syringe ISBT code?

[sajohnson]

Does anyone know of a ISBT code specific for syringes. We aliquot RBC and FFP into syringes for pediatric transfusion and are searching for the specific ISBT code. Any help appreciated.

[tcoyle]

Wouldn't this be a divide of a unit? Product code with A0, B0, C0, D0...up to 26 instances?

[MAGNUM]

Syringe aliquots are divided units.

[sajohnson]

Wouldn't this be a divide of a unit? Product code with A0, B0, C0, D0...up to 26 instances?

That would be the instinctual answer, but apparently we need a code that specifies syringe aliquots from pedipak aliquots. There will be differing expiration dates and times since syringes are always considered an open system whereas pedipaks can and usually are sterile docked and carry the original expiration.

[Sandy L]

We use the "Open System" E code that corresponds to the "closed system" E code of the original product. For example, E0181 (RED BLOOD CELLS|CPD/500mL/refg|ResLeu:<5log6) keeps the same E Code when divided in a closed system. It just gets the appropriate division characters. If aliquots are prepared in a syringe the E code becomes E0175 (RED BLOOD CELLS|CPD/500mL/refg|Open|ResLeu:<5log6) with appropriate division characters. For each E code that could be aliquoted we searched the ICBBA data base for the same description but “open”.

[sajohnson]

We use the "Open System" E code that corresponds to the "closed system" E code of the original product. For example, E0181 (RED BLOOD CELLS|CPD/500mL/refg|ResLeu:<5log6) keeps the same E Code when divided in a closed system. It just gets the appropriate division characters. If aliquots are prepared in a syringe the E code becomes E0175 (RED BLOOD CELLS|CPD/500mL/refg|Open|ResLeu:<5log6) with appropriate division characters. For each E code that could be aliquoted we searched the ICBBA data base for the same description but “open”.

Thank you Sandy, I think that will give us the bread trail to find the code we need.

[BANKTECH]

Maybe you could keep it simple and only aliquot into Pedi-pak. Then, nursing can put in syringe and trasnfuse. Once out of Blood Bank, unit should be transfused within 4 hrs. This way, nursing can have the full time with the unit, since they are probably infusing at a slower rate. This way you can keep the divided A0, B0, etc label on the unit.

Edited August 3, 2012 by BANKTECH
Added some info

[ECabana]

We use the "Open System" E code that corresponds to the "closed system" E code of the original product. For example, E0181 (RED BLOOD CELLS|CPD/500mL/refg|ResLeu:<5log6) keeps the same E Code when divided in a closed system. It just gets the appropriate division characters. If aliquots are prepared in a syringe the E code becomes E0175 (RED BLOOD CELLS|CPD/500mL/refg|Open|ResLeu:<5log6) with appropriate division characters. For each E code that could be aliquoted we searched the ICBBA data base for the same description but “open”.

What Sandy says is correct. The syringe aliquot would receive a corresponding product description code with an "Open" attribute.

Erwin Cabana

ICCBBA

[BBK710]

Maybe you could keep it simple and only aliquot into Pedi-pak. Then, nursing can put in syringe and trasnfuse. Once out of Blood Bank, unit should be transfused within 4 hrs. This way, nursing can have the full time with the unit, since they are probably infusing at a slower rate. This way you can keep the divided A0, B0, etc label on the unit.

Once the blood is transferred to the syringe from the aliquot by nursing how is the syringe labeled? All of the information is on the aliquot which would be discarded once the blood is put into the syringe.

[sgoertzen]

We prepare small aliquots into ISBT labeled and tagged bags, and nurses pull the product into a syringe at the bedside using a small Y-Set (Baxter 4C2223, 13 inches) with an in-line filter. The labeled/tagged bag is NEVER disconnected from the syringe throughout the transfusion. The syringe simply becomes a part of the line from the bag to the patient. We've been doing it this way for years and it works very well.

[Mabel Adams]

Ah, so the trick is to leave it connected. I was about to say that we got dinged a few years back by the FDA for not having labels on the syringes that nursing used to pull the blood from the aliquot bag--but we didn't leave them attached.

[BANKTECH]

Once the blood is transferred to the syringe from the aliquot by nursing how is the syringe labeled? All of the information is on the aliquot which would be discarded once the blood is put into the syringe.

We attach a notecard with the same label as the pedi-pak bag. It includes the ISBT label and patient label. When nursing draws the blood into the syringe, they rubberband the notecard to the syringe.

[tbostock]

We are just starting to do NICU transfusions here: we sterile dock the syringe on to the original unit, so it is not an open system. We bring the syringe, labeled with the ISBT label to the NICU for transfusion.

So...if we pull a few syringes from the same unit for the same baby, how do I charge for each aliquot, since it is still a closed system?

[Mabel Adams]

Split unit P code for charging for all aliquots, even plts or RBCs for whatever logic that shows. You can also charge a CPT code for splitting but not if you give the last part of the unit. You can add a separate code for Irradiation if the P code for the split product doesn't include irradiation in its description. Pretty sure I remember that right.

[sajohnson]

We are using syringes from Charter Medical. Because they include a luer lock, even if they are sterile docked, they are considered an open system. Not sure if other syringes have the same setup.

[BBfuntimes]

On Friday, August 03, 2012 at 1:38 PM, sgoertzen said:

We prepare small aliquots into ISBT labeled and tagged bags, and nurses pull the product into a syringe at the bedside using a small Y-Set (Baxter 4C2223, 13 inches) with an in-line filter. The labeled/tagged bag is NEVER disconnected from the syringe throughout the transfusion. The syringe simply becomes a part of the line from the bag to the patient. We've been doing it this way for years and it works very well.

Do you give the product an "open" ISBT code on the pedi pack?

[Sandy L]

On ‎05‎/‎07‎/‎2016 at 6:52 AM, BBfuntimes said:

Do you give the product an "open" ISBT code on the pedi pack?

We use the same E code as the original unit (closed system) for the satellite bag.  We only divide into the satellite bag the volume they are requesting plus 5 mL for the tubing.  When we prepare the syringe with the corresponding open E code, we pull the entire contents of the satellite bag into the syringe, thus the product in the satellite bag is destroyed by the LIS system.  If you leave product behind in the satellite bag and it is an open system, it would need an Open E code as well.

[BBfuntimes]

Do you use the same tubing 4C2223 for FFP, platelets, cryo?

[sgoertzen]

Yes, we use this small 4C2223 tubing/filter set for transfusion of all blood products that they choose to pull into a syringe at the bedside.

[Eagle Eye]

anyone using safetrace --divide in syringe.

for me it is not working---with close system it keep same expiration for syringe. if I use open system it is changing parent code to open system code though the expiration stays same for parent and 24 hrs for syringe.