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Prepare Plasma

Desired Epic Build * = editable field  

PDM 236203
Informatics - WorkgroupBlood Bank
Synonyms *FFP
PLASMA
BLOOD
PRODUCT
TRANSFUSE
Display Name *Prepare Plasma
Specimen Sources (combined Order Entry and Specimen Navigator) *
Specimen Types (combined Order Entry and Specimen Navigator) *
Product Order
Body Fluids (types sent through AOEs)
Specimen Navigator Specimen Types
Specimen Navigator Specimen Sources
Specimen Navigator Short NamePLASMA
Ordering info (EPIC SmartText)
IP Orderable (inpatient) Yes
OP Orderable (outpatient) Yes
AOEs *

AP AOEs

    
Special History No 
 
    
Build Comments

    
Filter *

    
    
Cerner Site RestrictForest Hills Hospital Laboratory
Glen Cove Hospital Laboratory
Huntington Hospital Laboratory
LIJ Valley Stream Hospital Laboratory
Lenox Hill Laboratory
Long Island Jewish Med Ctr

Mather Hospital Laboratory
North Shore University Laboratory
Northern Westchester Hospital Labs
Northwell Health Laboratories
Peconic Bay Medical Center Laboratory
Phelps Memorial Hospital Labs
Plainview Hospital Laboratory
SIUH North Laboratory
SIUH Prince’s Bay Division Laboratory
SSUH Laboratory
Syosset Hospital Laboratory

    
Cerner Results


            


     





    Actual Epic Build 3/11/2025
    






                

        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		
                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		
                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)