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30 minutes for return blood and blood products


AMER
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We do not allow the return of a product unless it has a Hemotemp II temperature monitor and can confirm that the temperature did not exceed 10 C. Last week a nurse returned a unit after ten minutes. I placed in the refrigerator for a few monutes then decided to apply a monitor. The temp of the unit was between and 9. WHatever you decide to do, you must be able to monitor the temp.

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We take the temps of all returned red cell units from all patient care areas that do not have approved storage devices and only return red cells to inventory if the temp is 1-10 C. We affix a Safe T Vue 10 indicator to all red cells if sending to patient care areas with approved storage devices and determine if red cells can be returned to inventory based on the indicator. We have different acceptance criteria for platelets, plasma and cryo.

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We do not use 30 minutes (or any time frame) for acceptability of return. It has to meet all of our criteria for temps (2-10 for rbcs and thawed FFP, 20-24 for platelets and cryo), and visual inspection criteria (bag not entered, segments still attached, passes visual inspection for appearance and color, label intact, etc). If it doesn't meet all of the above, they are discarded. FFP always fails because it does not usually leave here as cold as the RBCs do.

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Our criteria for plasma is a return temp of 1-10 C, however I may obtain pathologist ok to return to inventory if return temp is >10 C. Criteria for returned cryo and platelets is based on time as long at the return temp of the product is 20-24 C.

Question - What are your acceptance criteria for platelets, plasma and cryo? thanks
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You can tie the bag around a thermometer or use a temp device (infrared therm or HemoTempII). We only allow 15 minutes.

Where can I get a inrared therm to take temperature of the bag on return? Any recommendations of mfg and catalog number? I need to update my procedure.

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Both AABB and CAP until now we are thinking how to resolve this problem they gave us one month to solve this problem.when they read the procedures they found the 30 min . for RETURN Blodd and Blood Products.

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Terri ,We do all those criteria + 30 minuts But it is not enough for them.they need the approval?

Hi AMER. What type of approval are you looking for? Do you need to find out what the regulations are? Or are you looking for suggestions on how to properly document the inspection of the returned unit?

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I did several checks on expired units of red cells. Using a calibrated infrared thermometer (Global Sensors Model AQA1721), I found that the units reached >10 C in as little as 10 minutes when left on the counter at room temperature. This prompted us to start placing the units on refrigerated gel packs during issue. When sending the units to monitored refrigerators, each unit has a Safe-T-Vue temperature indicator placed on it and they are placed in coolers for transport to the refrigerators. If any unit comes back with a red temperature indicator and/or temperature >10 C, it is discarded. Platelets are a little more tricky...as far as I know, there are no temperature indicators that would indicate if the unit went outside the 20-24C range. We will discard any platelet unit that comes back outside that range.

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Looking in the Technical Manual, I see that they are still making the same comment with regard to Return of Blood Products:

"Transfusion services may set limits, based on validation, to the time that a unit can be out of the controlled storage environment before it is considered unsuitable for reissue (usually 30 minutes)"

Yet as others have pointed out, the "move" is towards actually determining the temperature upon Return; at least for RBCs. Years ago, I was told of another Hospital using an Infrared Thermometer; and that they worked great. At that time, I was ordering it because the FDA had cited that Hospital for not taking temps. on blood products that they received from their Donor Center (and up until then, we didn't either). I ordered the same one and set about to validate it. What I found was that you could get quite a variation of temps., depending on where on the unit you pointed it! Upon calling that other Hospital to ask them about their validation studies, the supervisor told me they got the same results. But her comment was: If they want me to take a temp., I will give them a temp.!

That being said, I did purchase an IR thermometer at my last place with the intention of validating it (hoping they are more reliable) for units Returned from Issue. This did not get done prior to my leaving, but hopefully is still on the to-do list of the person to whom I assigned the project.

Brenda Hutson

Brenda Hutson

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IR thermometers have to be adjusted for the emissivity of what you are testing. I find this understandable enough, I guess, but I wasn't prepared for that when we bought our IR thermometer. It works pretty goo d for us.

How did you adjusted your IR for the emissivity?

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We followed the instructions that came with it. Emissivity has to do with how reflective the surface you are reading is, I think. Once set for reading a certain kind of surface, it may not read right on a different kind of surface. So you may need to always read on the bag label or not but just be consistent.

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actually the question that I was going to ask is almost the same.

as far as I know, my teacher told me that according to one research it took around 30 minutes to increase the blood's temperature to 10 degrees (if the room temperature around 20-24 degrees).

but is there any real statement or research about this (it takes around 30 minutes bla bla bla) and about the consequence of getting the blood to 10 degrees high? is it really increasing the possibility of bacterial contamination and the hemolysis?

the problem is I still couldn't find the literature about that and the literature about what will happen if the blood's temperature gets 10 degrees.

my logic told me that it will increase the possibility of bacterial contamination, but I can't give any data about the percentage. I also said that it will make the blood lysis, but again I don't have the data.

anyone have?

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