Unit segments

[Darren]

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.

[Teristella]

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.

[goodchild]

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.

[kate murphy]

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.

[Sandy L]

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

[macarton]

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.

[gene20354]

We also do the same as Kate.

[Dansket]

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!

[AMcCord]

We keep segments for 21 days. !4 days for CAP plus an extra week to cover for extending expirations for preadmission testing.

[Winter]

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.

[Cliff]

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.

[DebbieL]

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

[mcgouc]

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. 

[Jennifer Castle]

We keep for seven days post transfusion.