![Fenwal 4R5707 Скачать руководство пользователя страница 441](http://html.mh-extra.com/html/fenwal/4r5707/4r5707_operators-manual_553093441.webp)
07-19-01-518 – January 2009
Site: _________________ Fixed/Mobile Instrument Serial #: __________ Unit # ___________
A. DONOR INFORMATION/VITAL SIGNS
Donor’s Name: _____________________________
DOB: __________ Wt: ______ Ht: ______
Arm Used: R / L Pre Hct/Hgb:
Kit Code ______________
Kit Lot #_________________
PLASMA PRODUCT
(or) PLASMA PRODUCTS
Plasma
Product
Volume _______
Total
Plasma
Volume ______
Product A
Plasma
Volume ______
Anticoagulant
Volume _______
Anticoagulant
Volume ______
Product B
Plasma
Volume ______
Anticoagulant
Volume
Proc Start Time ____:____ Proc End Time ____:____
(hrs:min)
Volume
Flow Rate
Time Collected (mL) mL/min Draw/Return
Abs RBC
Total RBC
Volume _________mL Volume ______mL Processed
Saline Used
Filtration Data
Filtration Time ____:____ (min:sec)
Comments:_____________________________________________________________________
____________________________________________________________________________________
Operator’s Signature ______________________
Sample RBC/Plasma
Procedure Data Sheet
A
LYX
C
OMPONENT
C
OLLECTION
S
YSTEM
Date: _________________
A
LYX
RBC/Plasma Procedure
WORKSHEET
Site: _________________ Fixed/Mobile Instrument Serial #: __________ Unit # ___________
A. DONOR INFORMATION/VITAL SIGNS
Donor’s Name: _____________________________ SS# ____________________
DOB: __________ Wt: ______ Ht: ______
Sex: M /F
ABO/Rh: __________
Vital Signs: Temp
B/P
Pulse
B. DISPOSABLE INFORMATION
Kit Lot #_________________
Exp. Date: _______________
C. PRODUCT INFORMATION
(or) PLASMA PRODUCTS
RED CELL PRODUCT
Total
Plasma
Volume ______
RBC Product
Volume _________
Product A
Plasma
Volume ______
RBC Preservation
Solution Volume _________
Anticoagulant
Volume ______
Product B
Anticoagulant
Plasma
Volume ______
Volume _________
Anticoagulant
Volume ______
D. PROCEDURE INFORMATION
____:____ Proc End Time ____:____
Total Proc. Time __________ min.
hrs:min)
Flow Rate Cycle
Collected (mL) mL/min Draw/Return Comments/Alarms
D
R
D
R
D
R
D
R
D
R
Total RBC
Total Volume
Volume _________mL Volume ______mL Processed
_________mL
Anticoagulant Used
Filtration Time ____:____ (min:sec) Percent Post Leukoreduction Recovery ______
Comments:_____________________________________________________________________
____________________________________________________________________________________
_____________________________ Reviewer’s Signature____________
YSTEM
O
PERATOR
’
S
M
ANUAL
A
PPENDIX
A-13
Date: _________________
Site: _________________ Fixed/Mobile Instrument Serial #: __________ Unit # ___________
Exp. Date: _______________
RED CELL PRODUCT
Volume _________
Solution Volume _________
Volume _________
__________ min.
VP Staff
Check Initials
S
U
S
U
S
U
S
U
S
U
_________mL
Post Leukoreduction Recovery ______%
Comments:____________________________________________________________________________________
_____________________________________________________________________________________________
_ Reviewer’s Signature_____________________________
Содержание 4R5707
Страница 2: ......