Electronic ordering of blood products

Electronic ordering of blood components is done through Saga or Heilsugátt. Prerequisite for electronic ordering of products is having a known blood group and for a compatibility test (BAS/BKS) to have been performed at least once before. If an order for units of red blood cell concentrate is to be placed, the compatibility test (BAS/BKS) must be valid.

For further details see the Blood Bank's quality manual and/or 22 chapters of the Landspítali University Hospital Quality Guide.

Ordering blood products by telephone or on a Blood bank request

If a blood product is to be ordered for a patient and cannot be electronically placed through Saga or Heilsugátt, you can call the Blood Bank, where the employee of the Blood Bank takes down an order for blood products. You can also order red blood cell concentrate on blood bank request that are sent with blood sample. Always call or send an electronic order to the Blood Bank if ordering platelet concentrate or plasma.

If an order for units of red blood cell concentrate is to be placed, the compatibility test (BAS/BKS) must be valid. If an order is to be placed for platelet concentrate or plasma, the patient must be blood grouped twice in the Blood Bank to ensure the safety of transfusion.

Information from the Blood Bank, a registration of the transfusion of blood components from Interinfo can be found in the Heilsugátt under menu.

The information system ProSang is a directory and a secure system closed to users other than within the Blood Bank.

Interinfo is a kind of a customer window into the ProSang information system and can be accessed online.

Interinfo retrieves information from the Blood Bank information system electronically.

Interinfo provides employees with tools, information, overviews and documentation on everything related to blood grouping and blood components for the patient.

Open up History. Enter the personal identification number of the individual to be viewed. To the left of the screen, there is a key, there is a button "Bloodbank - Interinfo"

Click on "Blood Bank - Interinfo" and you will find a picture for the patient in question.

In Interinfo, the user can view information under the following tabs:

Patient information

The latest research answers on blood grouping, status of tests and reserved blood components are shown here.

Answer texts

This is a look at previous studies with special answer texts, such as information on blood group antibodies and HLA studies.

Reading with scanner

Here, a barcode of the patient's bracelet is read together with a barcode on a blood component. Replacing the work of two workers reading together the product numbers and code.

Register blood transfusion

Here, blood transfusion is recorded electronically with a scanner or a cursor.

Registered blood transfusion

An overview of the transfused blood components and adverse reactions are listed here.

Tissue grouping

This is a chart of results from the Tissue Grouping Department as of 1.1.2013.

Stem cells

Results from the Stem Cell Department are presented here as of 1.1.2013

Red blood cell concentrate, plasma and platelets can be given between blood groups if certain rules are observed. Platelets can be given between ABO blood groups, thought attempting to give the patient platelets from his/her blood group if possible.

Red blood cell concentrate

When red blood cell concentrate there is virtually no plasma. Red blood cells of blood group O do not have ABO antigen and can therefore be given to individuals of groups A, B, and AB. Those with AB blood group have no ABO antibodies in their plasma and can therefore accept red blood cells from all ABO blood groups .

Blood plasma ( plasma )

The plasma of individuals within blood group O contains antibodies to A,B and AB antigens. Blood plasma of Group O can therefore only be administered to individuals of Group O blood group.

Individuals with blood group AB do not have antibodies to the ABO blood group in their plasma. AB plasma can therefore be given to individuals of all ABO blood types.

What is emergency blood

In an emergency situation, a life-saving procedure may need to be performed without the normal blood grouping and compatibility tests. Under such circumstances, emergency blood is used.

Emergency blood is O Rh D negative and K negative red blood cell concentrate. Consequently, it is as neutral as red blood cell concentrate can become, and can therefore be administered to a great majority of patients in emergency situations without side effects.

AB Rh D negative plasma can also be used as a emergency plasma.

In the absence of emergency, blood donation should always be withheld until the results of the blood grouping and compatibility test have been obtained and blood components reserved for the individual patient on this basis.

Position of emergency blood:

The Blood Bank is responsible for having emergency blood stock available throughout the country.

There are four blood stations in Iceland, they store, distribute and perform compatibility tests for blood and blood components within the facilities. These blood stations are located in the local health centers in Akranes, Ísafjörður, Neskaupstaður and Vestmannaeyjum.

There are also two non testing stations. There blood components are only reserved for patients after a compatibility test has been performed in the Blood Bank in Reykjavík. Emergency blood is also stored at these stations. These stations are located in the hospitals in Sauðárkrókur and Reykjanesbær.

In these locations, approved blood cabinets are certified by and regularly supervised by the Blood Bank.

The blood bank provides blood for these stations and withdraws unused red cell concentrates before they expire. This procedure is necessary to ensure an adequate supply of red blood cell concentrate in rural areas, while minimising its disposal.

The Blood Bank also has a working unit at the Akureyri Hospital where emergency blood is stored.

Four different facilities within the National University Hospital

• 4 units in the Emergency Room Fossvogur

• 2 Units in Fossvogur

• 4 units at the Women's Hospital on Hringbraut.

• 6 units at a blood cabinet at the Intensive Care Unit in Hringbraut

Two non testing blood stations (at Healthcare Institutions)

• 4 units at the in Sauðárkrókur (north)

• 4 units at the in Reykjanesbær (south-west peninsula)

Four blood stations

• There are 4 units in Neskaupsstaður (east)

• There are 4 units in Ísafjörður (westfjords)

• There are 4 units in Vestmannaeyjar (south)

• There are 4 units in Akranes (west) Akranes also has an emergency stock of plasma.

Regional unit of the Blood Bank in the north

• 4 units Akureyri Hospital (with other facilities)

Units are also available in the Blood Bank in Reykjavík for the Coast Guard Medical Flights.

The package leaflet is attached to all blood components supplied by the Blood Bank. The leaflet contains the name and ID number of the patient, as well as the identification and product code of the blood component. Further instructions on the labelling of blood components:

The results of the compatibility test is also shown.

The package leaflet lists the validity period of reservation of the blood component for the patient.

The role of the package leaflet is to assist the person who uses the blood component in making sure that the component is intended for the right patient. The identification number on the leaflet must be the same as the identification number on the blood component. If a part of a blood component is electronically recorded in the Interinfo system, paperwork may be disposed of after the donation of a blood component.

Blood components reserved/transfused:

The first unit of each reservation is accompanied by an overview of the individual units on the transfusion recorder. It includes the number of units reserved for the patient in the reserved round and the duration of the reserved round. The identification numbers and product code of the units are also displayed.

This form has to be completed if the donation of blood components is not registered in the Blood Bank Interinfo system. This is to record the patient's transfusions. When transfusion is started, the person responsible for the transfusion sticks the tab of the unit in the designated field on the form and records the date of administration. When the transfusion is completed, the form should record whether the infusion caused an adverse reaction or not and should be signed off with initials. As such, each unit given should be marked and recorded. This form should be preserved in accordance with health records rules.

If a blood component is registered as transfused in Interinfo, the transfusion form does not need to be completed, and may be discarded at the end of the infusion.

Blood order leaflet:

• The first unit in each reservation is accompanied by a new blood order leaflet.

• Always use the latest ordering form, discard the older one.

• The blood order note contains the name and ID number of the patient, along with the blood group.

• It is important to fill in all the fields about the number of units to be ordered and the date of blood component transfusion. An illness and/or operation date should also be observed. The sampling date and the identity certificate for sampling must also be recorded.

• List the sender (division/institution), the recipient and the payer if different from the sender.

• Ensure that the blood order is prominently displayed in the patient file for increased safety in the collection of samples.