ORs at satellite locations - requiring crossmatched blood!

[mobea]

Hi all,

My hospital has a satellite location approximately 25 miles away, where some (minor) OP/day surgery is currently being performed. This location does not have a Blood Bank or lab on site, nor are there plans for one at this time. There is currently a small blood refrig out there with 2 O- in it in case of emergency.

A decision has been made to expand the number and kinds of surgeries performed at this location, and this will include surgeries for which blood will need to be available/crossmatched. Theoretically what this means is that the samples will be sent to main hospital for T & X, units packed in patient specific coolers which will (all) be picked up by a courier in the morning and delivered to OR for disbursement to each room. The coolers would then have to be shipped back at the end of the case/day/whatever. (if there was an icon available showing someone freaking out, I would put it here!) And what about the potential need for FFP/platelets etc??!!

Is there anyone out there who has an arrangement like this in place? If so, how do you do it?

Or, if you had an arrangement like this that failed please tell me the details.

Thanks to all!

[John C. Staley]

Try this one.

Probably the best you can hope for is to explain all of the potential dangers such as the coolers getting switched and ending up in the wrong room and hopefully some one will see the light.

At the very least I would try to get a blood bank refrigerator installed and monitored by a blood bank emplyee who would be responsible for dispensing the products as needed.

[Bill]

New York state would require a Limited Transfusion Service permit with regulations pertaining to much of what you are concerned about. The regulations can be found on website: http://www.wadsworth.org/labcert/regaffairs/bloodbanks/index.htm. Hope it helps address some issues for you.

[LABKING]

:(thats horrible, I would not want any extensive surgery there, Especially any kind of L&D

Hi all,

My hospital has a satellite location approximately 25 miles away, where some (minor) OP/day surgery is currently being performed. This location does not have a Blood Bank or lab on site, nor are there plans for one at this time. There is currently a small blood refrig out there with 2 O- in it in case of emergency.

A decision has been made to expand the number and kinds of surgeries performed at this location, and this will include surgeries for which blood will need to be available/crossmatched. Theoretically what this means is that the samples will be sent to main hospital for T & X, units packed in patient specific coolers which will (all) be picked up by a courier in the morning and delivered to OR for disbursement to each room. The coolers would then have to be shipped back at the end of the case/day/whatever. (if there was an icon available showing someone freaking out, I would put it here!) And what about the potential need for FFP/platelets etc??!!

Is there anyone out there who has an arrangement like this in place? If so, how do you do it?

Or, if you had an arrangement like this that failed please tell me the details.

Thanks to all!

[jhaig]

Viewing this situation from the outside, this sounds like trouble waiting to happen. This is a much larger can of worms being opened by this facility. At a very minimum they need to consider having a blood bank employee as an integral part of their team ON SITE to handle their transfusion needs.

What happens when a surgery goes bad? Your 2 O neg's may not be enough. If your main blood bank is 25 miles away, a patient could find themselves in real trouble. That's assuming there's no antibody problems.

Picture an OB patient going into DIC and having no cryo, platelets, PC's or FFP immediately available. I don't know what kinds of surgeries you're looking at, but anything can happen. Your O.R. needs to consider a lot more that just having more blood ready.

Your administration should be concerned about this setup.

[BB001]

Mediware has a solution you may want to take a look at. It is called BloodSafe™ and is a 510(K) cleared system for remote storage and management of blood. BloodSafe is equivalent to a “Pyxis†system for blood management. BloodSafe’s remote release refrigerator management provides a controlled environment that is monitored from the blood bank making blood products quickly and safely available throughout the hospital or at remote locations.

[Mabel Adams]

Not only do you have patient ID issues and the accompanying training and competency of any staff that might use the blood products, don't forget transfusion reaction training and competency. Tough to keep up when each surgical staff person might be involved in one transfusion a month or less. Then there is cooler validation and proper use--I'd be putting Safe-T-Vue or Hemotemp stickers on the units. If you put in a fridge there will be alarm tests, daily temps, response to alarms, maintenance, chart changes etc. etc.