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Hours of Operation
Special Collections Scheduling Office Hours of Operation are
Monday through Friday, 8:30 AM to 4:30 PM
Special Collections Scheduling Office Telephone -
757- 446- 7792
Fax 757- 446- 7711
Special
Collection Order
Form |
Autologous
Collection Sites
Tidewater location:
Hampton Chapter American Red Cross
Virginia Beach Chapter American Red Cross
Norfolk Chapter American Red Cross
Sentara Leigh Hospital
MaryView Medical Center
Louise Obici Memorial Hospital
Rappahannock General Hospital
Southampton Memorial Hospital
Southside Regional Hospital
RiversideTappahannock Hospital
Riverside Walter Reed Hospital
Williamsburg Chapter American Red Cross
Jennings Center
Autologous Collection Site
North Carolina location:
Greenville Center American Red Cross
Albemarle Hospital
Carteret General Hospital
Craven Regional Medical Authority
Duplin General Hospital
Lenoir Memorial Hospital
Nash General Hospital
Roanoke-Chowan Hospital
Autologous Collection Site
Charlottesville location:
Charlottesville Chapter American Red Cross
Fredericksburg Chapter American Red Cross
Culpepper Regional Hospital
Fauquier Hospital
All directed donations are scheduled to be collected at American
Red Cross Fixed Site locations only (need connection to fixed
site locations, addresses and hours of operations).
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| General
Eligibility Criteria for Autologous Donations |
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Medical history of Autologous Donors is often compromised and complex
requiring individualized evaluation prior to autologous collection.
As autologous blood is only used in autologous setting (cross-over
to homologous pool does not occur) eligibility criteria is not as
stringent as that for allogeneic donors and causes for deferral
are based primarily on donation safety criteria instead of recipient
safety criteria. In general autologous donors must be in stable
condition on day of donation, without any sign of infection (elevated
temperature or initiation of antibiotic treatment) in previous 3
days, hematocrit greater than 32%, and an interval of at least 72
hours from previous donation and prior to surgery date. The following
conditions would preclude eligibility for autologous donation:
- Angina occurring at rest or with increasing frequency
- Congestive heart failure, uncontrolled, with shortness of breath
- Cyanotic Heart Disease
- History of bood disease (Hemophilia, ITP, TTP)
- Unstable diabetes
Special Collections Scheduling Center
Phone: (757) 446-7792
(800) 240-8169
Fax: (757) 446-7711
AUTOLOGOUS:
ORDERING AND SCHEDULING INFORMATION
1. The Special
Collection Order must be completed and signed by the ordering
physician prior to scheduling an autologous donation. Physician
or designee MUST complete sections A, B, and C. If the ordering
physician is unable to complete Section C: Autologous Preassessment,
the name and telephone number of the responsible physician must
be given.
2. A
Patient
Information Card should be given to the patient by ordering
physician when the pre-operative autologous donation is ordered.
3. Medical
Clearance is required for all patients with cardiac/cardiovascular
disease. When applicable, please complete cardiologist/primary physician
information.
4. The
physician's office is requested to fax the Special Collection Order
for
autologous donations to the American Red Cross, Mid-Atlantic Region.
The fax number is (757) 446-7711. We recommend that you allow three
(3) weeks for your order to be processed and the patient's blood
to be collected, tested, and delivered to the hospital.
5. Upon
receipt of the faxed order, the Special Collections Scheduling Staff
will log in the name of the patient, surgery date, physician, number
of units ordered, and the transfusion facility.
6. The
staff will review the order to make sure all vital information is
correct and completed. If at this time there is a question, more
information is needed, or there is a problem with the order, the
physician's office will be contacted and asked to fax a new completed
and correct order, prior to scheduling a patient for donation.
7. The
staff will prioritize the orders to allow all units to be collected
no later than 5 working days prior to surgery. The units are prioritized
according to:
a) Number of units ordered
b) Surgery date
c) Type of blood component ordered
8. If,
as ordering physician, you have special instructions that need to
be considered (i.e. completion of autologous donations two weeks
prior to surgery date, etc.) please note those instructions in Section
C: COMMENTS: on the Special Collection Order form.
9. The staff will contact the patient and review their medical
history to determine donor eligibility. If the patient is eligible
to donate the donations are scheduled. If donation criteria are
not met the ARC Medical Director will be notified. He will make
a determination whether or not to collect the autologous unit using
National American Red Cross Blood Service Directives, National guidelines
and speaking with the patient's physician if necessary.
10. If
the ARC is unable to collect the autologous blood or the total number
of units ordered for any reason, the ordering physician and transfusion
service will be notified.
11. After
the first unit is collected a copy of the Special Collection Order
form and insurance form is faxed to the receiving transfusion facility.
This assures the transfusion facility receipt of a correct order
and the patient has met the medical criteria and is able to donate.
Special Collections
Scheduling Center
Phone: (757) 446-7792
(800) 240-8169
Fax: (757) 446-7711
DIRECTED
DONATIONS: ORDERING AND SCHEDULING INFORMATION
For Virginia
1. The Special Collection
Order must be completed and signed by the ordering physician
prior to scheduling a directed donation. Physician or designee MUST
complete sections A and B.
2. Directed
donors must be recruited by the patient or patient representative,
and a list of the recruited directed donors must be provided to
the American Red Cross Special Collections Scheduling Department
on the Special Collection Order form. Only donors from this list
will be scheduled for directed donation.
3. It is the
patient or patient representative's responsibility to ensure that
only ABO compatible donors are recruited.
4. If directed
donor is donating prior to required 56 day interval from previous
donation the following policies apply:
- A written
order from the intended recipient's physician indicating the need
for the specific donor's blood.
- The donor
must be examined by a physician on the day of donation and certified
in writing to be in good health.
- The donation
must be approved by American Red Cross physician.
- The donor
must meet all allogeneic criteria except the 56-day interval.
- The donor
must wait at least three (3) days between donations when a full
unit is drawn.
5. If the patient
is being treated at Children's Hospital of The King's Daughters
in Norfolk, Virginia and needs directed donor blood, please contact
the Transfusion Services department at Children's Hospital of The
King's Daughters before ordering directed donations for your patient.
Special Collections Scheduling Center
Phone: (757) 446-7792
(800) 240-8169
Fax: (757) 446-7711
DIRECTED
DONATIONS: ORDERING AND SCHEDULING INFORMATION
For North Carolina
1. The Special
Collection Order must be completed and signed by the ordering
physician prior to scheduling a directed donation. Physician or
designee MUST complete sections A and B.
2. Directed
donors must be recruited by the patient or patient representative,
and a list of the recruited directed donors must be provided to
the American Red Cross Special Collections Scheduling Department
on the Special Collection Order form. Only donors from this list
will be scheduled for directed donation.
3. It is the
patient or patient representative's responsibility to ensure that
only ABO compatible donors are recruited.
4. If directed
donor is donating prior to required 56 day interval from previous
donation the following policies apply:
- A written
order from the intended recipient's physician indicating the need
for the specific donor's blood.
- The donor
must be examined by a physician on the day of donation and certified
in writing to be in good health.
- The donation
must be approved by American Red Cross physician.
- The donor
must meet all allogeneic criteria except the 56-day interval.
- The donor
must wait at least three (3) days between donations when a full
unit is drawn.
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