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I thoroughly enjoyed both of your presentations, Malcolm! and it was nice to meet Dr. Pepper in person! Cheers to the blood bankers of the world.

Back in the olden days when I worked in a hospital transfusion service, we allowed pre-printed labels, but the date and time of collection and ID of collector needed to be hand written. One of the unfortunate issues with computer generated labels is the amount of real estate allowed for patient names. With some names, especially hyphenated names, either the last name or the first name gets truncated and that can be an ID problem.

Lady is at low risk bleeding at delivery so plan is to transfuse ABO and D and Rh compatible in case of emergency with methylprednisolone or if she is stable but need blood than frozen unit can be obtained.

I agree with the above post. Case in point: We had someone call for emergency release blood and then someone came to get emergency release for a different patient. Thinking it was the patient they had called about, the tech issued the blood. It gets worse (nobody died) but suffice it to say that this went to risk management and the results were not pretty for the employees! A few days later, the nurse got upset because a different tech would not give her any emergency release blood without a name and DOB. They want it both ways! This final case was dropped as the tech was correct.

We go with 4 hours from the time they spike the bag.

The Circular of Information for the use of Human Blood and Blood Components has information regarding transfusion within 4 hours. Here is an excerpt: "Transfusion should be started before component expiration and completed within 4 hours." And another, "The initial portion of each unit transfused should be infused cautiously and with sufficient observation to detect onset of acute reactions. Thereafter, the rate of infusion can be more rapid, as tolerated by the patient’s circulatory system. It is undesirable for components that contain red cells to remain at room temperature longer than 4 hours. If the anticipated infusion rate must be so slow that the entire unit cannot be infused within 4 hours, it is appropriate to order smaller aliquots for transfusion."

Thank you Dianna, and it was great to meet so many PathLabTalk people - and put faces to names!

4 hours from issue in BB LISS. As the BB generally assumes audit responsibility it removes ambiguity.

Hi Cliff We count 4 hours from the time it's out of controlled temperature. If you pack your unit in controlled transport box than time start from it opened the box. It's worth looking JPAC guidelines

Hi Cliff. We do 4 hours from the time the unit leaves the blood bank. We use a electronic time stamp to document this time on the blood administration tag that is attached to the unit. We teach the nurses that they have 4 hours from this time to complete the transfusion. This does not apply if we send products in a cooler.

In my opinion, "unique" does not equal "independent". We used to require handwritten blood bank tubes but switched to allow computer generated specimen labels. The impetus for this change was the acquisition of hand-held phlebotomy scanners which printed the labels at the bedside after scanning the patient's wristband, however we had surgery personnel begging us to allow pre-printed labels for years because they cannot generally access the patient's wristband once the procedure has started and they often misspelled, copied, and omitted information. Additionally, some people's handwriting is atrocious! We have so many fewer headaches now that we made this change!

https://www.fda.gov/downloads/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Blood/UCM425952.pdf This is in Draft status, but should be finalized this year. Once finalized, FDA will give 2 years for implementation. Transfusion services should not be mandated to make changes until some time in 2019 or later. There are some misstatements in some previous posts that should be clarified. PAS apheresis platelets can be stored up to 5 days and must have a "safety measure" test within 24 hours of transfusion if transfused on Day 4 or 5. The use of platelet additive solution does not confer any protection against bacterial proliferation. Plasma-stored apheresis platelets can be stored up to 7 days and must have a "safety measure" test within 24 hours of transfusion if transfused on Day 4, 5, 6, or 7. Pathogen reduced apheresis platelets can be stored up to 5 days and can be transfused up until expiration without additional testing.

Found early mornings and evenings are best. A martini in hand doesn't hurt either.