Darren Posted December 21, 2016 Share Posted December 21, 2016 Ah. Thank you! When I did a search in my CAP list PDF I looked for the word segment. And, no, I've not been honored to mess with a delayed transfusion reaction. Most all of our reactions are febrile. There was a patient a few months back who came in and got some units before being shipped out. No history, all testing negative, and the receiving hospital's BB called later in the week to ask about his history because they'd detected some antibody likely a past one triggered by his transfusion here. Link to comment Share on other sites More sharing options...
Teristella Posted December 21, 2016 Share Posted December 21, 2016 You must have very well-trained nursing staff and very good luck, because I've had multiple occasions where the bag was just plain gone, no where to be found, so if you haven't saved a segment, what will you do your testing on? The chance of a delayed transfusion reaction, as goodchild mentioned, is the other important reason. Link to comment Share on other sites More sharing options...
goodchild Posted December 21, 2016 Share Posted December 21, 2016 When we log incoming RBCs into Meditech it orders a donor unit retype. We save our segments when we pull off segments to do the retype. They go in a biohazard bag labeled for the day they were performed and keep that bag for seven weeks. This process has worked for us for quite a while. Link to comment Share on other sites More sharing options...
kate murphy Posted December 22, 2016 Share Posted December 22, 2016 We label a seg with the DIN at receipt. All segs received TODAY are in a ziplock, we toss in 8 weeks. Bags are labeled "Rec'd Date Disc Date (+8wks)" That captures 1 week past the longest outdate of 7 weeks. Easier to pull original seg in a delayed - just look for the bag of that receipt date. I would be hesitant about taking a seg at issue - what happens in emergencies, even a small place can have a ruptured AAA? And if anyone forgets? You're pulling a seg at receipt anyway... but whatever works best for you...there is no ONE way to do this. Link to comment Share on other sites More sharing options...
Sandy L Posted December 22, 2016 Share Posted December 22, 2016 (edited) We do the same as Kate, i.e. pull at receipt; would not like to try pulling segs from every unit during a Massive Transfusion episode. Each days segs go into a ziplock bag labeled with the date. We have a giant ziplock label for the month. At midnight the previous day's bag goes into the month bag and a new daily bag is created. The month bags are kept two months after the end of the month and then tossed so that the most recent segs are kept 2 months. It works well for us and we've never encountered a problem retrieving a seg for a delayed transfusion reaction investigation Edited December 22, 2016 by Sandy L Link to comment Share on other sites More sharing options...
macarton Posted December 22, 2016 Share Posted December 22, 2016 We pull at time of issue and keep them with that days sample rack. We hold samples for 19 days. Odd time due to way we extend the date to use pre-op samples and CAP requirement post transfusion. Link to comment Share on other sites More sharing options...
gene20354 Posted December 22, 2016 Share Posted December 22, 2016 We also do the same as Kate. Link to comment Share on other sites More sharing options...
Dansket Posted December 23, 2016 Share Posted December 23, 2016 To minimize the number of steps required to issue blood, we retain donor tubing segments as part of the ABO/Rh confirmation process on receipt of donor units from the donor center. I dislike trying to find the end of the donor tubing that is tightly rubber-banded together under any circumstance and certainly not when a nurse is standing beside me! exlimey and goodchild 2 Link to comment Share on other sites More sharing options...
AMcCord Posted December 23, 2016 Share Posted December 23, 2016 We keep segments for 21 days. !4 days for CAP plus an extra week to cover for extending expirations for preadmission testing. Link to comment Share on other sites More sharing options...
Winter Posted December 24, 2016 Share Posted December 24, 2016 We pull a segment at issue and keep in a rack for a week. We have three segment racks so once a week, the segments in the third rack are discarded and the rack is pulled forward. We have three labels with clips; 0-7 days, 8-14, and 15-21 so the racks are relabeled weekly allowing a 21 day storage. Link to comment Share on other sites More sharing options...
Cliff Posted December 25, 2016 Share Posted December 25, 2016 23 hours ago, Winter said: We pull a segment at issue and keep in a rack for a week. We're a fairly large facility, many issued units are returned, so this would not work for us. We pull a segment when we log the unit in and keep it in a bag for 49 days. Then if we need to pull that for a reaction, or anything else, we simply look up when it was received and that is the bag it is in. We issue a couple hundred units a day. Link to comment Share on other sites More sharing options...
DebbieL Posted December 26, 2016 Share Posted December 26, 2016 We have 6 large zip lock bags labeled week 1 thru 6. We pull two segments when entering the RBC into inventory. We use one to test and the other we wrap a unit number on it. We have a biohazard baggie labeled with the day's date by the check-in area and we drop the segment with the unit number into the bag. We combine Saturday and Sunday into 1 bag since we don't check in much blood. At midnight we make a new baggie and roll up the previous day's baggie and put into a bigger zip lock bag labeled with the current week number of 1-6. On Sunday night, we have a week of segments in the "week" bag. We put the week bag at the back of a box in the bottom of the fridge and the other "weeks " make their way closer to the front. As the "week" bag makes it's way to the front of the box, the baggies inside will be thrown away on the beginning of week 7.This works for us and it is not too difficult. If we need a segment we can find the day that it arrived by going to the "week" bag. I hope this makes sense. All segments are kept for 42 days regardless of when they were transfused. This process is part of the nightly duties of the night techs. We used to pull a segment in a tube at issue but they would get lost or put back on the wrong unit when the unit was returned. Plus in a trauma or bad surgery, segments might be forgotten in the rush. It was a mess. Many mistakes were made. This works better for us Link to comment Share on other sites More sharing options...
mcgouc Posted December 26, 2016 Share Posted December 26, 2016 As long as the segments are kept seven days post-transfusion, it is up to the facility to determine how to meet the requirement. When we were preparing for the electronic crossmatch, I knew our method of keeping the seg when we crossmatched was not going to work so we started pulling extra segs when we processed as described above. I did think it would be difficult retrieving the segs when needed, but i would dump the segs in the correct day's bag on a counter & it wasn't bad. Thankfully, I didn't have to do it often, but on delayed reactions, I would pull segs to type transfused units. Link to comment Share on other sites More sharing options...
Jennifer Castle Posted December 26, 2016 Share Posted December 26, 2016 We keep for seven days post transfusion. Link to comment Share on other sites More sharing options...
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