Pediatric Syringe?

[MicheleKay]

Is anyone using a pediatric syringe for neonatal transfusions? Do you like it? What don't you like about it? Are there different types? We're thinking about switching, but I think the neonatal unit dictates the final decision. Something about the transfusion pumps....Anyone know anything about these pumps?

[John C. Staley]

We use a syringe set from Charter Medical. It has an inline filter so the nurses don't need to use a filter for transfusion. We attach the syringe set to the blood bag using an SCD. The syringe is 60cc. Check with your NICU and see what pumps they use and what size syringes they can use. The 60cc seems to be somewhat standard. We add 5cc to the order for the transfusion set.

[sgoertzen]

From Children's Hospital Central California:

We use both the 30 ml (REF 309651) and 60 ml (REF 309654) BD Syringes for making our aliquots. We don't prefilter, but rather, we issue a 33 cm 80 Micron Filter Blood Component Infusion Set (Y type for saline flush) Baxter (4C2223) along with the syringe aliquot. Our hospital uses the Medex Medfusion pumps 3010a, and the Trilogy multichannel pumps. Any small aliquot (less than 50 ml) is automatically placed into a syringe prior to issue.

Anything larger than 50 ml is issued in a pedi-bag or the original container.

[DFields]

Please tell us what type label you use for the syringe aliquot--so that it still fits in the pump and has all required info.

[32387]

We recently changed to Hemonate from CharterMed. The CharterMed syringes were recalled due to a failure to perform proper QC. We like the Hemonate because it is DEHP-free and our neonatal pediatician feels that DEHP is potentially harmful. We have the donor center attach pedi-satellite bags to a unit, then draw off an aliquot into the bag, seal it and fill the syringe from there. I don't know much about the pumps, but our intensive care unit just attaches the Hemonate syringe to the pump. We get up to 8 aliquots from one unit. Hemonate is sold by Utah Medical Products, Inc.

[MicheleKay]

32387: I looked that particular syringe up online and noticed that it's not compatible with a sterile connecting device which prompts you to enter the bag causing an open system. It seems that by attaching a pedi-bag and then drawing off into the syringe you are doing too many steps. Not to mention not maximizing your usage of the main component. I find this way to be a little too wasteful. Thanks for the info though, very helpful!!

[Alan Hoffstadter]

Just curious.... For those infants of the NICU variety whose weight mandates Irradiation, is the syringe irradiated or is it the aliquout bag or the primary bag? There was only one mention of the Sterile Connecting Device, so I wondered if that was being employed as well at the other facilities.

Labeling? When we were using syringes many years ago, we used the 60cc, attached about an inch of the standard label, and folded over the rest upon itself so that the gradations were visible. It could still be wrapped around the syringe but it didn't stick.

[sgoertzen]

We use a SCD to attach multiple pedi-bags to the original container with one weld. When an aliquot is needed, that volume is then pushed off into one of the pedi-bags and the pedi-bag is irradiated. (The blood irradiator cannister can accommodate the 30 ml syringes, but the techs prefer to irradiate the pedi-bag). Then if the aliquot is less than 50 ml, we enter the bag with the syringe and pull it into the syringe just prior to issue. We label the barrel of the syringe with the crossmatch or assignment card (which we print on a label instead of paper) and we attach a tag to the end of the plunger of the syringe which holds all the remaining labels (facility, product type, irradiation, etc.) The syringe pumps do not have a problem with this attached tag and it does not get in the way. I would be happy to share my procedure if you would like to see it. sgoertzen@childrenscentralcal.org

[John C. Staley]

We are not able to irradiate in-house so we get the unit irradiated from the blood supplier and use it through the life of the unit. The corporate transfusion medical director decided that all neonates would get irradiated and the neonatologists went along with it which makes inventory management easier. One baby per unit is our standard. We use a standard 4x4 base label duplicated to match the original label with 2 exceptions. The component modified by label has our name on it and the component lable is a divided product label. On a 60cc syringe we put one side of the label on each side of the graduations and then seal the lable around the syringe from there. There is a little fold left but it is no problem with the pumps. There are a few more details involved like how old a unit can be when we set it up on a baby and thing like that but this is the reader's digest version of what we do. I can't imagine trying to support our NICU without a SCD.

[luhubert]

We use the Charter Neonatal syringe set, get an irradiated unit from our supplier with 4 - 6 aliquot bags attached. We push into an aliquot bag and then take our syringes from that, leaving the rest of the bag intact until original expiration.

We made our own label using Word and card stock. Copy attached.

We attach it to the syringe with string through a punched hole in the corner of the tag. We put the assigment/crossmatch information that prints on adhesive labels on the other side of the label.

Aliquot tags.doc