Patient/Blood component verfication prior to surgery

[mwlister]

I have been approached and asked to put this question out for peer review and would appreciate your response.

Question:

CV Surgeons want blood to be delivered to the OR in coolers and Surgical personnel would do patient ID and clerical checks prior to OR. Once the case started they would not check it again, just transfuse.

Does anyone do this? They are claiming that this is done at other institutions.

AABB Standards clearly states "the transfusionist shall verify that all information matching the blood or component with the intended recipient has been verified in the presence of teh recipient, item by item" pg. 53-54, Standards.

Thanks, Mark

[Lcsmrz]

I've seen all units in a cooler checked against the patient wristband before draping, then not checked before hanging. But the cooler and patient never leaves the OR suite.

Our facility places the patient info on a piece of tape on the forehead, which is used to verify the patient during any procedure done while the draped.

[PamD]

We do this. The cooler is taken into the surgical suite and units are checked against the patient's wrist band prior to draping. Two people check the tag against the band and sign the slips. If the units are transfused, the perfusionist only has to fill in the start/stop time. The cooler stays in the room with the patient, so I feel the standard has been met. If untransfused units are returned to blood bank in the cooler, we just print a new unit tag.

[John C. Staley]

I would like to add a question to this thread.

Do you attach irreversible temperature indicators to each unit of blood in the cooler?

We do and it's a nightmare. The nurses pull the units out of the cooler and go through the ID process and claim to put the blood back in the cooler right away. Then when the unused blood comes back half the temp indicators have changed color and are thrown way. This has really become an issue since coolers became storage and not transport and we are using indicators that change at 6oC instead of 10oC. It's hard to get the indicators on the units and into the cooler before they change.

[David Saikin]

John - at a previous institution we attached HemoTempIIs to the units (stored in a refr in the OR). They ALWAYS came back converted. Inquiries were met with a response of "your tags must be defective". We paralleled them with units in the blood bank (the tags never converted). It became a hot political issue and tagging the units sent to the OR was discontinued . . . interesting and enough said.

[Lady_Jeni]

John-

We also send blood to OR in coolers and we attach Safe-T-Vue 10 indicators from Williams Laboratories. They do not start to change until ~ 9.0 C. OR can keep the blood in the coolers for up to 6 hours before they need to return it to be repacked. If any of the indicators have started to turn red, we discard the unit. This has only happened a couple of times.

Jeanette Daniels, MT(ASCP)

[GilTphoto]

I had used Hemo-Temp II indicators back in the 80's, and they worked fine. I recently ordered them for the current hospital I work, and they don't seem as good as they used to be. The flower is very faint. We are using a water bath to activate.

Has anyone compared the Hemo-Temp II to the Safe-T-Vue 10 indicators?

[Mary]

They sell a dry heat block for activation.