Epic Build / Desired Build Test Compendium
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Prepare Plasma Epic Compendium  

▶ Desired Epic Build * = editable field  

Actual Epic Build 12/05/2025

PROCEDURE ID 8052
PDM 236203
ORDER DISPLAY NAME Prepare Plasma
PROCEDURE NAME PREPARE PLASMA
PROCEDURE MASTER NUMBER LAB487
SHORT PROCEDURE NAME PREP PLAS
CATEGORY CODE 3.0
CATEGORY CODE RECORD NAME BLOOD BANK PRODUCT ORDERABLES
SYNONYMS FFP
PLASMA
BLOOD
PRODUCT
TRANSFUSE
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?OR=Teams-HL&CT=1704998429160&clickparams=eyJBcHBOYW1lIjoiVGVhbXMtRGVza3RvcCIsIkFwcFZlcnNpb24iOiI0OS8yMzExMzAyODcyMCIsIkhhc0ZlZGVyYXRlZFVzZXIiOmZhbHNlfQ%3D%3D
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
OP LAB TEST COMPONENTS FOR REPORT
ORDER QUESTIONS ["3045300161", "3040000019", "3040000030", "3045300104", "3045300060"]
ORDER QUESTIONS RECORD NAME NH IP BLOOD BANK SPECIAL REQ PLASMA
NH IP BLOOD BANK PLASMA TRANSFUSION INDICATIONS
INPATIENT ORDER QUESTIONS ["3045300161", "3040000019", "3040000030", "3045300104", "3045300060"]
INPATIENT ORDER QUESTIONS RECORD NAME NH IP BLOOD BANK SPECIAL REQ PLASMA
NH IP BLOOD BANK PLASMA 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
3040000019 NH IP BLOOD BANK PLASMA TRANSFUSION INDICATIONS Transfusion indications Custom List INR >= 1.5 Neurosurgical Patients (in the absence of warfarin)
INR >= 2.0 surgery or invasive procedure (in the absence of warfarin)
Active Bleeding with suspected coagulopathy (in the absence of warfarin)
Therapeutic plasma exchange
Therapy of thrombotic thrombocytopenic purpura (TTP)
CONVALESCENT PLASMA for the treatment of hospitalized patients with Coronavirus Disease 2019 (COVID-19)
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
3045300161 NH IP BLOOD BANK SPECIAL REQ PLASMA Special Requirements Custom List IgA Deficient
COVID-19 Convalescent		 No
EPIC IP AOEs

Question IDQuestion NameQuestionResponse TypeResponse ListRequire Response
3040000019 NH IP BLOOD BANK PLASMA TRANSFUSION INDICATIONS Transfusion indications Custom List INR >= 1.5 Neurosurgical Patients (in the absence of warfarin)
INR >= 2.0 surgery or invasive procedure (in the absence of warfarin)
Active Bleeding with suspected coagulopathy (in the absence of warfarin)
Therapeutic plasma exchange
Therapy of thrombotic thrombocytopenic purpura (TTP)
CONVALESCENT PLASMA for the treatment of hospitalized patients with Coronavirus Disease 2019 (COVID-19)
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
3045300161 NH IP BLOOD BANK SPECIAL REQ PLASMA Special Requirements Custom List IgA Deficient
COVID-19 Convalescent		 No
EPIC Components (results - crosswalked through Cerner)