Remote location for administration of blood products

[velliott]

I need help with the particulars in shipping/ issuing blood products for patients that are at one of our remote locations that is an oncology center (the center is 6 miles from our hospital). The center is part of our facility so the employees will be under our regulations but my concern is packing units to send to the center and then they sit there for several hours during the transfusion process. My concern, well actually I have a bunch, but the one right now is a patient who gets 2 red cells and 1 platelet. They typically transfuse the red cells first and finish with the platelets because they get a 1 hour platelet count before the patient is discharged. In my current setting we rotate platelets for 30-60 minutes before we issue them and if they are sitting in a transport container for 5-6 hours won't they need to be "mixed" before transfusing?

Anyone's experience / comments in this type of setting will greatly be appreciated.

[David Saikin]

You could always have them transfuse the plts first . . . I would think the red cells would be fine in the shipping container with ice during their sojourn to your remote site.

[Deny Morlino]

The AABB Standards 26th ed indicate the maximum time without rotation for all platelet products listed is 24 hours. For a remote site either the procedures will need to indicate an exception from the "in-house" procedure (i.e. no mechanical rotation available), or a small single unit platform rotator could be obtained and the platelets allowed to rotate while waiting for transfusion. If this is a frequent situation (?) I would probably be more comfortable with the second option. Platelets while transported from our supplier may spend several hours off of a rotater. We normally have the unit in the rotater for more than your indicated 30 minutes, but have had occassions with less time than that prior to signout. Hope this helps!

[JOANBALONE]

I am not aware of any requirement of rotating platelets for any amount of time before transfusing.