We are a 20 bed critical access hospital. We do not do many massive transfusions. We recently have had a patient that we have given a lot of units. Looking at our procedure it does not say when you should collect a new specimen. We currently go with the 72 hour rule. My question is should we redraw the patient and redo type and screen and more crossmatches on a new specimen. Thanks for any input.

Cassie:confused:

We are a 20 bed critical access hospital. We do not do many massive transfusions. We recently have had a patient that we have given a lot of units. Looking at our procedure it does not say when you should collect a new specimen. We currently go with the 72 hour rule. My question is should we redraw the patient and redo type and screen and more crossmatches on a new specimen. Thanks for any input.

Cassie:confused:

The simple answer is "yes".

You must treat these patients in exactly the same way that you would treat other patients, with the proviso that they are possibly more likely to make alloantibodies, as they have been exposed to many that are foreign (although, that having been said, I doubt if their immune system is up to much for the first couple of days).

Yes, you must redraw the patient and repeat the Type & Screen only if the patient needs more blood set up after the 72 hour span has lapsed. (ie: The same as you would treat any other patient.)

I know we use the 72hr time period in the UK - and it looks like in the US too, but I seem to recall that 96hrs was/ is used in Canada. Could anyone clarify if this is correct?

thanks!

We use 72 hours in Australia.

We have a 900 bed hospital with a mass tx procedure. Males get O pos uncrossmatched and females of child bearing age or kids get our O neg uncrossmatched. As far as the sample is concerned; if we currently have a sample we will crossmatch the units when time permits, and once the 72 hour period ends we will re-draw and retest. (example: pt sample expires in 50 more hours. Mass tx called, send units, xmatch units, redraw new sample when the specimen expires. So like 50 hours later a new sample will need to be drawn.) So if you are asking if a new sample needs to be redrawn right after a mass tx, I dont believe so as long as the current specimen is not expired within the 72 hours.

As far as Canadia I have a friend that works in a hospital so ill give him a shout and see what he says.

I know we use the 72hr time period in the UK - and it looks like in the US too, but I seem to recall that 96hrs was/ is used in Canada. Could anyone clarify if this is correct?

thanks!

The US is 3 days (which depending on when the sample is drawn on day zero could be up to 95 hours and 59 minutes) but some choose to be more restrictive and shorten that to 72 hours since it's sometimes easier for computers to manage the expiration date and also simpler for some staff to understand/follow.

We also use "3 days", not 72 hours.

We also use 72 hours in Vancouver, Canada. It used to be 48 hours many years ago.

We also use "3 days", not 72 hours.

We use 3 days (expiry is at midnight), but we use our discretion in some cases and extend to 72 hours.

With bleeders we will often extend if the 72 hour expiry is in >12 hours time (e.g. it's 4 am and the specimen officially expired 4 hours ago, it really expires at 8pm tonight, and the patient is going off again)

We use 3 days (expiry is at midnight), but we use our discretion in some cases and extend to 72 hours.

To Lateonenite: 3 "days" in the blood bank world is longer than 72 hours so I'm not sure how you could extend to 72 hours. For example, if a sample is collected at 8AM on a Monday (day zero), the sample would expire at midnight on Thursday (day 3), which is 88 hours. By your statement it appears you are really only using your samples for 2 days but will extend to 72 hours??

"3 days" is inclusive of day of collection, so a specimen from Monday 8am expires Wednesday midnight, but we can extend to Thursday 8am.

Sorry, wasn't clear!

To Late one nite--

In the blood bank world, the day of collection is considered day zero. For example, a 5-day platelet product collected on Monday (regardless of time of day) expires at midnight on Saturday. The same counting method is used to determine expiration dates/days of a sample. So in the scenario you described, Monday is day zero, Tuesday midnight is end of day 1, Wednesday midnight is end of day 2 and Thursday midnight is end of day 3. Your routine practice actually appears to be to use a sample for 2 days, but on occassion extend to 72 hours (which is shorter than 3 days and OK since more restrictive than the standards). ....I find that late-at-nite, it's easy to loose track of even what day of the week it is!......

Hiya,

Are we counting differently? If I say Monday midnight, I mean the midnight following Monday <day>, even though it is technically counted as 0000, the beginning of Tuesday. Convention. Maybe it's a down under thing.

When I read you reply, at first I calculated Mon (0) 24 + Tue (1) 48 + Wed (2) 72 + Thu (3) 96; this makes sense from the other posts, but not for an Australian blood bank.

We use "3 days" as convenient shorthand - by guideline it is 72 hours (ANZSBT 2.1.7), but we mean inclusive of day of collection; again, sample collected 0800 Mon expires by lab protocol at midnight Wednesday, but we can extend to Thursday 8am - but no longer than that.

Some laboratories religiously adhere to the 72 hour guideline, but that has a lot to do with the limitations of their LIS - our old one had no idea about specimen expiry, others, like the local LabLink and one of the PathNet BBT builds, expires the sample promptly so that there is no possibility of a lab-induced adverse transfusion outcome.

Cheers,

Fran

Edited August 12, 200915 yr by lateonenite
Can't spell

The US is 3 days (which depending on when the sample is drawn on day zero could be up to 95 hours and 59 minutes) but some choose to be more restrictive and shorten that to 72 hours since it's sometimes easier for computers to manage the expiration date and also simpler for some staff to understand/follow.

We actually use this system also. i always refer to the expiration as 72 hours but in fact if we recieve a specimen at 00:01 then it would expire in 95 hours and 59 mins. Thanks!

Aren't semantics wonderful; they make everything so clear!

As I implied in my thread on Nomenclature in the Education Section, if everyone used the correct terminology, there would not be these arguements; but first we all have to agree what is correct!!!!!!!!!!

:cries:

Me! I'm right!

(Shades of Monty Python - "I'm Brian and so is my wife!")

Me! I'm right!

(Shades of Monty Python - "I'm Brian and so is my wife!")

I see what you mean!