I know this topic has been discussed before (see thread below) but I wondered if anyone in the current crowd had a literature reference, standard, documented recommendation or anything concerning 'resting' platelets for a short period of time before issuing them for transfusion, if they just arrived in a platelet shipment.

 

http://www.pathlabtalk.com/forum/index.php?/topic/6060-issuing-platelets/

 

This resting period is taking place for platelets that were packed the night before and arrived that morning with the standing order and for platelets that are packed shortly beforehand and picked up ad hoc for emergency transfusions.

 

I'm trying to break the technologists of this practice.

Edited August 13, 201410 yr by goodchild

I think you are off base on this one - the only resting period for plts is immediately after collection.  There is no need to "rest" them after transport - read the link you provided.  OR - if you know of a standard that requires resting at some other point in a plt's life please inform me.

I think you are off base on this one - the only resting period for plts is immediately after collection.  There is no need to "rest" them after transport - read the link you provided.  OR - if you know of a standard that requires resting at some other point in a plt's life please inform me.

 

David, please know that I'm trying to contest this practice that's been taking place in the blood bank now for an untold number of years. I've already brought it up several times but I'm always kind of shushed because I don't have as many years in the field and I "just don't understand."

I think the problem you are going to run into is that there simply isn't any documentation or literature surrounding this issue.  You might try to point out the fact that there isn't anything written on this issue and that you cannot find any other institution anywhere that does this.  You could compare that to the fact that apheresis manufacturers all specify the resting period after collection for their instruments but are silent on resting after any kind of shipment. (this latter is significant since blood centers have satellite centers collecting apheresis platelets and they will not adhere to any protocol requiring resting after shipping them to the main center.  And really, unless you have a position of authority to force the issue you might not be able to do anything even though it is pretty unnecessary.

There is no AABB or CAP Standard or FDA guidance on this issue - if these guys don't address this it would seem that it is a non-issue.  Plts get plenty of agitation during their transport.   If they swirl well upon receipt they should be ready for infusion.  

I would contact the platelet supplier and see what they say.  They might carry the weight you are looking for.  Also, I agree with what David has posted above.  If the regulating agencies don't address the issue then it is a non-issue.  I'm afraid you are fighting inertia (we have always done it this way) and as I have noted on a number of occasions, inertia is the most powerful force in the universe or at least in the blood bank!

I have seen this "resting" period in other hospital's SOP's from time to time.  It says that platelets should be agitated for 10 minutes after transport or upon receipt back in the blood bank after issuing.

 

I have never found a reference for this-  not in AABB,CAP, Circ of Information-- nowhere.

 

One hospital that had this requirement could not provide a reference for me, either.

John, thanks for that idea, I'll call the blood supplier and see if they have anything to say. It might be easier for them to digest if it comes from a third party.

If you get your shipments from Red Cross, or whomever you may, just call them.  I know with the ARC platelets are supposed to be rotating unless in shipment, but are supposed to be placed on a rocker when delivered.  As JEM said, the fact that there isn't anything to support the practice of "resting" is your literature there. 

 

Even in the current AABB technical manual ed 17 pg 272-274 it outlines storage requirments for platelets, requiring constant gentle aggitation.  No mention of "resting"