what type bag do you issue blood products in?

[suhu]

We put our blood products into an Infecon biohazard specimen bag for issue (mostly through a pneumatic tube). We recently have been told it will now take up to a month to get these type bags as the supplier no longer stocks them.

I'm curious what others do. The Infecon are more $$ because they have are leak-proof. A regular biohazard specimen does not claim to be leak-proof.

What type of specimen bag do you put your blood products in? If not using the Infecon bags, do you double-bag, or this not a concern?

[clmergen]

We just use a clear ziplock bag. We purposely do not use a biohazard bag because units of blood are not considered a biohazard. Exception of course would be an autologous unit that was positive for an infectious agent, those are issued in biohazard bags.

[David Saikin]

Celar zip loc bag, but don't usually lock them.

[nanste]

none. closed system

[Cathy]

We do the same as clmergen.

[Eagle Eye]

we use regular thawing bag.

[skopti]

We just use a clear ziplock bag.

[cooltech]

Clear plastic bags

[nmartin]

We use a plain ziplock bag, and we double bag when issung in the pneumatic tube.

[Joanne P. Scannell]

An opaque white zip lock bag. The opaque bag is for privacy ... these are being carried throughout the hospital (elevators, hallways, staircases) ... patient confidentiality issues.

[eric1980]

My lab uses a box with ice packs to transport the blood product in the hospital... What's your take on this method? =/

[Joanne P. Scannell]

Unless you get a lot of returns, its probably overkill to issue every unit on ice.

We actually issue units a number of ways:

Single units in a plastic bag; if units are returned to the BB, we take it's temperature.

Rule Say: Unit must be maintained at prescribed temperatures. So, if a component that is supposed to be 'refrigerated' is less than 10oC, it can be returned to inventory. If not, it is a discard.

However, Rule Say: the transfusion must be completed within 4 hours. So, if they pick up a unit at say 12n, they have until 4pm before they have to discard that unit. That's 4 hours to do whatever adjustments/troubleshooting they have to do that may delay the initiation of the transfusion. If they return it 'immediately', chances are it will be still under 10oC, otherwise, we say to keep it up there and let us know whether it was discarded so we don't inadvertantly record it as 'transfused' in our LIS.

Multiple Units go in iced coolers (yes, validated) with thermometers and temperature record tags.

[Likewine99]

Ziplock bag labeled biohazardous because nursing wanted it that way.

[bbbirder]

I would be very distressed to put a unit into a bag labeled 'biohazardous'. These units are not biohazards, only autologous with positive infectious disease markers should get this designation.

If I was a patient, and saw a bag like that, I'd be a little worried about my transfusion.

Linda Frederick

[eric1980]

Our boxes with ice are validated annually and have shown to be able to keep blood products under 10C for more than 6 hours.

It is a cold hard fact that the wards in my hospital have a very bad habit of getting and holding on to the blood so that the doctor could commence transfusion once the doctor is there... if he's there within 4 hours.

Without the boxes, my lab would have to discard a lot of blood so I'm quite inclined towards using the boxes...

Linda: I will be very distressed to have other people's blood running in my veins, especially when I am aware that someone is going to transfuse a stranger's blood into me, and if I can see it, I probably don't need it.

But well, the patient do not have to see the biohazard bag. xD It probably would be biohazardous to the nursing staff.

[Cathy]

We just use zip loc bags, single, not double bagged. Make sure they are sealed tightly before issue. Get rid of them when they start to tear.

[Jaimie Nicholson]

Opaque ziplock bag, white for platelets and cryoprecipitate, green for FFP, and red for red cells.

[Judy hedglin]

We do not send any blood products through the tube system as a "person" must be documented as responsible for the product when it leaves our control and reaches the nursing staff.

[suhu]

Thank you everyone. All your replies were put to good use....we have switched from the pricey Infecon bags to regualr ole ziplocks, at 1/2 the cost. Now if I was only allowed to buy them at Target, I could get them for 1/2 the cost again!!

[VATB00]

Im just curious is it acceptable to issue units of blood through the pneumatic tube?

[eric1980]

Some institutions do that. Provided the work culture will not allow a unit of blood to be at room temperature for long periods of time, I guess it's okay.

[VATB00]

Thank you

[Dr. Pepper]

The AABB has a nice little booklet on validation of pneumatic tube systems for transport and outlines the variables that should be considered.

Regarding coolers that keep blood <10o for x # of hours, I have always felt that if a cooler is sitting around in an OR or on the ward awaiting possible use, then it is storage, not shipping, and should be kept <6o. We had a recent AABB assessment and were told that the AABB considers blood in coolers going to the OR for possible use to be "transport" (it was explained that the blood "takes a little trip to the OR, stops and enjoys the scenery for a while, then continues the trip back to the lab...") and the <10o rule applies. The FDA, however, (and this is also from the AABB home office), says to consider the intent of the cooler use: if it's going from point A to point B to be moved into another storage medium like an OR fridge, it's transport (<10o rule). If it's going to sit around for possible use, then return from whence it came, it's storage (<6o rule). So there's a dichotomy here.

[nanste]

I have attached a summary that was received via e-mail from William Laboratories. It is a summary of the discussion at the AABB Annual Meeting in 2009..........this is in addition to Dr. Pepper's posting from earlier today!

Vuepoint home.doc

[shasby]

Our area health service has up until now used clear plastic bags so that the product was made immediately visible. That may all be about to change...we had an incident recently at one of our major hospitals during which a visitor to the hospital saw a unit of blood being carried in a clear plastic bag and proceded to faint, resulting in a head injury. Our blood products management committee has been asked to review our blood transportation.