mollyredone Posted January 3, 2017 Share Posted January 3, 2017 I had this question asked by my staff and I wanted to get some other opinions. An inpatient had a blood bank sample drawn. A unit of PRBC was issued on this patient before the patient sample expired, but the transfusion was not completed until 12 minutes after the sample expired. The patient had received three previous units of PRBCs, starting 5 days prior. When they wanted another unit we got a new sample. My feeling is that if the unit was started before the sample expired, it was still okay to issue it. What is your policy/process for this situation? Thanks! Link to comment Share on other sites More sharing options...
tcoyle Posted January 3, 2017 Share Posted January 3, 2017 We issue until the sample expiration. Our samples are good for 3 days with day 0 being the day of draw. Our computer expires the samples at midnight regardless of draw time. Link to comment Share on other sites More sharing options...
Ensis01 Posted January 3, 2017 Share Posted January 3, 2017 Issue products until the specimen expires, the BB LISS therefore has the pertinent records that can be checked. Same principle as when issuing products until just before they expire, think platelets close to midnight. The infusion timeframe is under nursing SOPs. Link to comment Share on other sites More sharing options...
AuntiS Posted January 4, 2017 Share Posted January 4, 2017 We do the same - issue until the sample expires. s Link to comment Share on other sites More sharing options...
MAGNUM Posted January 4, 2017 Share Posted January 4, 2017 Issue until the specimen expires. Pretty much that same as everyone else. Link to comment Share on other sites More sharing options...
mollyredone Posted January 4, 2017 Author Share Posted January 4, 2017 Thanks everyone! That's what I will go with! Link to comment Share on other sites More sharing options...
cheru26 Posted January 5, 2017 Share Posted January 5, 2017 It is ok to as long as the sample was in date when issued. No problem at all. mollyredone 1 Link to comment Share on other sites More sharing options...
mollyredone Posted January 5, 2017 Author Share Posted January 5, 2017 Is that written in any AABB publication or inspection checklist, or is it just common sense? Link to comment Share on other sites More sharing options...
Dansket Posted January 5, 2017 Share Posted January 5, 2017 1 hour ago, mollyredone said: Is that written in any AABB publication or inspection checklist, or is it just common sense? AABB Standards 30th Edition 5.14.3.2 states, "The sample shall be obtained from the patient within 3 days of the scheduled transfusion in the following situations. Day 0 is the day of draw." The three conditions are 1)transfused in the preceding 3 months with blood component containing allogenic red cells, 2)pregnant within the preceding 3 months or 3) history of transfusion or pregnancy is uncertain or unavailable. I interpret this to mean that the blood component must be issued before the sample expires at 2359 on day 3. AABB Standard 5.28 Administration of Blood and Blood Components states, "There shall be a protocol for the administration of blood and blood components... The protocol shall be consistent with the Circular of Information for the Use of Human Blood and Blood Components. Standard 7.5 applies." I don't have a copy at hand but it may address blood being infused after blood sample has expired? Link to comment Share on other sites More sharing options...
goodchild Posted January 6, 2017 Share Posted January 6, 2017 2 hours ago, Dansket said: I interpret this to mean that the blood component must be issued before the sample expires at 2359 on day 3. We interpret this to mean 96 hours from the specimen's collect time. We also issue up to the expiration time. Similar concept with blood product expiration. If they start transfusing platelets at 23:30 that expire at 23:59, they don't have to stop the transfusion at 00:00. Link to comment Share on other sites More sharing options...
mollyredone Posted January 6, 2017 Author Share Posted January 6, 2017 I agree, it's not like the patient's sample or the product turn into pumpkins at midnight! All of the evening shift techs have 3 years or less experience as techs, so sometimes you have to spell it out for them, hence flowcharts and printed directions on processes in Meditech. Saves me a lot of calls! Link to comment Share on other sites More sharing options...
milesd3 Posted January 9, 2017 Share Posted January 9, 2017 On 1/3/2017 at 3:33 PM, mollyredone said: I had this question asked by my staff and I wanted to get some other opinions. An inpatient had a blood bank sample drawn. A unit of PRBC was issued on this patient before the patient sample expired, but the transfusion was not completed until 12 minutes after the sample expired. The patient had received three previous units of PRBCs, starting 5 days prior. When they wanted another unit we got a new sample. My feeling is that if the unit was started before the sample expired, it was still okay to issue it. What is your policy/process for this situation? Thanks! Unless I'm mistaken AABB changed it wording on how good a sample is good for. Years ago it said 72 hours but that was changed to read 3 days so if the unit was given within those 3 days there is no problem. Might be a grey area after midnight since technically its a new day. Link to comment Share on other sites More sharing options...
Dansket Posted January 9, 2017 Share Posted January 9, 2017 2 hours ago, milesd3 said: Unless I'm mistaken AABB changed it wording on how good a sample is good for. Years ago it said 72 hours but that was changed to read 3 days so if the unit was given within those 3 days there is no problem. Might be a grey area after midnight since technically its a new day. That is correct. We should be thinking in terms of calendar days not hours. A calendar day starts at 0000 and ends at 2359. A specimen collected at 0000 does not expire until 2359 of that calendar day. Link to comment Share on other sites More sharing options...
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