Pediatric transfusions without ISBT labelling available

[jschlosser]

We are a small hospital that didnt have the option of investing in an ISBT label printer so we cant aliquot units for pediatric transfusions. What are our options if we have a trauma involving a child needing blood? Can we hang a unit with the option of stopping the transfusion at the recommended volume for the child's weight and waste the remainder of the unit? Any other suggestions? (Our blood supplier is 4 hours away)

Edited April 10, 2015 by jschlosser

[tbostock]

Normally I would recommend buying the printer and not trusting them to get the volume right (I know of a hospital that "accidentally" gave the child the whole unit and it led to a very bad outcome). But if you're talking about something that might happen once every few years and you don't have the ability to aliquot/label, you'll have to give the whole unit. I would just want to be VERY involved to make sure I verified the correct volume and ensure that the nurse knew exactly how much to give. Even if that meant being present for the transfusion...yeah, yeah, I know...not Blood Bank's job, but I also like to sleep at night.

[Lbiggs]

If aliquoting a unit for neonatal resuscitation at the bedside, would that syringe be required to be FDA relabeled?

[David Saikin]

We don't transfuse neonates but would have to give release the entire unit.  Currently unable to provide aliquots (even for adults).  this would also hold true for small children transfusions.  Maybe someday the ivory tower guys will wake up!!!!  

Edited September 23, 2015 by David Saikin

[mcgouc]

I agree that, as long as the unit is issued with correct labeling, they can syringe at bedside. We would issue the entire unit with one or more of the neonatal/pediatric syringes with a filter attached. They filter & measure volume in syringe at bedside. We are usually able to get aliquoted/ISBT labeled bags from supplier. We issue each aliquot with one of the syringes as needed. We average transfusing only one neonate a year.

[NLiveris]

I believe the US Standard requires that syringes be labeled.  Digi-Trax makes a special 4" x 4" blank on-demand label that can be applied to syringes plus all ISBT 128 compliant labels.  We have Stand-Alone (HemaTrax) on-demand print system that is lower cost and will print all the required labels.