Reserve And Issue The Unit

The Issue Desk is where a matched unit of blood actually leaves the blood bank. You reserve a unit that has passed its crossmatch, then issue it: an electronically signed hand-out that records who collected the blood and when, so the cold chain has a named, time-stamped owner from the moment it leaves the fridge. For the worst emergencies there is a faster path that issues group-O Rh-negative units before a crossmatch is even finished — explicit, signed and fully audited.

A few terms first. FEFO means first-expiry, first-out — units closest to expiry are offered first, so nothing is wasted. O-negative is the universal red-cell donor group, safe to give when the recipient’s group is not yet known. MTP is the massive transfusion protocol, the rapid multi-unit response to catastrophic bleeding. An eSign PIN is your 6-digit electronic signature, separate from your login password.

Who / when: the lab scientist or blood bank officer at the Issue Desk, when a crossmatched request needs its units handed out — or when an emergency demands blood before crossmatching can finish.

We will follow Bayo, a blood bank officer issuing a unit for a ward request.

The main path

1. Lab Scientist / Blood Bank Officer — open Blood Bank → Issue Desk. The left panel, “Open Requests”, lists requests that can hold or issue units. Click the request you are fulfilling to open its issue panel on the right.
2. Lab Scientist / Blood Bank Officer — under “Compatible Units (FEFO)”, find the unit you want. A unit is only reservable when it carries a signed Compatible crossmatch — its “Crossmatch” pill reads “Compatible”. Press “Reserve” on that row. The unit moves from Available to Reserved and drops into “Reserved — Awaiting Issue” with a hold deadline.
3. Lab Scientist / Blood Bank Officer — in “Reserved — Awaiting Issue”, press “Issue” on the reservation. The “Issue Unit” dialog opens, naming the unit and its group.
4. Lab Scientist / Blood Bank Officer — in “Collected By (Porter / Nurse)”, search and pick the person taking the blood to the patient (a nurse, clinician or blood-bank scientist). Enter your 6-digit eSign PIN under “eSign PIN” — this signs the cold-chain checkout — and press “Sign & Issue”. The unit moves to “Issued” and appears in the “Issued” list with the collector, the checkout time and a “Signed” mark.

Note

A reservation can only be made against a signed Compatible crossmatch. If a candidate unit shows no crossmatch, or one that is incompatible or still unsigned, its “Reserve” button stays disabled — hover it and Veona tells you “A signed Compatible crossmatch is required.” Crossmatch and sign the unit first.

Tip

Each unit you sign and issue raises the bb.unit.issue charge against the recipient’s bill — one charge per issued unit, priced from your facility’s tariff and captured only because the issue is signed. The issue is the chargeable moment the blood product is handed out.

Caution

The eSign PIN on the issue is not a formality — it is the signature on the cold-chain record. Issuing without a valid 6-digit PIN is refused (“Enter your 6-digit eSign PIN to sign the checkout.”). The signed checkout is what lets a unit be traced, later, all the way from the donor to this recipient.

Other ways this goes

Emergency: uncrossmatched O-negative / MTP rapid issue

1. Lab Scientist / Blood Bank Officer — for an Emergency or Massive request, an “Emergency O− / MTP Issue” button is shown on the issue panel (it appears only for those urgencies). Press it to open “Emergency Uncrossmatched Issue”.
2. Lab Scientist / Blood Bank Officer — Veona warns that this issues group-O Rh-negative units without a completed crossmatch. Set “Units (MTP Round Size)”, type a mandatory “Override Reason” (for example massive haemorrhage, group unknown), enter your “eSign PIN”, and press “Sign & Issue O−”.
3. Lab Scientist / Blood Bank Officer — Veona rapid-issues that many FEFO O-negative units as an explicit, signed, audited override. A retrospective crossmatch must follow. Both the reason and the PIN are required — leave either out and the issue is refused.

Massive request flips MTP on and partially issues

1. Lab Scientist / Blood Bank Officer — when the request’s urgency is “Massive”, the emergency issue switches the massive transfusion protocol on for that request (it gains an “MTP” marker) and moves the request to “Partially Issued” as the rapid round goes out.
2. Lab Scientist / Blood Bank Officer — continue issuing rounds as the protocol demands; each issued unit is individually eSigned and charged.

A group-and-save request holds a sample — nothing issues yet

1. Lab Scientist / Blood Bank Officer — open a group-and-save request and the panel reads “This is a group-and-save request — a sample is held; no units are reserved until it is converted.” There are no candidate units to reserve.
2. Lab Scientist / Blood Bank Officer — the recipient’s tested sample is held ready. Only once the request is converted to an issuing request do candidate units appear, to be reserved and issued in the normal way.

No compatible units to reserve

1. Lab Scientist / Blood Bank Officer — if “Compatible Units (FEFO)” reads “No compatible Available units. Crossmatch a unit (and sign it out) to make it reservable.”, there is nothing yet carrying a signed-Compatible verdict for this recipient.
2. Lab Scientist / Blood Bank Officer — go to the Crossmatch bench, crossmatch a TTI-cleared candidate unit against the request and sign it Compatible, then come back to reserve and issue it.

What happens next

An issued unit is now in transit to the patient under a named collector and a signed cold-chain record. At the bedside it is given through a two-person identity check before the transfusion starts, and the recipient is watched for any reaction. Because every reservation and issue is recorded — and emergency overrides carry their reason and signature — the unit can later be traced vein-to-vein, from the donor through this issue to the patient who received it.

Follow the trail

• Previous: Crossmatch A Request Against A Unit
• Next: Run The Bedside Two-Person Check And Transfuse
• Related: Raise A Transfusion Request · Report A Transfusion Reaction (Haemovigilance) · Trace A Unit Vein-To-Vein (Lookback)