Posted March 16, 20205 yr comment_79825 How do you handle units being returned (within the appropriate temperature and time frame) from a patient who is isolated (and units not in a cooler- but it was in a biohazard bag- did they take it out of the bag? I don't know). We don't have very many returned units, but this past weekend we had a patient under precautions for COVID-19 and her unit was returned to us. You can't sterilize a unit...so then I got to thinking, what about other isolated patients. The patient actually has Flu B. So is it ok for this unit to be used for someone else? I have never actually had this problem that I know of.  Â
March 16, 20205 yr comment_79826 Blood products that were taken into isolation are never returned to us.   If they are not used, they are discarded in the room.
March 17, 20205 yr comment_79829 I'm curious, why was blood requested for a patient with covid19/flu like symptoms??  Â
March 18, 20205 yr Author comment_79834 10 hours ago, John C. Staley said: I'm curious, why was blood requested for a patient with covid19/flu like symptoms??   She an oncology patient who gets regular transfusions. She was just unfortunate to get Flu B this year. We have been transfusing her for years.Â
March 18, 20205 yr comment_79836 What about any coolers that might have been taken into the isolation room? Who is responsible for cleaning the cooler prior to it's return? Plus if it has been in an isolation room with COVID-19, who is going to go into the isolation room and retrieve the cooler and clean it appropriately prior to it being carried thru the hospital halls?
March 24, 20205 yr comment_79861 I wondered the same thing, both about units and the samples from the patients. The only related thing I could think of are policies regarding CJD/vCJD, and those only covered samples. Besides following universal precautions and wearing the necessary PPE, seems to me the only difference is vigorous cleaning of non-disposable equipment with bleach after testing and that samples sent to micro are handled under BSL-3. Another point, you don't know the status of every single patient getting blood products, so do you even know who had Flu B before all this madness?
March 30, 20205 yr comment_79905 2 hours ago, PerkinsSutton said: Can you not wipe the bag down once returned? The bags are engineered with a sort of "breathable" membrane, so you could, in a way, poison the product. We have found floors trying to wipe down units with bleach before they come back to the Blood Bank, which totally isn't okay !!!! but, they wouldn't know otherwise. The products would have to be discarded,
April 1, 20205 yr comment_79928 We decontaminate our coolers daily because they go into the OR. If a cooler came back from an isolation room, we would decontaminate (wipe down with a bleach wipe). Units returned are also rare because it is difficult to have the RN staff to return blood in a timely manner to ensure it is still 10C or less. Consequently this is not an issue. It would be interesting to hear the lessons learned on this subject from the Medical Centers in NYC.
April 2, 20205 yr comment_79945 Is there any FDA approved disinfectants for cleaning the bags? I have an ID doc who said if I have the IFU for the product I should be able to see any approved disinfectants. The only issue is, they are not my bags and I don't necessarily have the manufacturer's information. Any thoughts? Â
April 2, 20205 yr comment_79949 Most bag manufacturers suggest a diluted bleach solution for RBC bag surfaces. Not sure about platelet bags since they are semi-permeable.Â
April 12, 20205 yr comment_80016 At our facility we wipe the coolers down upon return from each patient. Inside, outside, ice... We also started wiping all products returned with 70% isopropyl alcohol or 70% ethanol. We do this for all coolers and all products as we have no idea what the diagnosis is of the patient. Here's one reference: https://www.sciencedirect.com/science/article/pii/S1743919105001147
April 13, 20205 yr comment_80022 At our facilities last week, we implemented a temporary "no return" policy during this COVID crisis. Only exceptions are those issued in ice chest to O.R., massive transfusion, or ECHMO, provided they are not COVID patients or patients under investigation. The nurses have become much more compliant with completing the pre-transfusion checklist before picking up the unit as a result.
April 13, 20205 yr comment_80028 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.
April 17, 20205 yr comment_80062 On 4/1/2020 at 11:57 AM, Johnv said: We decontaminate our coolers daily because they go into the OR. If a cooler came back from an isolation room, we would decontaminate (wipe down with a bleach wipe). Units returned are also rare because it is difficult to have the RN staff to return blood in a timely manner to ensure it is still 10C or less. Consequently this is not an issue. It would be interesting to hear the lessons learned on this subject from the Medical Centers in NYC. Whatever units you issue, do you just assume they're not coming back then? You treat it as "once theyre gone theyre gone" ?
April 17, 20205 yr comment_80063 On 4/13/2020 at 11:14 AM, Smarty pants said: 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. Coolers can still go... I think the units in the cooler are more of the issue, but it seems by the responses above that facilities have created their own workarounds.Â
April 22, 20205 yr comment_80102 We assume that every patient is a COVID patient. We place each unit in a zip lock bag with the unit tag placed along the back of the bag, seal the zip lock and place a label across the top of the seal warning that if the seal is broken the unit will be discarded. We do this for every unit.
June 4, 20205 yr comment_80354 This came up at our facilities during the Covid-19 pandemic. Infection control advice was to handle blood units as per usual precautions, given that PPE would be worn by anyone handling the blood units and hand hygiene performed before initiating transfusion. All coolers returned to the blood bank are disinfected at our facilities regardless of patient isolation status.Â
June 5, 20205 yr comment_80359 On 4/22/2020 at 6:32 AM, Monique said: We assume that every patient is a COVID patient. We place each unit in a zip lock bag with the unit tag placed along the back of the bag, seal the zip lock and place a label across the top of the seal warning that if the seal is broken the unit will be discarded. We do this for every unit. At what rates have you been trashing the opened units? Does your individual bagging cause more conservative usage?
June 12, 20205 yr comment_80392 On 3/16/2020 at 9:07 PM, ElinF said: in my opinion, the device cannot be used again without being well disinfected Â
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