This question was raised recently:   why do we always place Red Cells in the upright position for storage and shipping?  The shipping part is easy--that's the way the Blood Supplier says it is supposed to be.  I cannot find an answer to the storage in the refrigerator.  Does anyone know of any standards, recommendations, etc for how to store Packed RCs in the refrigerator--and why?

 

Thank you,

You need to be able to observe for hemolysis or other changes in appearance.  Hard to discern if the unit is lying flat.

We discontinued storing RBC units upright in holders years ago.  You can observe "hemolysis or other changes in appearance" regardless of storage position, flat or upright.

It is true that haemolysis can most easily be seen if the unit is stored in an upright position (note the phrase "most easily" - I am NOT saying that haemolysis cannot be seen if the unit is stored flat), however, more units can be stored in an upright position WITH the expiry date showing, than can be stored with them flat.  If you have to move an upright unit to see an expiry date (or, in the UK, an Rh and K type - available on ALL units), you can easily do so without disturbing the red cell - plasma/SAGM interface, so that haemolysis is still easily seen, particularly as the units are usually in a cardboard box type thing to keep them upright.  This is not so easy if the unit is stored flat and, in addition, it takes up more space in the average blood bank refrigerator, most of which are designed to take upright units.

Upright: so you can read the unit number plus the segments can be kept tidy to avoid getting tangled with each other, and observe hemolysis. 

It is also easier to take inventory when they are standing up.  If they are flat you would have to pick them up to count????

We have clear plastic divider racks for our blood bank frig shelves that keep the units upright without having to use holders.  The last two frigs we've purchased have not had these racks available -- they have two sides to go across the drawer and two to go from front to back!  We just trim down the old racks to fit in the new drawers and hope that they continue to work well.  It really helps to view the units when they are upright.  It used to be a lot easier to see the expiration dates before we switched to the ISBT128 labeling, but we've adjusted.

Thank you to all who weighed in on this subject.

We keep our units sitting up for the obvious reason of space limitations, and all the other reasons quoted before.

 

The other Scott

As a historical note:  We used to store whole blood quads meant for neonates upside down and upright.  Can anyone hazard a guess as to why?

10 hours ago, Baby Banker said:

As a historical note:  We used to store whole blood quads meant for neonates upside down and upright.  Can anyone hazard a guess as to why?

So you could pull off an aliquot of "packed cells" from it?

 

12 hours ago, Mabel Adams said:

So you could pull off an aliquot of "packed cells" from it?

 

Yes.  And the K+ was generally lower than in a 'real' unit of PRBCs.  

Do racks even exist that allow units to be laid flat? Without any sort of holder, I feel like they could easily slide off each other, off shelves, and rub condensation onto other labels; overall make it fairly difficult to leaf through.

1 hour ago, Ward_X said:

Do racks even exist that allow units to be laid flat? Without any sort of holder, I feel like they could easily slide off each other, off shelves, and rub condensation onto other labels; overall make it fairly difficult to leaf through.

Not at all.  Bags lay flat in the drawer (without racks or dividers).  It all depends on the number of bags you put in the drawer.