Smarty pants

You should contact the bag manufacturer. It's on the bag and google will get you a contact. You may be destroying the plastic or leaching it into the blood product. Assuming bleach or alcohol is safe is a huge mistake. Our manufacturer is recommending distilled water ONLY on platelet bags. Coolers SHOULD NOT GO IN ISOLATION ROOMS. Period.

Just to clarify... there were several webinars last week with AABB, ASFA and US FDA. The collection of CCP (COVID Convalescent Plasma) is no different from the collection of ANY plasma. So blood centers can collect it as they would like. It doesn't require anything special if you've been collecting plasma. Most centers are collecting as much as they can once they get a donor (up to 1L) as a standard "dose" seems to be somewhere in the 300-400 mL range. It is the TRANSFUSION of the product that requires the IND, and the FDA has promised that they will be approved in 4-8 hours. They need to be submitted and approved on a per-patient basis. Many blood centers are working now to locate recovered patients and collect plasma. It can then be frozen and a standing inventory in place. In Australia, if you want to start doing something now... I would start getting an inventory of CCP. In the US, because of HIPPA (patient privacy) blood centers are having to contact doctors to contact their patients to see if they would be willing to donate and those donors then need to call the blood center. They are testing these "donors" for antibody titers and if it's been <28 days since the onset of symptoms, they are also testing to make sure the virus itself isn't present (so a negative RNA test). Locating these donors and doing the required testing is taking some time. Once found, it's pretty quick and easy process to get the plasma. Then it's a normal process to get it to the hospitals. It's looking like it's best to transfuse them earlier than later. There is no standard of care... but I would suspect that the best results will be seen if they can be transfused as soon as they're admitted to the hospital (those not admitted may not be sick enough to need this?). As for billing... your guess is as good as mine.

Pineapple juice mixed with orange juice (the "pulp" that looks like platelets) makes for an excellent platelet product!

If the MD has evidence that the unit has been opened and risks bacterial contamination - the unit shouldn't be used. If the MD doesn't have evidence, he should be taught about the steps the blood bank takes to eliminate that risk. If it is possible that the unit is contaminated, and is a rare group with no other unit to meet the patient's needs... it would be within his medical decision to use it or not. If he chooses to use it, it might make sense to administer some prophylactic antibiotics. But there are some very rapid tests for bacteria and it seems like taking the extra 10 minutes would be worth it to know for sure what the actual risk is before actually giving the unit.

Each manufacturer of platelet bags has validated conditions that must be met for 5 day storage. The AABB/ FDA cannot give you a standard because each bag is slightly different. Talk to your supplier to find out the storage requirements for the bag you are using. (I know Terumo is validated up to a concentration of 2,100,000 and Fenwal has a minimum volume requirement for a range of concentration). If you're outside of that storage recommendation... you probably will need to short-date those products, or at least test the pH prior to issue to ensure a quality product.

I think Verax is the only one available.

We learn something new from every war. Plastic bags are better than glass bottles. Additive solution prolongs the life of RBCs. It seems that the lessons learned in the current gulf conflict is the valuable use of whole blood in traumas. There are multiple studies, and they're pretty compelling. That said, I don't see much change in maintaining an inventory of WB. I see the change in ordering more FFP along with the pRBCs to treat traumas in order to get the component to be "more like" whole blood. The benefits of freezing the plasma are pretty apparent. There is also some interesting research being done on platelets stored at 4c. They have a longer shelf-life (the cold slows down their metabolism a bit). And they're already slightly activated, so they work faster when transfused to plug the holes. I think the DoD is actively doing some research on this, and there are a few articles published. Still a lot of work towards the feasibility on how this would be managed, because it is a whole new product with a specific indication. It would need ISBT products, FDA approval... we're still years away.... but it's interesting to read about.

The question is how the pedi pack/ transfer pack is attached. Not how it is removed. If it is attached via sterile technique so as to not jeopardize the sterility of the product, it should retain it's original outdate. When you remove it, you just need to ensure that it is a "permanent seal" not just a clamp with can accidentally open. Those grommets are generally considered a "permanent seal".

In my experience, one of the reviewers needs to be licensed (RN, MD...) the 2nd person does not. They're reviewing to make sure the paperwork matches the recipient, anyone can do that. The person to hang the unit and start the transfusion needs to ensure that the blood type is compatible and matches.... I struggle to find a single nurse who really understands that (unforrunately).

Could you store hot water in a 10 gallon thermos? It seems that replacing a valve shouldn't be more than an hour or two right? ("shouldn't") It seems that keeping hot water in a thermos to fill up your bucket might meet your need for that short time frame???

Are you talking about RBCs? I think most people are using flow for all WBC counts, but this is an interesting idea!

Terumo also makes a T-Seal... which might meet your need, it can be linked together (multiple devices with a single power source) to do a full line of segments in a single action which is quite handy if you're looking to do that too.

Intercept can be used on platelets in PAS and Platelets in Plasma. Make sure you got the right code!!

Can you please share with me the current practices of your hospitals for neonatal thrombocytopenic patients? Are you transfusing antigen negative units? Are you transfusing randoms vs apheresis? Do you collect from the mother for a directed transfusion? Thanks!

Eman - do you defer ALL donations for those medications? Or just platelets? (are the medications things like Ibuprofen or Naproxen? or something else?)