retention of used blood bags

[pluto]

Currentlly we keep used blood bags for 48hrs post transfusion which we are trying to reduce

Rationale is delayed transfusion reactions , you then have blood bags to go back to recrossmatch

anyone else keep them , number of times we require them are very rare - none that I recall this year

We are seeing it as infection control risk having these on the ward though they are stored in a designated area in a suitable container

thanks pluto

[phouck]

We do not retain the blood bags. The transfusing locations properly dispose of the bags when the transfusion is finished. We do, however, retain the segment from the unit that was used for crossmatch and we also retain a segemnt when the units are entered into inventory.

pat

[RR1]

We do similar to you Pluto, though I do have concerns about the infection risk. At my previous place the transfused bags were returned to the lab by portering staff, but boy, the infection risk when a bag leaked was probably a lot worse, especially as these were sometimes collected together with patient samples...yuck...the mess was horrible!

Pat- at least the way you describe is a lot cleaner, but does seem a bit time-consuming. How do you manage inventory of the segments themselves?

Thanks

[Malcolm Needs ☆]

Hi Rashmi,

I'm not totally sure about this, but I think each "pigtail" has a unique number on it that corresponds to the bag (not the ISBT number on the bag, but the manufacturing number of the bag itself).

You could also tag the segments with a sticky label with the patient's name, Date of Birth, Hospital Number, etc, on it.

:confused::confused:???????????????

Edited November 16, 2009 by Malcolm Needs
The first post was even less useful than the one I actually posted!!!!!!!!!!!

[pluto]

thanks Rashmi

years ago we also had them returned but is was very messy and we also had rare occasions when they were posted back in the internal mail - ubelievable

Transfusion team have just audited this and found some on wards long after 48 hours , in one example months

[RR1]

Thanks Malcolm,

The lines do have a manufacturing number repeated along the length, but if you were to keep a segment the actual ISBT number would need to be linked as even if patient details were written on each segment , you wouldn't know which bag it was linked to.

[Malcolm Needs ☆]

Thanks Malcolm,

The lines do have a manufacturing number repeated along the length, but if you were to keep a segment the actual ISBT number would need to be linked as even if patient details were written on each segment , you wouldn't know which bag it was linked to.

True, but there would be extremely few times when you would need to know.

When you do need to know, you just telephone "Big Brother" (the NHSBT) and they would be able to tell you the link between the two!!!!!!!!!!!!!!!

We keep records on EVERYTHING (some of them, just occasionally, being useful)!

:):)

[RR1]

True, but there would be extremely few times when you would need to know.

When you do need to know, you just telephone "Big Brother" (the NHSBT) and they would be able to tell you the link between the two!!!!!!!!!!!!!!!

We keep records on EVERYTHING (some of them, just occasionally, being useful)!

:):)

Good to know this- thanks, but I don't really want to go down this route as I am certain my staff would kill me!

Now that you have reached your 1000th post- are you now a decaying/ old/ mature/ senile, or is there another term for this status as a poster on BBT?:tongue:

Oh...forgot to add....the drinks are on YOU!

Edited November 16, 2009 by RR1

[Malcolm Needs ☆]

Now that you have reached your 1000th post- are you now a decaying/ old/ mature/ senile, or is there another term for this status as a poster on BBT?:tongue:

Oh...forgot to add....the drinks are on YOU!

Edited November 16, 2009 by Malcolm Needs

[clmergen]

We wrap a unit number around a segment and throw it in a bag that is labeled with receive dates. if we need a segment, we sit down and sort through the bag. We don't often go back to the bag , maybe a couple of times per year. It works for us.

[BBK710]

We wrap a unit number around a segment and throw it in a bag that is labeled with receive dates. if we need a segment, we sit down and sort through the bag. We don't often go back to the bag , maybe a couple of times per year. It works for us.

We do the same except that we put it in a bag marked with the expiration date so that we know when we can discard the bag - 7 days after the expiration of the units. We rarely have to go back to find a segment though.

[phouck]

Rashmi,

We put a small label from Meditech on a 12 x 75 tube and put the crossmatch segment in it. We retain these for 3 days after crossmatch. The ones that are retained at entry into inventory are kept for a couple of months and then destroyed. We always have the current month and 2 months back in the refrigerator. We are not a big hospital and we give most of what we crossmatch either the day it is crossmatched or the next day.

Forgot to tell you that we attach the small unit number from the bag to the segment. This makes it easier to find the segment.

pat

Edited November 16, 2009 by phouck

[adiescast]

We retain the actual crossmatch segment in a bag with the sample it was crossmatched with. If we did electronic crossmatch, we retain a segment (unopened and cleaner!) with the sample. We may not be able to continue that if we change our current process of having the "crossmatcher" (the person who did the type and screen) select and tag the units whether there is a serological crossmatch or not. We retain a segment from each unit that comes into our inventory. We place a DIN sticker on the segment and put it in a bag with the receive date and discard date. These bags are retained for 56 days (42 days for the longest possible time on shelf + 14 days to allow for delayed transfusion reaction). We do occasionally have to go through the bags. How much of a chore it is depends on how many units we received that day.

[RR1]

Thanks everyone, it just seems quite a lot of effort for something you may only need once or twice a year at the most. If a patient reacts immediately, the unit would still be readily available. However, if there is a suspected delayed reaction for folk that don't hold onto segments, we could potentially lose that part of the investigation process.

Malcolm, or anyone else- would you know how long donor samples are retained in the UK, in which case in the rare event of this happening we might be able to forward the samples for you to test?? ( I know..moan, moan, moan!!!)

[Malcolm Needs ☆]

Not off the top of my head Rashmi (I'm at home at the moment), but I will try to find out.

We would be delighted (moan, moan, moan??????????) if poeple did this, because this is what is recommended by SHOT. It is not there to "catch people out", but so particular techniques/technologies can be monitored to see if there is a national trend with one particular technique/technology missing clinically significant antibodies.

[Joanne P. Scannell]

Bags are discarded at the infusion site as soon as the transfusion is over.

To address the issue of having samples for TXRX workups, when RBC's are initially entered into our system, we take 2 segments from each unit and place them in a plastic tube labeled with the donor number. These tubes are placed in a container and kept in the refrigerator for 2 months. This allows for 'time until outdate' with time to spare (in case a unit gets transfused on the expiration date, we need to keep the segment for 10 days after that). If there is a TXRX, we go find the segments.

[John C. Staley]

We had stopped having the empty bags returned many years ago. I don't recall ever going back to the empty bag for anything. We would pull two or three segments from each bag when they arrived from the supplier, place them in a storage bag labled for the day and each set of segments had a number from the bag attached for identification. Takes up much less space and no MESS!!!!

:disbelief

[RR1]

So for folk keeping segments, are the component lines pre-segmented when you receive them or are you segmenting on receipt then pulling these off?

[L106]

We stopped having the nursing units return the empty bags to us many years ago. (What a mess!)

We pull (or cut) 2 segments from the donor units and label them with a sticky donor unit number sticker from the donor unit at the time the unit is issued. They go in the rack with all patient samples that were tested that day, and we keep the patient samples and donor segments for two weeks. (We don't, but one could also put a patient computer sticker on the tube with the donor segments.)

[clmergen]

Units come to us all pre-segmented, we just have to pull off what we need.

[Eoin]

We were disposing on the wards, but it was "suggested" at regulatory audit that we retain for 48 hours post infusion. Haven't had need to attack yet, but did in my previous life in Oz.

We insist they use strong, sealed bio-hazard bags - with patient addressograph label and date on outside.

Seems to work - must audit to see number of returns.

Thanks Folks,

Eoin

[skopti]

The transfusing location disposes of the empty bags. The bloos bank keeps 2 segments when the unit is issued and retained for 7 days post transfusuion.

The units arrive at the blood bank pre-segmented

[Trek Tech]

We stopped having the nursing units return the empty bags to us many years ago. (What a mess!)

We pull (or cut) 2 segments from the donor units and label them with a sticky donor unit number sticker from the donor unit at the time the unit is issued. They go in the rack with all patient samples that were tested that day, and we keep the patient samples and donor segments for two weeks. (We don't, but one could also put a patient computer sticker on the tube with the donor segments.)

We tried pulling of at time of issue but we had too many people forget to pull them at time of issue (especially in stressful situations or off shifts). We currently pull them when the units come in and stick a unit number on each one. We put them in a zip lock bag. The bag is then labeled with the date the unit was received and is dated for discard in 42 days (longest possible out date of units).

[SMW]

To Trecktech2 but add additional days to the discard date since samples need to be retained for at least 7 days after transfusion and product could be transfused on the day of expiration (42 days)....although I realize it's highly unlikely to receive a unit on day 0 or even day 1.

[L106]

SMW - You make a valid point. (That kind of detail is something that our FDA inspector would zero in on.)