Completing the Request Form/Electronic Request and Sample Labelling

It is essential that the request form (PCO2) is written clearly and contains the following information

  • First name
  • Surname
  • Medical record number (MRN)
  • Date of birth (if available)
  • Gender

(Please note the patient’s addressograph label can be used for the above information).
The request form should also include:

  • Name/signature and bleep number of the person making the request
  • Location of the patient
  • The blood component required/test required
  • The number of units required
  • Date and time blood component is required for
  • Patients consultant
  • Clinical details (pre op is insufficient). Pre procedure is sufficient reason when ordering non red cell products on the EPR.  For instructions on using E.P.R. see PARIS / EPR System – Quick Reference Guide at Publications / Manuals on the St James’s Intranet
  • Transfusion history
  • Obstetric history
  • Special product request  eg. CMV negative or irradiated

The Sample must be labelled as follows

  • Details must be hand written and signed
  • Sample tubes must not be pre labelled.
  • Addressograph labels must not be on the sample / Safetrack labels are acceptable

After the blood is taken the sample must be labelled with the following information taken from the patient’s identity band.

  • Surname
  • Forename
  • Hospital number
  • Date of birth
  • Signature of person taking the sample.

Should also contain:

  • Location
  • Gender
  • Date and Time (sample taken)

Please note: -

  • Information on patient’s identity band, request form, and sample must be identical – No abbreviations to be used.
  • All writing on sample must be clear and legible.
  • Samples not meeting these minimum requirements will not be accepted.  
  • Please do not label samples with fine/felt tip pens, as these tend to smudge. 
  • Addressograph labels are acceptable on the request form but not on sample.
  • Requests for products other than red cells must be completed on the EPR before processing