Manitoba Transfusion Best Practice Resource Manual
Appendices
- 1. Informed consent (general) form Sample A
- 2. Informed consent form documenting (specific) reason for consent Sample B
- 3. Frequently Asked Questions Regarding Informed Consent
- 4. Proper labeled specimen
- 5. ABO 2 Sample
- 6. Visual Inspection Guide
- 7. Cumulative Blood Product Record Completion Guide
- 8. Record of Transfusion
- 9. Record of Transfusion Emergency Component
- 10. Transfusion Reaction Algorithm
- 11. Transfusion Reaction Quick Reference Guide
- 12. Blood Warming Devices
- 13. Patient Resources
- 14. Log Book Receipt of Blood Sample
- 15. Blood Out of Fridge Shared Health Policy
- 16. Blood Product Transport Training Shared Service Policy
Shared Health Forms
| Shared Health Customer Feedback Form | Form F160-INV-23 |
| Equipment Malfunction & Corrective Action Record | F160-QC FORM 15 |
| Inter-facility Shipping of Blood, Blood Components and Derivatives | F160-INV-18 F160-INV-18A F160-INV-18B F160-INV-18C |
| Daily Temperature and Weekly/Monthly Maintenance Record: Fridge QC Forms | F160-QCFORM-08 F160-QCForm-09 |
| Daily Temperature and Weekly/Monthly Maintenance record: Freezer QC Forms | F160-QCFORM-06 F160-QCFORM-07 |
| Daily Temperature and Weekly/Monthly Maintenance Record: Platelet Incubator | F160-QCFORM-11 |
| Alarm System Check: Blood, Blood Component and Derivative Storage Equipment | 160-QC-14 |
| Alarm Response/Malfunction: Blood, Blood Component and Derivative Storage Equipment | 160-QC-13 F160-QCFORM-15 |
| Storage Equipment Standards: Blood, Blood Components and Derivatives | 160-QC-02 |
| Transport of Blood, Blood Components and Derivatives (Within a Facility) | 160-INV-17 |
| Issuing, Returning and Documenting the Final Disposition of Blood, Blood Components and Derivatives | 160-INV-14 160-INV-16 160-INV-19 |
| Receiving Blood, Blood Components and Derivatives | 160-INV-07 |
| Visual Inspection of Blood, Blood Components and Derivatives (When Performing Blood Bank Duties) | 160INV-12 |
| Emergency Issue of Donor Red Cell Units (Non Crossmatch Facilities) | 160-MP-20 |
| Job Aid, Obtaining Plasma Protein Products in PMH NOTE: for PMH Region | JA160-28INV-14C |
| Job Aid, Obtaining Crossmatched Units for Blood Banks in PMH NOTE: for PMH Region | JA160-28INV-14B |