Epic Build / Desired Build Test Compendium
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Prepare Platelet Pheresis Leukoreduced Epic Compendium  

▶ Desired Epic Build * = editable field  

Actual Epic Build 12/05/2025

PROCEDURE ID 58661
PDM 236205
ORDER DISPLAY NAME Prepare Platelet Pheresis Leukoreduced
PROCEDURE NAME PREPARE PLATELET PHERESIS LEUKOREDUCED
PROCEDURE MASTER NUMBER LAB1720
SHORT PROCEDURE NAME PREPARE PLAT
CATEGORY CODE 3.0
CATEGORY CODE RECORD NAME BLOOD BANK PRODUCT ORDERABLES
SYNONYMS BLOOD
PRODUCT
TRANSFUSE
PLT
CLINICALLY ACTIVE Yes
ORDERABLE Yes
PERFORMABLE Yes
FILTER GENOMICS
REFERENCE LINK URL https://northwell.sharepoint.com/sites/NWHPolicies/Sys-Lab/(12)%20SLS.705%20-%20Northwell%20Health%20System%20Transfusion%20Guidelines%20Policy%20-%207.23%20Prov%20Final.pdf
ORDERING INSTRUCTIONS
DEFAULT SPECIMEN TYPE Product Order
SPECIMEN TYPE PICK LIST Product Order
SPECIMEN TYPE LIST
OP SPECIMEN TYPE LIST
SPECIMEN SOURCE PICK LIST Blood, Arterial
Blood, Capillary
Blood, Central Line
Blood, Venous
SPECIMEN SOURCE DEFAULT - MALE Blood, Venous
SPECIMEN SOURCE DEFAULT - FEMALE Blood, Venous
SPECIMEN SOURCE LIST
OP SPECIMEN SOURCE LIST
IP LAB TEST COMPONENTS FOR REPORT PLT:4:7
OP LAB TEST COMPONENTS FOR REPORT PLT:4:7
ORDER QUESTIONS ["3045300162", "3040000017", "3040000030", "3045300104", "3045300060"]
ORDER QUESTIONS RECORD NAME NH IP BLOOD BANK SPECIAL REQ PLATELET
NH IP BLOOD BANK PLATELETS TRANSFUSION INDICATIONS
INPATIENT ORDER QUESTIONS ["3045300162", "3040000017", "3040000030", "3045300104", "3045300060"]
INPATIENT ORDER QUESTIONS RECORD NAME NH IP BLOOD BANK SPECIAL REQ PLATELET
NH IP BLOOD BANK PLATELETS TRANSFUSION INDICATIONS
ORDER SPECIFIC QUESTION OVERRIDE
INPATIENT QUESTION OVERRIDE
LOCATION RESTRICT LIST IP
LOCATION RESTRICT LIST IP RECORD NAME
LOCATION RESTRICT LIST INCLUDE IP
LOCATION RESTRICT LIST OP
LOCATION RESTRICT LIST OP RECORD NAME
LOCATION RESTRICT LIST INCLUDES OP
EDP AMB ORDER SPECIFIC QUESTIONS RECORD NAME NH IP BLOOD BANK TRANSFUSION DURATION PER UNIT
NH IP BLOOD BANK UNIT SPECIAL INSTRUCTIONS
NH IP BLOOD BANK PROVIDER CONTACT
EDP IP ORDER SPECIFIC QUESTIONS RECORD NAME NH IP BLOOD BANK TRANSFUSION DURATION PER UNIT
NH IP BLOOD BANK UNIT SPECIAL INSTRUCTIONS
NH IP BLOOD BANK PROVIDER CONTACT
EDP IP SPECIMEN SOURCE
EDP OP SPECIMEN SOURCE
EDP IP SPECIMEN TYPE
EDP OP SPECIMEN TYPE Blood
Blood, Arterial
DERIVED EDP IP BUTTONS S
DERIVED EDP IP BUTTONS T
DERIVED EDP OP BUTTONS S
DERIVED EDP OP BUTTONS T
IP ORDERABLE
OP ORDERABLE
STANDARD LAB COMPONENTS
STANDARD LAB COMPONENTS RECORD NAME
COMPONENT DATA REQUIREMENT
EPIC OP AOEs

Question IDQuestion NameQuestionResponse TypeResponse ListRequire Response
3040000017 NH IP BLOOD BANK PLATELETS TRANSFUSION INDICATIONS Transfusion indications Custom List Platelet count < 10,000/µL prophylactic and not due to ITP, TTP, HIT or post transfusion purpura
Platelet count < 20,000/µL prior to central venous catheter placement
Platelet count < 20,000/µL minor bleeding (epistaxis, oral mucosal bleeding, etc.)
Platelet count < 20,000/µL outpatients; or upon discharge in patients who are platelet transfusion dependent
Platelet count < 50,000/µL with active hemorrhage
Platelet count < 50,000/µL undergoing invasive procedure within the next 4 hours (e.g., surgery, lumbar spinal procedure, etc.)
Platelet count < 50,000/µL on anticoagulation
Platelet count < 50,000/µL on extracorporeal membrane oxygenation
Platelet count < 100,000/µL with active hemorrhage on extracorporeal membrane oxygenation or post cardiopulmonary bypass
Platelet count < 100,000/µL intracranial hemorrhage, neurosurgical procedure, ophthalmic surgical procedures
Active hemorrhage with dysfunctional platelets (e.g., medication, disease-related)
Other		 Yes
3040000030 NH IP BLOOD BANK TRANSFUSION DURATION PER UNIT Transfusion Duration per Unit Custom List As Fast As Possible
30 Minutes
1 Hour
1.5 Hours
2 Hours
2.5 Hours
3 Hours
3.5 Hours
4 Hours		 Yes
3045300060 NH IP BLOOD BANK PROVIDER CONTACT Ordering Provider's Pager/Contact # Free Text No
3045300104 NH IP BLOOD BANK UNIT SPECIAL INSTRUCTIONS Unit Special Instructions Free Text No
3045300162 NH IP BLOOD BANK SPECIAL REQ PLATELET Special Requirements Custom List Irradiated
CMV Negative
HLA Match
Washed
Designated		 No
EPIC IP AOEs

Question IDQuestion NameQuestionResponse TypeResponse ListRequire Response
3040000017 NH IP BLOOD BANK PLATELETS TRANSFUSION INDICATIONS Transfusion indications Custom List Platelet count < 10,000/µL prophylactic and not due to ITP, TTP, HIT or post transfusion purpura
Platelet count < 20,000/µL prior to central venous catheter placement
Platelet count < 20,000/µL minor bleeding (epistaxis, oral mucosal bleeding, etc.)
Platelet count < 20,000/µL outpatients; or upon discharge in patients who are platelet transfusion dependent
Platelet count < 50,000/µL with active hemorrhage
Platelet count < 50,000/µL undergoing invasive procedure within the next 4 hours (e.g., surgery, lumbar spinal procedure, etc.)
Platelet count < 50,000/µL on anticoagulation
Platelet count < 50,000/µL on extracorporeal membrane oxygenation
Platelet count < 100,000/µL with active hemorrhage on extracorporeal membrane oxygenation or post cardiopulmonary bypass
Platelet count < 100,000/µL intracranial hemorrhage, neurosurgical procedure, ophthalmic surgical procedures
Active hemorrhage with dysfunctional platelets (e.g., medication, disease-related)
Other		 Yes
3040000030 NH IP BLOOD BANK TRANSFUSION DURATION PER UNIT Transfusion Duration per Unit Custom List As Fast As Possible
30 Minutes
1 Hour
1.5 Hours
2 Hours
2.5 Hours
3 Hours
3.5 Hours
4 Hours		 Yes
3045300060 NH IP BLOOD BANK PROVIDER CONTACT Ordering Provider's Pager/Contact # Free Text No
3045300104 NH IP BLOOD BANK UNIT SPECIAL INSTRUCTIONS Unit Special Instructions Free Text No
3045300162 NH IP BLOOD BANK SPECIAL REQ PLATELET Special Requirements Custom List Irradiated
CMV Negative
HLA Match
Washed
Designated		 No
EPIC Components (results - crosswalked through Cerner)