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