We are having discussions about how long units are good once crossmatched. We are using 72 hours for using the sample sample, but once the blood is crossmatched how long can we keep it on the shelf to be issued. We are currently holding units 48 hours past crossmatch if no blood products have been given.

Thanks,

John

The easiest way to go is in parallel with the pt sample: We hold the blood unit for 72 hours if no blood products have been given. In our case, it also depends on our blood supply; that is, if we suddenly have a trauma case (Red Alert) and need this unit we will use it and inform the doctor. We will of course replace it ASAP.

Liz

Thanks Liz,

We are currently trying to employ the AABB 3 days rule along with the LIS 72 hours and it is rather confusing. The AABB 3 day rule and the LIS going in hours is making this rather confusing. I like the blanket 72 hours as you suggest.

Thanks!

John

Just one more reason why electronic crossmatch is good if you have the capability. You don't have to tie up blood for long periods.

Just one more reason why electronic crossmatch is good if you have the capability. You don't have to tie up blood for long periods.

Excellent point Marilyn.

We also only keep out crossmatches tied up for 3 days.

We use the 3 day rule (from date of sample draw) and just override the 72 hour thing in Cerner. Date of draw is day 0. If you go for 48 hours after crossmatch and did the crossmatch on day 3, you are now up to 5 days which of course is fine if you are sure the patient has not been transfused in the last 3 months. It would be a huge pain, here to ascertain that this has not occurred and to document.

We do 72 hours but have been known on SEVERAL occasions to take the blood down at 48 hrs. Especially if pt went to surgery and has a stable hgb.

Day zero is the spec date, XM's expire at midnight on day 3 and it is controlled by the comptuer system. We choose the midnight cut off to make it simple for daily inventory reconciliation.

This is pretty close to our procedure. We have tweeked it a little to have sample and units expire at 72 hours. We tried the 3 days rule, like you mentioned, but found that less than 0.5% of those units were ever used past the 72 hours until release at midnight. So far our 72/72 has worked fine. We also feel a little safer as we are in a resort area and have a lot of residents and "snowbirds" come for treatment and we have no BBK history. It is surprising how many have antibodies and without histories we feel safer with 72 hours vs. 3 days.

We keep it for the viability of the sample . . . at the most 3 days. If we xm on day 3 it comes down the next day if not going to be used. For preop xm, they come down the 2nd day p-op, unless the specimen outdates sooner.

We tie the crossmatch hold time to the specimen outdate. Sample and any reserved units on-hold expire at 23:59 on the third day.

That really only applies if the patinet has been pregnant or transfused in the past 3 months. If not, the crossmatches may be held longer than 3 days.

That really only applies if the patinet has been pregnant or transfused in the past 3 months. If not, the crossmatches may be held longer than 3 days.

Yes, Mary nice point.

72 hours from specimen date/time.

This keeps our inventory turning over and we don't have to worry about documenting "no pregnancy or transfusion" in the last three months.

Somewhere in the AABB Standards there is a statement that reads something to the effect that a crossmatched unit of blood should be performed only on an indate specimen. The indate specimen is only good for three days and therefore the crossmatched blood can only be good for this maximum time of three days. If the unit was crossmatched on the second day of the indate specimen then the crossmatch is only good for two days; so forth and so on.

Somewhere in the AABB Standards there is a statement that reads something to the effect that a crossmatched unit of blood should be performed only on an indate specimen. The indate specimen is only good for three days and therefore the crossmatched blood can only be good for this maximum time of three days. If the unit was crossmatched on the second day of the indate specimen then the crossmatch is only good for two days; so forth and so on.

I think the three day frame have a premise which is previous 3 monthes transfusion or pregnancy.

If not, the antibody status will not chang except decrease with time.

So, I think if the patient has not been transfused or pregnant during the three month and have not been transfused after the day of blood specimen been drawn, the blood crossmatched can be transfued safely in any day of its life span.

That is right, Shily:

5.13.3.2

If the patient has been transfused in the preceding

3 months with blood or a component containing

allogeneic red cells, has been pregnant

within the preceding 3 months, or if the history

is uncertain or unavailable, a sample shall be

obtained from the patient within 3 days of the

scheduled transfusion. Day 0 is the day of draw.

We keep units up for 48 hours so we can keep our inventory rolled over. If a physician requests that we hold the blood for 72 hours, we can (and do) comply with their wishes.

Thanks Liz,

We are currently trying to employ the AABB 3 days rule along with the LIS 72 hours and it is rather confusing. The AABB 3 day rule and the LIS going in hours is making this rather confusing. I like the blanket 72 hours as you suggest.

Thanks!

John

All of our crossmatches expire at midnight of the 3rd day in our LIS. So the max we hold the XM is 72 hrs. Plus, this way, we know when all the XM's expire.