Emergency RBC for Pediatric Hospital

[heathervaught]

Greetings Community!  I would like to talk to anyone who has experience operating a blood bank in the pediatric setting.

The Blood Bank that serves my Pediatric hospital is located in the building next door, and therefore the staff at the Pediatric hospital feel that they "do not have a blood bank" (even though they are all connected by pneumatic tube and you can walk out of the door of one and into the other within several strides).  Therefore, there are several refrigerators throughout the hospital containing a unit or two of O- Emergency RBCs that they can grab and transfuse as uncrossmatched (filling out the appropriate paperwork and sending with samples to the Blood Bank).  They are located in the ER, OR, PICU, and NICU.

For anyone who stores RBCs like this for pediatric use, how old are the RBCs in the refrigerator?  Do you irradiate them? 

For anyone who does NOT store RBCs like this, how did you convince everyone that you could deliver uncrossmatched RBCs quickly enough that they should just order them from the Blood Bank?  I have suggested that they can just call and we can get them what they need, but was met with the argument that "when we need them, we need them now."

Thanks in advance!

Heather

[goodchild]

How do you review the rate of utilization/indication for use of blood products stored outside of blood bank? Compiling historical data might be a good place to start.

[David Saikin]

You can only review all their usage and see how/why they need them - how critical is their need. 

Your Medical Director will need to be intimately involved.

Good Luck!

[Auntie-D]

In the UK we are forbidden from having remote sites now. We have O-Neg, CMV neg, K-neg, HEV neg, units. We do not have irradiated units, or less than a certain date as we do not have babies who have undergone IUT, and if we do we are notified in advance and we get irradiated units in for them.

[Malcolm Needs ★]

49 minutes ago, Auntie-D said:

In the UK we are forbidden from having remote sites now.

First I've heard of it.  Forbidden by whom?

[Auntie-D]

1 hour ago, Malcolm Needs said:

First I've heard of it.  Forbidden by whom?

ISO inspectors have said the fridges have to be under direct control of the lab - a few labs I know have been told to remove their remote fridges.

[Malcolm Needs ★]

Oh UKAS getting above themselves again.  They should learn to stick to what they are supposed to cover.  Be interesting to see how they manage this "dictat" in somewhere like Leeds Teaching Hospitals.  I would be inclined to challenge them/tell them in no uncertain terms just where (and how) to get off!

Edited August 19, 2016 by Malcolm Needs

[Auntie-D]

12 minutes ago, Malcolm Needs said:

Oh UKAS getting above themselves again.  They should learn to stick to what they are supposed to cover.  Be interesting to see how they manage this "dictat" in somewhere like Leeds Teaching Hospitals.  I would be inclined to challenge them/tell them in no uncertain terms just where (and how) to get off!

In the MHRA inspection I had when I was BBSup I challenged on 4 different non-conformances and had them wiped off. My current employer (and others too) seem to think that you cannot challenge their interpretation of your policies - and sometimes the interpretations are incorrect.

[Dan87]

On 8/18/2016 at 10:16 AM, heathervaught said:

 

For anyone who stores RBCs like this for pediatric use, how old are the RBCs in the refrigerator?  Do you irradiate them? 

 

 less than 7 days old and they are not irradiated. 

[gagpinks]

On 19/08/2016 at 11:14 AM, Auntie-D said:

ISO inspectors have said the fridges have to be under direct control of the lab - a few labs I know have been told to remove their remote  fridge. 

 

Yes first time heard.  We have 2 remote fridge one in maternity and one in theatre for emergency o neg and recently  we had UKAS inspection but they didn't raise any NC. In fact they actually went to examine both remote fridge. 

 

Edited August 24, 2016 by gagpinks

[Baby Banker]

We do ECMO and have refrigerators in those locations.  We are thinking about getting a Blood Track Emerge for the Trauma Room in the ED.

[Teristella]

6 minutes ago, Baby Banker said:

We do ECMO and have refrigerators in those locations.  We are thinking about getting a Blood Track Emerge for the Trauma Room in the ED.

We used the Emerge for our trauma bay at my previous hospital... it worked well as long as the nurses were trained, but our trauma department had difficulties with high turnover. If they aren't trained well they ended up panicking and opening the fridge and not scanning out the units. As long as there was only one trauma at a time we could track everything easily; if not, and we were not familiar with the nurse working the kiosk, we would go down to manage it ourselves. A lot of it did depend on the physicians as well, some were very vocal about getting blood quickly and would bully the nurses into shortcuts.