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I would ditto this, and add that after a certain amount of time (I don't recall how long), the unit electronically will move from "issued" status to "presumed transfused" status. So in our system, "issue" is the time of time stamp and sending it out of the Blood Bank. Whenever the care team wants to spike it is their problem.

I would suggest considering "issue" as the time the product is out of controlled temperature.

I must respectfully disagree with Malcolm (a rare occurrence). In my transfusion service we documented the time of issue as the time the blood product left the blood bank and became the responsibility of the nursing service. Maybe this is one of those things where we have 2 countries separated by a common language. From Merriam-Webster Definition of issue (Entry 2 of 2) transitive verb 1a: to put forth or distribute usually officiallygovernment issued a new airmail stampissue orders b: to send out for sale or circulation : PUBLISH cBritish : PROVIDE sense 1a, SUPPLY

We didn't have very good luck with our Igloo coolers holding temp. so we always used plenty of wet ice. Could have been the specific cooler type that was the problem, however. Our current coolers are Credo and they use cooler inserts (with different liquids inside) that are specific for the temp maintained. The inserts for red cells are conditioned in the refrigerator. The inserts for platelets are conditioned at 22C. As long as someone doesn't leave the lids of the coolers open and remove the tops of the inserts, they will hold temp for 8 hours easily. (When I validate them I let the data logger run for 24 hours and they are all still holding temps at the end of that time.)

If the total inventory is only 6 units at a rural hospital, I would stock 4 O Pos and 2 O Neg. I'm not suggesting every hospital should stock only 'O'!

I would probably switch my inventory to stock only 'O'.

NedB, My understanding is that the reason you do more than one calibration set is because of the difference in VISCOSITY of the reagents - Albumin (22%) is significantly different in viscosity from saline, therefore if you use albumin or high protein anti-D, then you DO need to do an albumin calibration. But LISS is not significantly different in viscosity from saline, and therefore wouldn't need it's own calibration. PeG is irrelevant because you are not centrifuging for agglutination with PeG in the tube - you've washed the PeG away. You are actually centrifuging with AHG, which again (at least for us) is not of a viscosity significantly different than saline. What do I use my serofuge for? Test systems with a viscocity not significantly different from saline, and washing. Washing would be a separate calibration because of the huge difference in saline volume... So, that's why we just do the saline style cal, and a wash cal. What are your thoughts on that line of logic?