what type bag do you issue blood products in?

[BrianD]

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.

we allow tube transport in our facility to only specific areas: 1) Emergency Department, 2) CVR (post cardiothoracic surgery recovery unit), and 3) critical care units. A tube transport request is submitted with all the appropriate identifiers and a copy of the physician's order indicating the unit is to be given immediately. the request and a copy of the physician's order are kept in the BB and we haven't decided how long we'll keep them yet. the tube transport request also includes an area indicating the name of the nurse initiating the request, who shipped it, and there is documentation of a phone call confirming receipt of the unit and by whom. confirmation should be made within 5' of transport.

only packed RBCs and plasma products can be sent via tube transport since the vacuum and somewhat physically violent passage in the pneumatics activates the platelets in our experience. no significant hemolysis was detected during validation for the PRBCs. we were actually surprised, the blood bank staff was actually expecting the pneumatics would rupture the blood bags or hemolyze them.

[adiescast]

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!!

Oh so true! I don't understand why we can't buy the same product from the least expensive source.

[jcdayaz]

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

The coolers need/have to be tested, verified and DOCUMENTED that blood is maintained at appropriate temperatures for the amount of time that your blood bank allows the coolers to be issued. Each unit issued in a cooler must have a temperature indicator on it. When you say "ice packs" I hope the units are not being placed directly on the ice. We have an inner plastic type square bucket in our coolers and place one frozen pack and two ice packs on either side of the bucket. The coolers have been calibrated to be acceptable for 6 hours. We start calling and telling the ER, OR and ICU after 4 hours to return the coolers. It gives us a little time to be sure we get the cooler back in time. We will not send coolers to regular floors except in extreme circumstances like a plasma exchange or something like that.

[Mabel Adams]

I don't think there is a regulation that you have to put temperature indicators on units in verified coolers. At least we have never been cited for not doing it.

[Eagle Eye]

we do not put temperature indicator. there is no regs.

[swede]

We put temperature indicators on our cooler units because we don't trust anybody.....in the past, "they" were known to take units out of the cooler, line them up on the bed, and then place them back in the cooler when the patient stopped bleeding. After a lot of education over many years, this no longer occurs, but we still use the indicators....

[dgibaud]

We use Fisherbrand Biohazard specimen bags, 8x10 (01-800-08). These also have a paper pouch. They're for "light duty". Your blood product should already be in a leak-proof bag, so these are fine. In 15+ years of sending blood products via tube, we've only had one problem, and that was from a leaky pool of platelets (tech problem). We don't double bag.

[kate murphy]

[

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.

[Dr. Pepper]

[

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.

So you're saying it's the intent and not the actual science of temperature fluctuations that should apply? What is the difference between units in a box with ice packed and shipped in a truck or plane vs units packed in box with ice taking a trip to the OR? I really don't mind being compliant with reasonable regs, but there does not seem to be reason here.