Returned blood temperature

[Theresa112]

Is anyone recording/documenting the actual temperature of a returned unit of blood when it comes back from surgery, ED or the floor? If so can you direct me to the FDA regulation stating that we need to record an actual temperature versus having a policy stating what the criteria is for determining whether returned blood is suitable for reissue. Thanks, Theresa 828-213-0995

[PamD]

The CFR does not require you to determine the actual temperature of the blood product when it is returned. You just need to have a SOP that defines the criteria for accepting product and determining that it is still acceptable for transfusion.

[Theresa112]

The CFR does not require you to determine the actual temperature of the blood product when it is returned. You just need to have a SOP that defines the criteria for accepting product and determining that it is still acceptable for transfusion.

Thank you for responding.

[Stoogiesfreak]

We have set a 30 minute time frame starting at the time of issue. If a unit is returned within the 30 minute time span we do not take temperatures. Over 30 minutes the unit is destroyed. We are working of a temperature policy for OR, ER and other critical areas.

John

[John C. Staley]

Unless I'm mistaken or they've changed standards recently (which they have been known to do with alarming frequency) AABB Standards note acceptable temps for return and reissue of blood but no mention of a time frame. You will find multiple threads on this subject.

[Stoogiesfreak]

John, It is mentioned in the AABB Manual, but it is vague like many thing in the AABB manual!

They do not come right out and say that 30 minutes is the time limit, but they mention something like "most facilities use 30 minutes" or something like that. You are correct in stating that it is not one of their standards - just one of those things they mention in passing.

John

[Abdulhameed Al-Attas]

Hi Theresa,

We are recording/documenting:

Date,Unit #,Component and the Appearance Check-list(Clot,Discoloration,Gas,Leaky and entered)

Temperature, action taken:like the Unit was kept for the same patient,Quarantined or made Available & retuned to stock.Also Returned by and the Technologist who recieves back.

[adiescast]

Unless I'm mistaken or they've changed standards recently (which they have been known to do with alarming frequency) AABB Standards note acceptable temps for return and reissue of blood but no mention of a time frame. You will find multiple threads on this subject.

This is correct. Standard 5.18.3 #2 states Blood, components, tissue, or derivitives that have been returned to the BB or TS shall be reissued only if the following conditions have been observed...the appropriate temperature has been maintained.

The Primer of Blood Administration states in Chapter 5:

Transfusion must begin within 30 minutes (less if so-stated in the institutional policy) after the component is released from the blood bank. If transfusion cannot be started in this timeframe, the unit should be returned to the transfusion service for reissue. The AABB Standard 5.18.3 applies (see Chapter 4, page 10. )

[AMcCord]

We specify a 15 minute return time and take the temp. Over 10C, they have the option of taking it back to the unit, starting the unit as soon as they can and finishing it within 4 hours of the original checkout. Under 10C, we will put it back in stock if not spiked and tag is on it. Our SOP defines time, temp and other conditions. If the temp is over 10C and they know they are not going to be able to start it, we take it back for disposal. We found that 30 minutes meant every unit was warmer than 10C. Some returned in 15 minutes are too warm...depends on which nursing unit it went to and where they laid it (like the heat vent or on the patient's chest).

[L106]

We handling things similarly to how AMcCord just described.

[John C. Staley]

Our policy was the same as Ann's even though the nursing policy never changed from 30 minutes most of them knew the window was much closer to 15 min. Luckily it was not a problem often. For a 300+ bed hospital we wasted very few units because they were returned out of temp.

[estiner]

We do not specify a time - just take the temperature of the unit. Then our policy lfollows the one described by AMcCord. Less than 10 degrees and it is returned to inventory, greater than 10 degrees it is quarantined but can still be transfused within the 4-hr limit if possible. If not, then it is discarded. The 30-min rule does not assure that "all components have been maintained at the appropriate temperature" STD 5.18.3 (2). In Florida it takes about 15-17 minutes for a unit to reach 10 degrees - the limit by FDA.