Our FFP and platelets come from our blood supplier with a specific volume, but our red cells do not. We have always used a default volume, which prints on our Transfusion Records (unit tags). The nurses either document the volume given, or circle the word "ALL".

We were just recently inspected by the Joint Commission, and she suggested that we give the nurses the exact volume for each unit of red cells, and have them document this exact amount on the Transfusion Record.

How many of you do this? And if so, don't you have to weigh the unit, convert it to volume, subtract the weight of the empty bag and segments, etc...

Seems like a lot of work, I just want to make sure it has value. I've asked some nurses here, they don't seem like it would make a difference to them and how they transfuse the unit on a pump.

That's a very good question. I've heard that it would be more appropriate for volume restricted patients to have an exact number. This has come up at transfusion committees several times and the subject was quickly changed.

We give exact volume to our neonates and pediatric patients. Adult receive the default volume.

We do the same as BBCLS, exact volumes for neonates, default volume for adults.

 

Most of the time the units are being given through IV pumps that track the actual volume given, granted it is total volume of blood plus saline but the nurse is still documenting fluid volumes which is what they really want to know for I&O

We do the same as BBCLS, exact volumes for neonates, default volume for adults.

 

Most of the time the units are being given through IV pumps that track the actual volume given, granted it is total volume of blood plus saline but the nurse is still documenting fluid volumes which is what they really want to know for I&O

 

I should note that we use electronic transfusion documentation and if a unit of blood actually has more volume than what the default volume populates to be, the nurse is unable to document the actual volume transfused.

We give exact volume to our neonates and pediatric patients. Adult receive the default volume.

Ditto...

just curious...what default volume do you use?

Hello:

We have recently started the same protocol at our facility. Nurses  seem to think that the volume measured by the pump is not accurate enough and we discovered this was the case because they are not adequately resetting the volume after each patient, hence the discrepancy. We have agreed to record actual volumes on the transfusion slip and unit (this is obtained from packing slip from shipment) and we update this in computer. This is more work for us but when it comes to nursing, hospitals seem to like to entertain their 'bright' ideas.

I should note that we use electronic transfusion documentation and if a unit of blood actually has more volume than what the default volume populates to be, the nurse is unable to document the actual volume transfused.

We ran into the same issue.  We changed our default volume to 350 but that is probably overkill, since most are around 300.  Because the nurses actually enter the volume they transfuse, it hasn't been an issue.  No inspectors have even mentioned this as an issue to date, but next year he/she probably will since I've said this.

We don't have babies and use a default of 350 and have had no inspector issues. If you wanted to be more exact with your default, you could weigh an empty bag with segments, then weigh a dozen full units, subtract the empty bag weight from the average, and do the specific gravity conversion to volume.........As Terri said, that's a lot of work to do with every unit, although if you were really into it you could make a conversion chart by whatever increments you are masochistic enough to do, 350 g = 335 ml, 355 g = 339 ml, or whatever. Once the chart is done you'd just have to weigh them. Hopefully I'll be retired before anyone asks me to do that. 

..........and then you have to take into account how much is left in the giving set.

 

Ho hum!!!!!!!!!!!!

As a pediatric hospital, we weigh all units before issue if the volume isn't already given by the supplier.  Weight of blood product (grams) - average weight of bag (about 40-45g, less for a transfer bag) then divide by 1.06 to account for specific gravity (rbc's only) to convert to ml.

 

Stephanie Townsend, MT(ASCP)SBB

We were just recently inspected by the Joint Commission, and she suggested that we give the nurses the exact volume for each unit of red cells, and have them document this exact amount on the Transfusion Record.

 

 Since it was just a suggestion, I'd take it with a grain of salt and not weigh them!

We use 300 mL for the RBC's from whole blood. The apheresis collected RBCs have the volume on the bag.

For split units Neonates the volume is on the bag. We do not issue in syringes.

Sad to say that we weight every RBC unit when it comes in (400 bed Level II trauma center) and enter the stated volume when we bring the unit inot inventory.  On plt and frozen products we enter the volum stated on the bag lablel.

 

We were asked many years ago by nsg to provide this service.  We used to weight it when we signed it out of the BB but that was getting missed.  

 

Just one of those battles we decided not to fight

 Since it was just a suggestion, I'd take it with a grain of salt and not weigh them!

 

EXACTLY! 

During my AABB assessment in June, we were told that we had to enter the volume on plasma and platelets since it is on the label.  We use a default volume on the RBC.  The only time the volume transfused is recorded is when only part of the unit is transfused. 

If they ask for a volume to set the pump, we give them a default volume of 300 mL for units from whole blood. If they happen to get a 'fat' unit, they have to adjust the pump volume accordingly. Most units here seem fall at or slightly below 300 mL. After doing lots of chart reviews, documentation of volume infused seems to be hit and miss unless it's a patient on volume restriction. I hope no one here sees this thread cause I REALLY don't need another project  .

I hope no one here sees this thread cause I REALLY don't need another project  .

 Amen to that!

We have default value of 300ml for PRC bags (350 ml collection) or 405 ml for PRC bags (450 ml collection). For FFP we have default value of 150 ml. We have FFP with default value of 50 ml for pediatric patients. For PRC to pediatric patients we issue quantity they ask for +25 ml, since they use pumps and there is always some calci problem. We do not issue any components in syringes.