Hi folks,

How long do your facilities keep unit segments for? I've been at three facilities now and each had a different practice. I'm trying to get a clearer view of what the norm might be.

Thank you.

We keep it for 2 months. We have a box for each month. Eg. on Dec 1st, we discard Sept. box.

By the way we take out the segment at the time of log in the blood in our inventory. Long time ago we use to take out the segment before issue but we were running out of segment because of OR returns & recrossmatch.

We pull a segment with each crossmatch, then retain it with the sample for two weeks before discard.

Standards say 7 days post transfusion.

We take off a segment upon receipt and keep them 14 days post transfusion.

We keep them for 10 days post transfusion.

We pull the segments off at issue, attach DIN sticker and patient sticker, then keep them for 10 days.

We pull segs when units are processed then keep for three months, or until someone cleans out the bottom shelf of the fridge!

I agree with lcsmrz. Both sample and donor blood segment should retain seven days (at least) post transfusion. I like the way how Nancy L keeps cuz you can easily find that segment you want when someone suspect a transfusion and need an investigation, but you need extra work.

CK Cheng, MSc, SBB(ASCP), CQA(ASQ)

Jan 18, 2009

That will only work if you know that your unit will not be returned (If you have very active OR it may not work). Smaller hospital -it will not be a problem. Very busy trauma center, transplant center...there is no way you have time to pull the segment at the time of issue.

The bottom line is what ever system you use, you want to make sure that you are meeting the intent of standard and process is defined in your SOP.

After the unit leaves the BB, we pull a couple of segments, attach a unit number sticker, and keep them 10 days post-transfusion.

I agree totally with aakupaku's comment that our method would not work for everyone, especially in an extremely busy OR or Trauma Center. We come from such a wide variety of situations around the world that it would be ludicrous to think what works best in one place would work best in all. If that was the case, we could all follow one master set of SOP's. That diversity is part of what makes this forum so valuable. Even though not everything applies to me, I appreciate reading everyone's input, learning what works other places, and gleaning what may be helpful in our blood bank. Points are brought up that I may have not thought of before. It's great that we're willing to help each other improve and advance in our knowledge base and patient care. My thanks to forum administrators and all who are willing to share.:star_full

We do the two week retention. It was easy to set up a rotation of 14 days by the day of the week (This week and last week). We pull and label segments at xm and store them in 12x75 mm tubes along with the pretransfusion sample. Retrieval for Transfusion Reactions is facilitated and comparing segment numbers with number on the returned unit is one of our clerical checks.

The two week retention also simplified one other circumstance. If someone must extend a xm (no more than one week prior to surgery, i.e. four days longer than usual), the two weeks means not having to chance premature discarding. Not having to remember to do something works best.

When we had a donor center we retained samples 3 months until the NAT West Nile Virus test was made available, then no longer had any reason to retain donor segments. We kept the pilot samples (re-capped) for one month post collection.

Good luck.

We remove a segment and attach to the issue request with a DIN and retain for 10 days. We have a filing sysem with 10 files. Each day we discard the samples from 10 days previous and move to the next day.

We keepn the segments for 2 months in a small biohazard bag labeled with the month. These are kept in the refrigerator. We remove 2 segments when the units are entered into inventory. One for testing and one to keep in case it is needed later. We put one of the small DIN numbers on the segment.

phouck

I want to thank everyone for their input. It has been quite helpful.

We pull segs when units are processed then keep for three months, or until someone cleans out the bottom shelf of the fridge!

Love your reply. We pull segs when they are processed and keep in bags labeled with the exp. date of the unit. We keep each bag 7 days past the exp. date to assure that we meet the 7 day post transfusion requirement although most units are transfused well before the exp. date. We also keep them in the bottom of the frige and many times they are kept much longer than 7 days because no one remembers to check and throw them away. Some things are the same everywhere.

We pull at time of issue and then keep for 2 weeks (for the easy rotation.)

One thing we did to help remembering to pull at time of issue: when we get the units in, we label a plastic 12x75 tube with a unit bar code sticker, pull the end of the segments out and stick inside this tube, then place all in the rubberband with the segments. This serves as a good reminder at the time of issue (we even have nurses helping us pull these off.) We have more time when we get units in, vs when we issue them. We could pull the segments when we get them in, and stash them away, but then they would probably never get cleaned out, plus it is harder to find the one you need after a transfusion reaction.

Linda Frederick

For us it is easier to pull at the time of receipt, it will be harder for us to do at time of issue. and cleaning part is not a problem as we have 3 boxes in referigerator. once the month is over with all other papaerowrk segments gets cleaned up too.

How many reaction we get per month? maximum 10 per month so it is not a problem to pull out segment for reaction workup becasue we have receipt date in LIS and segments are stored in a plastic bag with receipt date on it.

We also pull a segment at the time of receipt. However, we seldom have to use them becausee we require that the bag and tubing, but not the needle, be returned to us when a reaction is suspected. We can pull a segment from the bag and examine the bag for discoloration, additives, etc. I suppose we would only use the saved segment for a delayed hemolytic reaction because we don't ask that all bags are returned.

We keep the segments in the refrigerator for 2 months in bins labeled for each month. We remove 2 segments when the units are entered into inventory. One for testing and one to keep in case it is needed later. We put one of the small DIN numbers on the segment. We rotate them each day when processing inventory - throwing away the segments from that date 2 months ago and replacing them with the ones from today. Works well for us.

A few years back, it was recommended to our facility that we store patient and donor samples post transfusion 1 month.

We also pull a segment at the time of receipt. However, we seldom have to use them becausee we require that the bag and tubing, but not the needle, be returned to us when a reaction is suspected. We can pull a segment from the bag and examine the bag for discoloration, additives, etc. I suppose we would only use the saved segment for a delayed hemolytic reaction because we don't ask that all bags are returned.

We remove 2 segments on receipt and mark it with a DIN sticker, place in a biohazard bag dated with date of receipt and latest OD of all segments. It has been an aid in working up a delayed transfusion reaction, because we could still access the segments. In reality you don't need them that often and the computer tells you which baggie to look in.

Three months is the time we keep the segments .

I was retyping a bunch of units the other day, pulling the segments off as usual, then I started wondering if there are regulations saying that keeping segments is necessary. A cursory glance at CAP standards didn't reveal anything. Anyone know what standard we're meeting when we keep unit segments? I've been doing it diligently for years and I can honestly say that in 15 years I've never had to dig through saved segments for any reason.

AABB 5.11.4

CAP TRM.41800

You've never encountered a delayed transfusion reaction?