Presentation of : GI upper / GI Lower / Obstetric with caesarean / Obstetric- all others / – Gynae / Vascular- aortic aneurysm (open surgical repair) / Vascular / Intraoperative / –other Cardiac / Trauma Final diagnosis…………………………………………………………………… Was a trauma call put out? Yes / No Blood components used Component Number ordered Number transfused Wastage- Avoidable Wastage- (units if (state units or mls if Unavoidable (state –mls paediatric) paeds) units or mls if paeds) Emergency O red cells Other red cells Platelets FFP Cryoprecipitate Length of time in hours: minutes from activation to transfusion of Emergency O red cells (if used) (can be a minus time if given before activation) ……………………………………………hh:mm Actual time (24 hour that request was logged on lab system ……………………………………………hh:mm Length of time in hours: minutes from activation to transfusion of Other red cells(can be a minus time if given before activation)……………………………………………hh:mm Actual Time (24 hour clock) that grouped red cells were ready for dispatch to patient on lab system………………hh:m Actual Time (24 hour clock) that FFP was ready for dispatch to patient on lab system………………hh:m Cell salvage Was cell salvage used? Yes/ No If Yes, volume returned if known …………………….(mls) If processed but not returned, record P …………………… Laboratory results Was TEG/ROTEM used? Yes / No Was Clauss fibrinogen checked? Yes / No Results should be result closest to activation and within 4 hours of actviation – Parameter 1st result after activation Hb g/L Platelets x 109/L Clauss Fibrinogen g/L Other coagulation parameters (PT,APTT, Normal / Abnormal INR)
Presentation of : GI upper / GI Lower / Obstetric – with caesarean / Obstetric- all others / Gynae / Vascular- aortic aneurysm (open surgical repair) / Vascular –other / Intraoperative / Cardiac / Trauma Final diagnosis…………………………………………………………………… Was a trauma call put out? Yes / No Blood components used Component Number ordered (units –mls if paediatric) Number transfused Wastage- Avoidable (state units or mls if paeds) Wastage- Unavoidable (state units or mls if paeds) Emergency O red cells Other red cells Platelets FFP Cryoprecipitate Length of time in hours: minutes from activation to transfusion of Emergency O red cells (if used) (can be a minus time if given before activation) ……………………………………………hh:mm Actual time (24 hour that request was logged on lab system ……………………………………………hh:mm Length of time in hours: minutes from activation to transfusion of Other red cells(can be a minus time if given before activation)……………………………………………hh:mm Actual Time (24 hour clock) that grouped red cells were ready for dispatch to patient on lab system………………hh:m Actual Time (24 hour clock) that FFP was ready for dispatch to patient on lab system………………hh:m Cell salvage Was cell salvage used? Yes/ No If Yes, volume returned if known …………………….(mls) If processed but not returned, record P …………………… Laboratory results Was TEG/ROTEM used? Yes / No Was Clauss fibrinogen checked? Yes / No Results – should be result closest to activation and within 4 hours of actviation Parameter 1st result after activation Hb g/L Platelets x 109/L Clauss Fibrinogen g/L Other coagulation parameters (PT,APTT, INR) Normal / Abnormal
rtc-nw_14_11_P_m_h_toolkit_v3_dec_13.docx