Most of the transfusions were requested by junior (26%) or senior (46%) residents.
Goodnough helped implement a program that uses the hospital's electronic medical record system to alert clinicians to blood-use guidelines and relevant medical literature whenever they request a transfusion.
Roosevelt also uses green bracelets, to mean "no blood transfusions," usually at the request of a patient with religious beliefs that conflict with transfusions.
Among 653 patients for whom blood was requested for transfusion, only one failed to receive a transfusion, three received fewer than the prescribed units, and 29 experienced some delay before the start of transfusion because of blood availability.
Physicians requesting the transfusion were then asked to identify the most important reason for the administration of red cells from a list of nine possible choices: age, disease severity, acute bleeding or ongoing blood loss, haemodynamic instability, severe hypoxaemia, improvement in wound healing and well being, augmentation of O2 delivery, coronary ischaemia, and others.
Each bedside questionnaire was administered within 24 h of the request for a transfusion.
Physicians who wrote transfusion orders were asked if they initiated the request or if another physician requested the administration of red cells.
Fuentes allegedly helped sneak a bag of blood into the hotel where, at Hamilton's request, the team doctor oversaw the transfusion.
A pre-alert should be delivered to the receiving major trauma centre with a request for activation of their massive transfusion policy if deemed necessary.
First, patients admitted to one of six Canadian tertiary level intensive care units (ICUs) during 1993 were enrolled in a combined retrospective and prospective cohort study and, second, a bedside questionnaire was completed by physicians requesting blood transfusions during the prospective phase of the cohort study.
