 5 pooled units (approximately
120mL). Suggested guideline = 1 unit/10 kg.
Transfusion
Transfusion
Transfuse Red Blood Cells (Neonatal) ONCE, Routine, Patient Weight
No data found for Wt
All cellular products are leukocyte-reduced (CMV safe).
1 Red Blood Cell Unit ~ 350 mL.
Run Over:
Total Volume to be transfused (mL):
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Copyright © 2016 University of Wisconsin Hospitals and Clinics Authority
 

Transfuse Plasma (Neonatal) ONCE, Routine, Patient Weight
No data found for Wt
REMINDER: Call Blood Bank at 263-8367 30-60 minutes
before transfusion to prepare products.
1 Plasma Unit ~ 200 mL
Run Over:
Total Volume to be transfused (mL):
Transfuse Platelets (Neonatal) ONCE, Routine, Patient Weight
No data found for Wt
REMINDER: Call Blood Bank at 263-8367 30-60 minutes
before transfusion to prepare products.
1 Plasma Unit ~ 200 mL
Run Over:
Total Volume to be transfused (mL):
Transfuse Cryoprecipitate (Neonatal) ONCE, Routine, Patient Weight
No data found for Wt
REMINDER: Call Blood Bank at 263-8367 30-60 minutes
before transfusion to prepare products.
1 Plasma Unit ~ 200 mL
Run Over:
Total Volume to be transfused (mL):
Criteria
Suggestions: UWIP C LOGIN DEPT IPPED NEONATAL INTENSIVE CARE[3001764]
Filter: UWIP ORDER SET RESTRICTOR - IP AND PEDS - NOT IP DC[3000404]
Restrict SmartSet:
Settings
Discontinue action:
Deselect sections for
Pended/Held orders:
Pended/Held orders display:
Release date: Use System Definitions Setting
Disallow user override:
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Copyright © 2016 University of Wisconsin Hospitals and Clinics Authority