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YorkshireExile

Returning FFP not used

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On behalf of a colleague:

 

Whenever we issue a blood product we employ the 30 mins rule for it to be returned if it is not used. If returned unused after 30 mins we would discard the product.

We strictly apply to this blood units (even though there is no direct evidence for the 30 minute limit, as has been mentioned previously in this forum).

 

Does everyone also apply this rule to FFP and platelets? Would you discard these units if returned after 30 minutes?

 

For those who would, is there any difference if the FFP is actually issued straight from being thawed in the waterbath so it is still relatively warm, or if the FFP is issued cold after being in the fridge for a while. Would the 30 minute rule apply regardless?

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If you ask the Blood Transfusion Service (in the UK) you will get a different answer each time. We have been told 2 hours, 4 hours, 24 hours and 30 minutes - take your pick ;)

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We just changed our policy to 60 minutes for non-red cell products.

 

Do you have references for this?  I don't have anything different for non-red cell products, but it makes a lot of sense.

 

TIA,  Mari

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We have a limit of thirty minutes for everything.  Not sure what it is based on, but the main reason is that if a product is outside of proper temp monitoring for more than thirty minutes, we do not want to re-issue it,  The only continuously monitored storage for blood products for our hospital is in the BB.

 

Coolers for OR or ER are issued differently so that we can return those products to inventory or whatever as long as the temps are properly verified when they are returned.

 

Scott

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There is no 30 minute rule. You have to accept returned products based on valid temperatures instead of time, unless you have validated a specific time. For example, some BBs have validated it themselves and found that after 10 minutes, it's out of range. It's way out of range by 30 minutes, so you may want to re-evaluate your process.

As far as FFP, since it goes out warmer than red cells, you can almost never get them to be in range for return. Platelets, as long as they are 20-24 and you do a visual inspection, you could have it in your policy to return them according to certain criteria.

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I agree with Terri. For years, AABB indirectly endorsed the 30 minute rule in the Tech Manual with a passage that read something like "Many facilities use a 30 minute limit....." but they dropped that a few editions ago and now want you to take the unit's temp. The 30 minute rule has to date back from the whole blood bloated bag days; if you try this yourself with a mock or outdated unit of packed cells you'll find it's more of a 15 minute rule at best. An inspection or two ago, I asked about the no-win situation with FFP, and they basically said you're screwed, it has to come back <10o, which is rather tough when you issue it straight from the waterbath.

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An inspection or two ago, I asked about the no-win situation with FFP, and they basically said you're screwed, it has to come back <10o, which is rather tough when you issue it straight from the waterbath.

 

If you use the Sahara III it alarms as soon as there is no ice so it is possible to issue it at 2-4 degrees :) There is a prinout charting the temperature during thawing as proof for records.

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I agree with Terri. For years, AABB indirectly endorsed the 30 minute rule in the Tech Manual with a passage that read something like "Many facilities use a 30 minute limit....." but they dropped that a few editions ago and now want you to take the unit's temp. The 30 minute rule has to date back from the whole blood bloated bag days; if you try this yourself with a mock or outdated unit of packed cells you'll find it's more of a 15 minute rule at best. An inspection or two ago, I asked about the no-win situation with FFP, and they basically said you're screwed, it has to come back <10o, which is rather tough when you issue it straight from the waterbath.

Dr.Pepper,

Do you have a specific temperature device that you can recommend?

Thanks,

 

Eva

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Dr.Pepper,

Do you have a specific temperature device that you can recommend?

Thanks,

 

Eva

 

I do!

 

If you use the Sahara III it alarms as soon as there is no ice so it is possible to issue it at 2-4 degrees :) There is a prinout charting the temperature during thawing as proof for records.

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I agree with Terri. For years, AABB indirectly endorsed the 30 minute rule in the Tech Manual with a passage that read something like "Many facilities use a 30 minute limit....." but they dropped that a few editions ago and now want you to take the unit's temp. The 30 minute rule has to date back from the whole blood bloated bag days; if you try this yourself with a mock or outdated unit of packed cells you'll find it's more of a 15 minute rule at best. An inspection or two ago, I asked about the no-win situation with FFP, and they basically said you're screwed, it has to come back <10o, which is rather tough when you issue it straight from the waterbath.

We did a 'validation' and found it took about an hour for 'just thawed' plasma to cool to below 6oC in the refrigerator.  Given that, if we issue Thawed Plasma within the hour from thaw time, we put a notation 'Issued Prior to Cooling'.  If it comes back, it is not expected to be less than 6oC, obviously, so here's our criteria for returning the product to inventory:  (Rationale: Room Temperature stored products, e.g. Cryo, are 'good' for 6hrs after thaw.)

Thawed Plasma:

  • ‘Issued prior to Cooling’ and it is less than 6 hours from THAW time.
  • Issued after cooling to 1-6oC and meets the same criteria as for Red Blood Cells.

Platelets:

  • Between 20- 24oC.
  • Has not been without agitation for greater than 24 hours.

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We take the temperature of everything when it is returned, unless it is returned in one of our coolers..that has been validated.

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