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Flying Squad Blood


AB123

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Just want to see how many labs out there use flying squad blood and if so how do you manage it? does your LIS have a process built in for managing such situations or do you have a manual process where the documentation is resolved later? 

Thanks 

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Without some sort of 'vending machine' device to control and document the in/out/in/out/transfused to whom information, just leaving O Neg RBCs in a refrigerator somewhere for nursing to take/return at will is not a good idea.  I'm not even sure if regulatory agencies will support that.

Not only that, giving O Neg to 'everyone' is not good management of resources.  We (and most hospitals in our area at) restrict the use of O Neg to Females <50yrs old.  (And even that is coming up for debate in some arenas.)

There are 'vending machines' out there that will interface with some Blood Bank Software.  Maybe someone who is using such a machine can comment on that.

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Absolutely agree w Joanne.  I worked in a large tertiary care hospital - night tech.  We'd order blood for someone and occasionally it would be delivered to the OR.  I've seen residents take blood from the box and transfuse it when they had tagged/xm'd units in the OR blood bank.  SCARY.  they knew it was for their patient.  SCARIER!

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On ‎07‎/‎14‎/‎2020 at 8:45 AM, Joanne P. Scannell said:

There are 'vending machines' out there that will interface with some Blood Bank Software.  Maybe someone who is using such a machine can comment on that.

I have not used these but ordered a couple $100000 worth a few years ago as a temp manager in California.  BB vending machine interface w the BBIS.  Performs e-crossmatch and/or distributes group O according to programming for uncrossmatched.   Vendor trains non-lab staff (Nursing) to enter data and the device does the rest.   Usually the vending machine is provided by your BBIS vendor.   Don't know if they will work for a different BBIS. 

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In the UK its common practice, every hospital I have worked at follow this practice, it is strictly for life and death emergencies where there simply isn't time to lease with the blood bank. 

I haven't seen anything in the CAP or AABB standards regarding it that's why I was asking, I guess under US regulations/practices this isn't a followed practice then. 

Regarding the vending machines these are more a sort of remote electronic crossmatch than emergency O neg I believe. 

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Not sure what flying squad is but we have something similar at our hospital  We call them Emergency Uncrossmatched RBC and have it located in the ED Trauma Bay and a few Surgical area.  These units are stored in a constant temperature monitor system CimScan and also have a door alarm  function that alert Blood Bank whenever it is open.  RN are require to notified Blood Bank of any product usage and what blood type  (O+ vs O=) based on gender.  Like O= for female of child bearing age.  If we do not receive any call within a few minute, we are require to call the charge RN to check in on the situation.

Each of these prepared units have an Emergency Uncrossmatch allocation label along with a transfusion report form to chart the vital and and 2 FDA ply sheet that require the Physician signature acknowledging the risk/need for transfuse outweigh the risk of waiting for a type&screen completion.  1 sheet for patient chart and other sheet send back to Blood Bank for crossmatch later when T&S receive before sending it to medical director review.    

Edited by HN327
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We keep blood on the nursing unit when we have an ECMO.  It is in case of emergency decannulation.  It is tagged for the ECMO patient and kept in a blood refrigerator on the nursing unit.  We check the temperature in the refrigerators every day.  

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We have a monitored and locked refrigerator between the two trauma OR's , adjacent to the ED. It has 6 O pos red cells and 6  A liquid plasma and access is made by  RN's trained to use it and they have to scan in their ID(linked to some training module) and the Patient's MR#. Blood bank and has a computer screen on the wall that shows that the refrigerator is being opened and you can see t he patient's information, what is being taken out and who is taking it out. Problem with this has been:

1. nurses trying to access it who haven't been trained to use it and they can't get in so  they call the BB and complain and want help. We then send a trauma pack from the refrigerators in the BB

2. The trauma nurses are the only ones trained and sometimes they say they are too busy to access it so ask the BB to send a pack but they really want what's in the refrigerator. The powers to be are discussing the possibility of have the OR runner access it. Which works for  me as they are the ones that pick up the blood in the BB anyway and really  have a better concept of storage and handling of these products than some of the RN's.

Note:  yes it is O pos red cells so if the patient is of child bearing age it is up to the  provider to make the decision to use the blood in the refrigerator if get O=  from the BB

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We have a system called bloodtrack. Basically crossmatched units for named patients and 2 O neg units for emergency use (labelled with dire warning about uncrossmatched red cells) are kept in a locked fridge. To access this fridge the user who comes to collect units has to scan their barcode then the barcode on the blood pack(s). Bloodtrack saves the information regarding personnel, unit details and time removed from temp. controlled storage.

There is an audit form with the emergency units which the medic has to fill in and return to the lab. so that we know which patient has received which emergency unit.

We keep a line segment from these units if case we need to retrospectively crossmatch (eg. for transfusion reaction investigation).

So, in conclusion, we rely on a paper based system to inform us that a specific emergency unit has been transfused to a certain patient.

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On 7/30/2020 at 7:50 AM, RichU said:

We have a system called bloodtrack. Basically crossmatched units for named patients and 2 O neg units for emergency use (labelled with dire warning about uncrossmatched red cells) are kept in a locked fridge. To access this fridge the user who comes to collect units has to scan their barcode then the barcode on the blood pack(s). Bloodtrack saves the information regarding personnel, unit details and time removed from temp. controlled storage.

There is an audit form with the emergency units which the medic has to fill in and return to the lab. so that we know which patient has received which emergency unit.

We keep a line segment from these units if case we need to retrospectively crossmatch (eg. for transfusion reaction investigation).

So, in conclusion, we rely on a paper based system to inform us that a specific emergency unit has been transfused to a certain patient.

I wish we could afford BloodTrack.

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On 7/20/2020 at 5:04 PM, noelrbrown said:

I haven't heard it called Flying squad blood for Donkeys years, srichar3 are you from the UK?

Yes from the UK originally but now working in the UAE where we follow AABB and CAP standards. Are you from the UK also?

Edited by srichar3
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