James Smith

Hi Got a solution for not putting donor units into inventory if you have Meditech. After RBC units are entered into inventory the techs make an inventory list, scan the units just entered before they go in the fridge. If in inventory a list is generated by scanning each unit. If a tech missed entering one it is immediately apparent as the unit will not go on the list. It's saved me a lot of headahes over the years. Let me know about Meditech and I'll send you our process. Also try check lists of daily or weekly duties so everybody knows a job got done because it is checkmarked.

Our lab uses buffered saline (pH 7.0-7.2) and the blood gas equipment to test the pH daily. In addition we run a visual inspection of saline and monoclonal diluent control and anti-D with Rh+ and Rh- cells in our daily QC which we run thru the cell washer to see if we get the expected positive or negative reaction agglutination pattern at IAT. Bench saline bottles use same source but not testing every bottle, just the saline 10L cube connected to a Helmer cell washer daily. I haven't seen any problems with saline bottles being contaminated.

Yes that is interesting. I would have done the same as your colleague. The patient must be given the transfusion within the 4 hours and of course the unit would be at RT the whole transfusion so this works assuming the unit can be given in the remaining time. So spend an hour fixing the iv leaves 3 hours to get the unit in. Re-stocking a unit must be for the safety of all recipients. If putting blood back in the fridge puts another patient at risk later on then re-stocking the unit should not be done. Do you measure the temperature of the unit before re-stocking? This to me is a better indicator of safety and we discard units if temp is >10C degrees regardless of time out...Jamie

Hi The options are to return it to blood bank and store until good iv gained, then re-issue or give blood with a delay but stick to stopping transfusion at 4 hours since issue from lab even if not all given...Jamie

CSTM (Canadian Soc for TM) Standards for Hospital Transfusion Services v3.0 2011 gives 5.8.4.1 "Administration of red cells shall be completed within 4 hours from the time of removal from a temperature-controlled environment". To keep it simple it's been extended to all products in our hospital and my guess is that all use this here.

What about D mosaic where missing parts of the antigen caused formation of a "D like antibody" which is the antibody to the parts the patient is missing...Jamie