R1R2

Suggest using a slower infusion rate, aliquot  (lower volume), or only transfuse if medically necessary?
I'm curious how everyone is looking at handling this requirement.

I don't think there are any regs.  Keep the blood products on top shelf, followed by reagents and then urine specimens on bottom shelf and label shelves. 

I have not looked at a CAP checklist since last summer (and may never do it again as Ibegone2016 at the end of the month), but it sounds like an overzealous inspector transposing his opinions into the CAP standards. Happens a lot. Follow Goodchild's advice.

Hi amym!  I am so happy to see you here too!   As a POC person now and blood banker in a past life, you are correct.  

Same reason I do not store my Guinness over my toilet...
 
Scott

I had a hematologist once that wanted all of her patients to get "double-filtered" products.  I asked her to provide me a reference to bring to Transfusion Committee; she couln't find one.
Request denied!  LOL

One word - shipping.   It is complicated, time consuming, fraught with error.   And I agree with all that David wrote.    

Hi amym!  I am so happy to see you here too!   As a POC person now and blood banker in a past life, you are correct.  

Hi amym!  I am so happy to see you here too!   As a POC person now and blood banker in a past life, you are correct.  

Hi amym!  I am so happy to see you here too!   As a POC person now and blood banker in a past life, you are correct.  

Thank you so much.   There are posts now!!!!   I am spreading the word to my fellow POCers.  

Agree with Malcolm but can be at any age.   Additional testing may need to be done for some babies receiving type specific.  It is outlined in CAP and AABB checklists. 

Agree with Malcolm but can be at any age.   Additional testing may need to be done for some babies receiving type specific.  It is outlined in CAP and AABB checklists. 

Agree with Malcolm but can be at any age.   Additional testing may need to be done for some babies receiving type specific.  It is outlined in CAP and AABB checklists. 

I don't think there are any regs.  Keep the blood products on top shelf, followed by reagents and then urine specimens on bottom shelf and label shelves. 

I don't think there are any regs.  Keep the blood products on top shelf, followed by reagents and then urine specimens on bottom shelf and label shelves. 

Damn I've been offline and missed it - at least I know I wasn't the culprit...

Nursing should have a policy not to do that and it should be part of their annual training.   I could audit that on occasion - blood issue to time started.  

Not always the case in US.   Volumes can vary depending on amount requested by MD.  

I would discuss how much can be removed and still be considered a whole unit with your medical director.   It seems a shame to waste a unit if just 25 mls were removed.  

Another thought would be if you have an active pediatric unit that could possibly use a reduced volume unit on one of their kids.  It would be a shame to discard perfectly good blood but I do agree that it would be unacceptable to issue it to an adult.  It never hurts to consult with the patient's physician and let them make the final decision on if a reduced volume unit would be acceptable.  
As a side note, we sterile docked syringes to our Neonate units and provided the exact amount the physician requested plus 5 additional mls to fill the tubing.  It was not unusual for a patient to either go home or go to a higher acuity facility leaving a unit short by less then 25 mls.  I don't recall doing anything with these units except throwing them away or setting them up on another neonate if they still met the criteria. 

We weigh each one of our units before issue (for the RNs input/output numbers) and our ADULT units range from 270 ml to 420 mls - a huge range to begin with.  The small ones are the pheresed units.  So - we base our decision to issue the remaining amount of a pedi-pak unit on the weight of the unit.  If it still exceeds 270 ml and has been handled correctly, we will give it to an adult.  After all, it is no smaller than some of the ADULT units our distributor sends to us to begin with..... 
 

I would discuss how much can be removed and still be considered a whole unit with your medical director.   It seems a shame to waste a unit if just 25 mls were removed.  

I would discuss how much can be removed and still be considered a whole unit with your medical director.   It seems a shame to waste a unit if just 25 mls were removed.  

I would discuss how much can be removed and still be considered a whole unit with your medical director.   It seems a shame to waste a unit if just 25 mls were removed.