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In the case I described above; the patient was retrospectively registered and the units issued and billed to them. My understanding was the hospitals, ambulance and police all had good communication, cooperation and shared all the information to treat the patient efficiently in unusual circumstances.

Sorry to hear this. My condolences.

So sorry to hear this. My condolences.

Unless things have changed, I would consider the length of time from issue to completion of the transfusion more important than the time from issue to start. I'm assuming that a unit still has to have the transfusion completed within 4 hours. As for start time, that was initially instituted for returned units to be placed back in the refrigerator for reissue and as stated above 30 minutes is way too long. The 30 minute rule was instituted when blood was issued as whole blood in glass bottles and I doubt in anyone currently following this website ever saw that, me included! Time to drag a few nursing protocols into the 21st century!

I hate to be the mercenary here but who's going to pay for it?? Probably going to be one of those "cost of doing business" things.

Welcome

I am so sorry to hear this

We have the Ortho Vision which interfaces to our LIS, Cerner. Pretty reliable overall and only 1-2 service calls per year. We run type and screens, Cord bloods, Unit Confirmations, and Panels. We do see a few ? reactions every day where my staff are allowed to view the gel card and edit grades based on their eye view.

Welcome to this wonderful site LindsayLajiness.

Thanks for the update, and very sorry to hear this.

It is with enormous sadness that I have to tell you that, having just arrived back from a short break, I have been informed of the death of Prof. Dave Anstee - one of the greats of the world of Blood Transfusion and Blood Group Serology. I am devastated.

If you set a time, such as less than 30 minutes, and they start the transfusion at 30 minutes, you can be cited by Joint Commission or FDA if they do a trace of that unit - unless there is a deviation from policy report on file. The 30 minute start time may be in the nursing policy, but when a tracer is performed, the deviation will fall back on the transfusion service to correct. Although we did ask that the nurses do the preparation before picking up the unit, there would be a phone call saying the start of the transfusion was delayed for some reason. (IV infiltrated while picking up blood is one I remember). When we started taking temperatures of returned units, we learned they were usually only acceptable to be returned for 15-20 minutes, depending on how they were handled after leaving the Blood Bank. After much debate, we changed the policy to start the transfusion as soon as possible with the emphasis on completing the transfusion within four hours of leaving the Blood Bank. We did require them to return the unit to the Blood Bank immediately if, for some reason, the transfusion were cancelled.

Hello LindsayLajiness, Welcome to PathLabTalk. Please feel free to browse around and get to know the others. If you have any questions, please don't hesitate to ask. LindsayLajiness joined on the 10/21/2021. View Member

Hi Justine, We switched from the Safe-T-Vues a few years ago for the same reasons. We use the Blood Temp 10s in our coolers (we validated for transport not storage) now. They are great and easy to validate with the coolers. The only thing is you have to make sure to place the indicator in the middle of the bag (on the back) and not the top or bottom because it can activate if there's no enough blood under the indicator. We've had problems with our washed RBC units and small volumes in transfer bags if they're not folded properly before going into the cooler. But I can't imagine having the same problem with whole blood. You can also get a temperature monitored cooler from MaxQ (they come pre-validated) https://www.packmaxq.com/ The Max Plus Alpha 2.0 has continuous temperature monitoring but I think it's only good for 24 hours. There may be other continuously monitored coolers out there we just use the MaxQ coolers so I have experience.

In this scenario, we would do as Ensis01 stated as long as the blood was not transfused in route. If it was transfused, you may have difficulty getting the receiving hospital to accept this. Then I believe you would have to have the patient registered, even if just as a John Doe, and perform an emergency issue in Meditech.

I have seen something similar once; if I remember correctly the BB kept track of the patient to confirm which hospital they went to, ensured the paperwork went to to our registration, who registered the patient and the BB then issued the uncrossmatched RBCs in the LIS. I do not believe there was a deviation as you have documented orders from an ER doc for uncrossmatched RBCs.

Hello, I am working in a small town hospital. I want to ask your opinion about this scenario. Patient stay in the ambulance and took by airmed. ER doc, requested blood and took by Airmed personnel. All documentation in paper, blood charges in paper. Patient not registered that day and no visit number .Is this accepted? or its a deviation? We are using Meditech in our facility but for this case patient has no registration number. appreciate all your response

We use started within 15 minutes of release. Our experience is that after 15 minutes, rbc temps are too high to return to inventory. We do the same as far as if Nursing wants to return but will continue the infusion as soon as they fix "whatever",i.e., keep the unit on the floor.

That is not unique to north of the border

Both our vendors are collecting either LVDS (large volume delayed sampling) apheresis platelets or Pathogen Reduced or both so we aren't implementing the Verax testing. We do, however, accept <3E11 platelets (low volume) LVDS if there's no other option. Implementing the Verax testing would be really complicated because 80-90% of our platelets are split at least once due to the size of our patients/children.

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We used to have sign in our BB: The Buck Stops Here. Of course someone altered the posters to "The Buick stops here". My boss was pissed off about that. The concept being that if you have a system of multiple checks and balances you better make sure the first one works. I have seen this concept evidenced too many times in my career. People get complacent.

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Clinical Aspects of Transfusion Reactions Clinical Aspects of Transfusion Reactions This question was submitted by forum member, Malcolm Needs. Any errors are those of the site admin, not Malcolm. Clinical Aspects of Transfusion Reactions.pptx Submitter Cliff Category BloodBankTalk Submitted 10/18/2021