Pediatric Transfer Bags

[jshafer]

At our facility we are currently working on a pediatric mass transfusion policy. We are in the process of looking for transfer bags. The closest thing I could find was 4 150 ml transfer bags. Unfortunately the company requires a case to be purchased at a time. We will probably only use 2-3 a year. Does anyone use anthing similar and were to purchase them.

Thank you!

[dragonlady97213]

Are you planning on getting a product from your blood supplier to use for this protocol?  Perhaps your supplier could provide the product with transfer packs docked on the unit before it is shipped to you.  When I was in a hospital blood bank, we got our baby units with a 6 pack of transfer bags docked on the unit.  If the unit didn't get used for a baby, we converted the unit for adult use and removed the transfer packs.

I work for a supplier now and we have several customers that are provided this type of service.

[MAGNUM]

Same here as Jeanne. I order a "baby unit" from our supplier, and they sterile dock 6 aliquot bags to the mother unit. If I find that I will not be using the unit for babies, at 14 days I remove the aliquot bags and transfer it to my stock to be used for adults.

[jshafer]

On ‎1‎/‎19‎/‎2017 at 8:02 PM, dragonlady97213 said:

Are you planning on getting a product from your blood supplier to use for this protocol?  Perhaps your supplier could provide the product with transfer packs docked on the unit before it is shipped to you.  When I was in a hospital blood bank, we got our baby units with a 6 pack of transfer bags docked on the unit.  If the unit didn't get used for a baby, we converted the unit for adult use and removed the transfer packs.

I work for a supplier now and we have several customers that are provided this type of service.

We do get one baby unit a week that has the transfer packs docked to the unit. I wanted to have transfer packs in house that we could sterile dock ourself since we have a welder if needed.

[MOBB]

Our pediatric hospital orders 150 mL and 300 mL bags and 30 mL and 60 mL syringes. Since they are pediatric, they do purchase cases at a time.

At our facility, we issue the whole unit. Nursing can run it with a pump and toss what they don't need. We never split units and wouldn't have a use for a partial unit.

Maybe you could cost share with another hospital or two and split the case?

[MelAnn]

If you are looking at the Fenwal quadruple transfer packs (150mL) they do not have an expiration date. We are a level 1 pediatric trauma facility and if we have a mass transfusion on any pediatric patient we don't split units. <20kg they get 2 adult units. 20-40kg they will get 4 adult units.

[Carrie Easley]

We are also revising our MTP procedure to include peds.  Although we routinely divide units for neonates and pediatric patients, we will issue full units during an MTP.  The clinicians do not want to wait while we physically and electronically divide the units.  The # of packed cell and plasma units issued per MTP "round" will be based on patient weight.  Once they hit 45-50 kilos (still under discussion), we will use full adult rounds ( 6prbc/6plasma).

[kate murphy]

I agree with CarrieM.  In an MTP, nobody wants to wait.

We issue full units, and full FFP units.  Pedi docs can transfuse partial units - we tell them if there is any blood left at 4 hours, to discard. 

On a general note, it's really hard to maintain competency in something that's only done rarely. 

Keep it simple for your staff. 

[jshafer]

CariieM we did decide that once the patient is 50 kg we will use the adult pediatric MTP policy. Kate Murphy, I was thinking we would take up whole units for the first red blood cell and plasma. Why they are runing them up another blood banker would split units based on the weight. I'm thinking you might be right in issueing full units since it will maybe only be done 1 a year. At your facility do the Dr. just take the amount they need from one unit then discard the rest?

[kate murphy]

jshafer - yes, the docs use only partial units for a little kid. 

From the medical staff side, they appreciate rapid response and having "enough" blood.  There's a comfort level is having a whole unit they can start/stop over a 4 hour period.

[Townsend]

When we initially instituted our MTP in 2007, we had our packs (based on weight) that included splitting/aliquotting for the smaller patients.  However, after a couple of years with that practice, we realized that it just took too long to do all of that preparation to get the products out.  Now the packs include full units of all products - We use a smaller pediatric plasma unit (about 70-100ml) that is prepared prior to freezing by our supplier for the little ones under 10kg.

We are a free-standing pediatric hospital (level 1 trauma center), about 500 inpatient beds and 25-30 MTPs each year - just to give you an idea of our patient population.

Stephanie

[jshafer]

On ‎1‎/‎26‎/‎2017 at 8:47 AM, Townsend said:

When we initially instituted our MTP in 2007, we had our packs (based on weight) that included splitting/aliquotting for the smaller patients.  However, after a couple of years with that practice, we realized that it just took too long to do all of that preparation to get the products out.  Now the packs include full units of all products - We use a smaller pediatric plasma unit (about 70-100ml) that is prepared prior to freezing by our supplier for the little ones under 10kg.

We are a free-standing pediatric hospital (level 1 trauma center), about 500 inpatient beds and 25-30 MTPs each year - just to give you an idea of our patient population.

Stephanie

I will have to check if we can get pediatric plasma units from our supplier. I didn't think of that.

[Carrie Easley]

The other issue is wastage.  We routinely have product returned at the conclusion of adult MTP's.  As long as the units were stored correctly, we are usually able to use them for other patients.  I doubt the same would be true of divided units...