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I would not be performing one hour post-transfusion vital signs unless the patient has signs or symptoms that require assessment. I would not be reacting to one hour post-transfusion data unless they were consonant with a transfusion reaction. If fever was the only sign or symptom, it's probably not transfusion related in the vast majority of cases. Routine vital signs in the absence of a clinical rationale are a problem, not a solution.

If the supplier is the one we use and the product is packed appropriately we bring it into the inventory, notify the sending facility and notify the blood supplier. If the blood comes from the other supplier which we don't have a contract with we notify the sending facility that we don't bring this supplier into our inventory and asked them what they want to do. Either we can send it back to them at their cost or if our couriers go to their facility we can send the product back to them . Of they can asked the blood supplier if they want it back (sometime they do as we share a parking lot with them). Don't ask why we don't use the blood supplier we share a parking lot with. Long sad story.

If it is from the same supplier we use and packed appropriately, I have no problem accepting the blood into our inventory. I contact the transferring facility for a transfer form if they did not pack one.

Personally, I never had a problem receiving in blood like you described as long as it met all the requirements that we required from out supplier. On the other hand I knew facilities that would discard any and all blood that was received from outside with out any thought. I considered this a dreadful waste of a precious resource! Just curious but did the blood have any of the temperature monitors attached to the units? If so, that could help you make the decision. Having said all that, I have been out of the world for a while and many things have changed since I was intimately involved in the art of transfusion medicine so there may be some new regulations that can provide guidance for this well beyond my opinions. I look forward to read what others have to say on the subject.