Cliff Posted May 23, 2017 Share Posted May 23, 2017 I think we can all agree that products must be transfused within 4 hours. I cannot find when this 4 hour window starts. Does it start from the time the transfusion starts? What if it took 45 minutes from the time it left a controlled environment to the time it started? Do I only have 3:15 left? Do you have a policy on when the 4 hour time starts? I'd like to propose it's from the time it leaves the controlled environment. This would be a huge change for an organization as large as us, I want to make sure I'm not missing something. Thanks Link to comment Share on other sites More sharing options...
gene20354 Posted May 23, 2017 Share Posted May 23, 2017 Hi Cliff. We do 4 hours from the time the unit leaves the blood bank. We use a electronic time stamp to document this time on the blood administration tag that is attached to the unit. We teach the nurses that they have 4 hours from this time to complete the transfusion. This does not apply if we send products in a cooler. mpmiola, MaryPDX, David Saikin and 1 other 4 Link to comment Share on other sites More sharing options...
gagpinks Posted May 23, 2017 Share Posted May 23, 2017 Hi Cliff We count 4 hours from the time it's out of controlled temperature. If you pack your unit in controlled transport box than time start from it opened the box. It's worth looking JPAC guidelines MaryPDX and Cliff 2 Link to comment Share on other sites More sharing options...
Ensis01 Posted May 24, 2017 Share Posted May 24, 2017 4 hours from issue in BB LISS. As the BB generally assumes audit responsibility it removes ambiguity. Cliff 1 Link to comment Share on other sites More sharing options...
tcoyle Posted May 24, 2017 Share Posted May 24, 2017 The Circular of Information for the use of Human Blood and Blood Components has information regarding transfusion within 4 hours. Here is an excerpt: "Transfusion should be started before component expiration and completed within 4 hours." And another, "The initial portion of each unit transfused should be infused cautiously and with sufficient observation to detect onset of acute reactions. Thereafter, the rate of infusion can be more rapid, as tolerated by the patient’s circulatory system. It is undesirable for components that contain red cells to remain at room temperature longer than 4 hours. If the anticipated infusion rate must be so slow that the entire unit cannot be infused within 4 hours, it is appropriate to order smaller aliquots for transfusion." mpmiola and Cliff 2 Link to comment Share on other sites More sharing options...
Cliff Posted May 24, 2017 Author Share Posted May 24, 2017 6 minutes ago, tcoyle said: The Circular of Information for the use of Human Blood and Blood Components has information regarding transfusion within 4 hours. Here is an excerpt: "Transfusion should be started before component expiration and completed within 4 hours." And another, "The initial portion of each unit transfused should be infused cautiously and with sufficient observation to detect onset of acute reactions. Thereafter, the rate of infusion can be more rapid, as tolerated by the patient’s circulatory system. It is undesirable for components that contain red cells to remain at room temperature longer than 4 hours. If the anticipated infusion rate must be so slow that the entire unit cannot be infused within 4 hours, it is appropriate to order smaller aliquots for transfusion." Thanks, I did read this but did not take it as a strict rule that it must be infused within 4 hours after leaving it's controlled environment. I need something more substantial than "undesirable". Regardless, I may make the suggestion we change to 4 hours from the time it leaves it's controlled environment. Link to comment Share on other sites More sharing options...
goodchild Posted May 24, 2017 Share Posted May 24, 2017 We go with 4 hours from the time they spike the bag. Eman, Cliff and seraph44 3 Link to comment Share on other sites More sharing options...
AMcCord Posted May 24, 2017 Share Posted May 24, 2017 Our rule is 4 hours after it leaves the fridge or cooler. MaryPDX and Cliff 2 Link to comment Share on other sites More sharing options...
heathervaught Posted May 25, 2017 Share Posted May 25, 2017 We do 4 hours after it leaves the Blood Bank. MaryPDX and Cliff 2 Link to comment Share on other sites More sharing options...
Kathyang Posted May 28, 2017 Share Posted May 28, 2017 we use 4 hours after it is issued in the computer. Cliff and BldBnker 2 Link to comment Share on other sites More sharing options...
Johnv Posted June 1, 2017 Share Posted June 1, 2017 A closed system room temp product expires in 6 hours. An open system room temp blood product expires in 4 hours. In most cases the blood product, ie RBC unit, doesn't become an open system until it is spiked. If your policy is to start the transfusion within 30 to 60 minutes from issue, then you would still comply with the regulations if the total time of the transfusion, from spike to completion is no longer than 4 hours. The 4 hour time limit is easier to comply when the RN is keeping track of the time it starts until completion, not when it is issued since that time is likely only documented in the blood bank computer. John Van Patten, MT(ASCP)SBB Cliff 1 Link to comment Share on other sites More sharing options...
Mabel Adams Posted June 3, 2017 Share Posted June 3, 2017 We had TJC tell us that the transfusion start time is when the blood reaches the patient's vein so we use 4 hours after that. That start time is more pertinent to calculating how long the nurse must stay with the patient at the beginning of the transfusion. If the blood takes 8 minutes to reach the vein after spiking then the nurse may only stay with the patient for the first 7 minutes of donor exposure which probably isn't long enough. Cliff 1 Link to comment Share on other sites More sharing options...
David Saikin Posted June 3, 2017 Share Posted June 3, 2017 have always used 4 hrs from release from Blood Bank. It seems that is the consensus. In lieu of a succinctly defined criteria I think you have to go with the standard of care in your area. Cliff 1 Link to comment Share on other sites More sharing options...
tbostock Posted June 8, 2017 Share Posted June 8, 2017 It's 4 hours from issue time from the Blood Bank. Cliff and BldBnker 2 Link to comment Share on other sites More sharing options...
Recommended Posts
Create an account or sign in to comment
You need to be a member in order to leave a comment
Create an account
Sign up for a new account in our community. It's easy!
Register a new accountSign in
Already have an account? Sign in here.
Sign In Now