Currently, our blood bank responds to all full team/class I trauma activations with O units (Rh dependent on age/sex).  The units are delivered in validated coolers that remain w/ the patient until the clinician feels they are not needed.  There has been a recent request that I evaluate remote storage in the trauma room.  Could those of you who store or have stored blood outside of the Blood Bank share experiences?  Thanks!

Copying a reply I made to another post concerning this, and I'll add some more info as well.

We used the Haemonetics Emerge kiosk for our trauma bay at my previous hospital... it worked well as long as the nurses were trained, but our trauma department had difficulties with high turnover. If they aren't trained well they ended up panicking and opening the fridge and not scanning out the units. As long as there was only one trauma at a time we could track everything easily; if not, and we were not familiar with the nurse working the kiosk, we would go down to manage it ourselves. A lot of it did depend on the physicians as well, some were very vocal about getting blood quickly and would bully the nurses into shortcuts. The Emerge will let nurses scan a patient label to link products to (they have to scan it once for each type of product and then scan out the required number of units). This was not interfaced to our LIS but we could find the patient name based on the account number they scanned. The computers in the blood bank had software that linked to the kiosk and would alert us when the fridge was opened, so we could monitor what was removed.

With the Emerge you have to program what types will be in the fridge, and as I recall, they did not allow for more than two choices per product type. That meant when we first started storing plasma there, the nurses had to select plasma, then select AB pos or AB neg. You could not remove the Rh on plasma and it drove us insane. We would make every effort to store only AB pos there, and train the nurses to only select AB pos... but the AB neg option was still there, and if they selected it, the kiosk informs them there are no units available and to contact the blood bank! You can imagine this got us a lot of frantic phone calls... we also ran into this problem when we switched to using group A liquid plasma and we would have to request only Rh pos from our supplier to try to avoid this problem.

Eventually we were storing 2 O neg packed cells and 6 A liquid plasmas, plus 2 pediatric units on the bottom shelf. We kept two thawed AB plasmas in the blood bank for pediatric use which they were to call us for.

The Emerge also does not have any checks in place to question the staff of the gender/age of the patient... for this reason my blood bank supervisor chose not to store O positive units in the kiosk. We surveyed a lot of hospitals in our system and many did keep O positive in the fridge. I was personally of the opinion that we needed O positive units down there, and had suggested that we get two bins, one pink and one blue, with signs on the top describing the indications. The trauma docs did not want the responsibility of telling the nurses operating the kiosk which type to grab so it was up to the RNs. We were a level 2, however, so the majority of our traumas were using O positive. If you were a level 1, I think you'd have to decide this for yourself -- do you let them figure it out or only give them the option of O negative? We were always so short on O negatives that we reduced the number of units in the fridge to 2, so that when they all panicked and transfused them to a 70 y/o male (they were supposed to call us for O positive), we wasted fewer Rh negs! They rarely gave products from the fridge unless it was a massive transfusion, and we would bring them the O positive (we kept 6 pre-labeled in the blood bank) with a platelet for their first batch, to use with the plasmas from the fridge. They could move the plasmas into the cooler we bought with the O pos and haul it off to CT or OR or wherever.

This seems awfully long so I really hope it makes a little bit of sense. Please feel free to ask any questions, I probably missed some important points.

I am attempting to get some Blood Safes for use in my EDs (3 hospitals) and one OR.  They can provide emergent release, e-xms when possible, and documentation of who the unit is going to  . . . of course, that will not prevent the unit from physically being given to another patient after it is "signed out" of the box.  You need a BBIS.  There are a few versions of these around . . . they pretty much are aligned with the BBIS vendor.  I call them the blood bank vending machines . . .

We use SoftBank.  Does anyone know if you can use the Haemonetics remote storage if you aren't using their BBIS?

We used Meditech and it worked fine. As I said, it was not interfaced.

it interfaces with cerne millenium as well

Haemonetics added age and gender rules.  There is logic that you can use to have the system assign the Rh based upon age/gender of the patient.

Michelle, does that apply to the Emerge, or only the Courier and OnDemand systems?

I believe you can use Haemonetics as a stand alone for remote storage. Probably won't interface with another system???

On ‎8‎/‎29‎/‎2016 at 0:30 PM, Teristella said:

Michelle, does that apply to the Emerge, or only the Courier and OnDemand systems?

I'm pretty sure applies to all of the systems.  They seem to run off the same basic software.

On ‎8‎/‎31‎/‎2016 at 7:59 AM, AMcCord said:

I believe you can use Haemonetics as a stand alone for remote storage. Probably won't interface with another system???

I'm pretty sure you they have an interface with most LIS systems.  Not sure if you need an interface for Emerge.  Most ER/trauma patients are unknown.

We keep 4 units of O Pos and 4 units of O Neg in our STAT EMR lab. This lab is manned by a med tech 24/7. They have the keys to the refrigerator. The physician has to sign an emergency release uncrossmatched form before the blood is released. When they have an emergency release, they notify the blood bank and we restock whatever was used. The segments and labels are segregated in the blood bank to work up the specimen as soon as we receive it. Women over 50 and males receive O Pos. I will say that having the blood right there tends to make them give uncrossmatched more frequently in my opinion.