C-Section and the age of the pRBCs

[Liz]

Hello,

I have been busy with inspection from various agencies. One more to go.. (

Is there a requirement stating that the age of the pRBCs for a C-section should be less than a certain number of days?

Thank you

[khalidm3]

More than 25 years in the transfusion, I had not listened any such requirement, though all my work and connections are in under developed countries. Did an inspector raised such question?

Edited November 15, 2010 by khalidm3

[Liz]

haha: not yet, but one requirement states: does "A policy and procedure exist for blood and blood products utilized during caesarian section and open heart surgery. This is a French inspection.

I was just wondering what they mean, is it the age, or what?

[Fluffy agglutinates]

Perhaps they mean what is available on standby at very short notice? Or if cell salvage is used where possible?

I was under the impression the evidence for 'fresh blood' being better for adults had been withdrawn/ not proved - so I can't imagine this is what they mean.

Could be wrong though!

[Liz]

I really cannot imagine what they mean.

I think we have been internationally inspected by now, including Australia, etc... I went to the EU policies but did not find anything.

Thanks for your thoughts. Do we have French members? guests?

[Likewine99]

I haven't seen this for C-sections but we've had some discussions re: age of RBC's for open heart surgery pts. Better outcomes for the pt if RBC's are "fresh" which is less than 14 days old.

[John C. Staley]

Liz, I'm curious. Where are you and why all the international inspections?:bonk:

[Malcolm Needs ☆]

I too have never heard about this for C/S.

I have heard of it for cardiac surgery - but whether it is justified by clinical evidence is another thing entirely.

[RR1]

haha: not yet, but one requirement states: does "A policy and procedure exist for blood and blood products utilized during caesarian section and open heart surgery. This is a French inspection.

I was just wondering what they mean, is it the age, or what?

Could this be a requirement to demonstrate that a policy exists for high risk procedures- and should cover caesarians and Heart ops?

Number of units on standby or group and hold only (maximum blood ordering schedule)

Are fresh (ish) units used for the heart ops or not?

K- / CMV- for C/sections?

Does the policy cover all clinical/lab staff actions in the event of a major obstetric haemorrhage/ massive blood loss event?

Why not directly ask the inspectorate what they expect sites to have available- much easier then speculating.

[Malcolm Needs ☆]

One reason, in my experience, is that some of them will not tell you (because they don't actually know themselves), or have just dreamed up the need on the spot (not all, by any means, but some).

:angered::angered:

[mel]

I've been in Blood Banking for 40 years and have never heard of such a requirement.

[Liz]

Liz, I'm curious. Where are you and why all the international inspections?:bonk:

John, the Ministry of public Health chooses different agencies at each inspection, and they come from different areas on the globe.

The great news is that we will now put down our checklist and they will use it for the country, of course this is a task for several years to come.

[Liz]

Could this be a requirement to demonstrate that a policy exists for high risk procedures- and should cover caesarians and Heart ops?

Number of units on standby or group and hold only (maximum blood ordering schedule)

Are fresh (ish) units used for the heart ops or not?

K- / CMV- for C/sections?

Does the policy cover all clinical/lab staff actions in the event of a major obstetric haemorrhage/ massive blood loss event?

Why not directly ask the inspectorate what they expect sites to have available- much easier then speculating.

Malcolm is right Rashmi they will not tell us and probably becase they dont know why it was put there age ago. and i certainly dont want to draw their attention to it.

[Liz]

Thank you for the replies, yes it sounds like I should have a policy to be prepared for transfusions with standby units. and thank you for confirming that "fresh" is not what they want...