administering blood products

Nurses General Nursing

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  • by ello7
    Specializes in ICU.

Ok, I have this gripe with our blood bank... Whenever you need to go down and get your blood (or FFP/platelets/etc) and request more than one unit at a time, they ask if the units will be administered within 20 minutes. This just baffles me. Our policy states that we cannot return something to bloodbank after 20 minutes of being distributed, but it says nothing about administering it within 20 min.

So has anyone dealt with this before or heard anything about it? Usually if I'm running multiple units of something, I like to get 2 units at a time so I"m not running back and forth a million times. But the people down there says after 20 min bacteria starts to grow... but what about our policy that says we have 4 hours to get something completely administered?

I don't understand this. I'm just peeved with them. You have to practically sell your soul to them to get more than one unit at a time.

skipaway

502 Posts

Our blood bank does not require a time for admin. They also issue us a cooler that allows us to obtain multiple units and keep the ones we're not using refrigerated. See if this is an option for your blood bank.

RN813

19 Posts

Specializes in Med/Surg. Oncology. GYN..

We're required to administer the product within 30 minutes but I have never had a problem with returning it to the bank if I ended up not needing it at that time.

iluvivt, BSN, RN

2,774 Posts

Specializes in Infusion Nursing, Home Health Infusion.

yep...its 20 min the AABB Technical manual ( American Association of Blood banks) states that once it leaves the controlled enviroment it can not be returned after 20min...and it should be time stamped when it leves the blood bank BUT if you are hanging multiple units and/or blood products the answer will be YES you will be hanging them in 20 min.....I know our OR has a blood refriderator...the coller may be helpful BUT it is my understanding that it will still be only 20 min....so if in a cooler and then tried to return to blood bank b/c of non-use they still will not accept it

Specializes in cardiothoracic surgery.

Blood bank is right. According to the guidelines as stated in the previous post, you have 20 minutes to administer it after receiving it from blood bank and then 4 hours to administer it (from the time it is taken out of the refrigerator). If it is not hung within the 20 minutes, it is then returned to blood bank and discarded because of the risk of bacterial contamination. But I do understand what you are asking about having 4 hours to hang it, so why must it be discarded after 20 minutes if you have 4 hours to infuse it? Could someone clarify that, because I honestly don't 100% understand the reasoning behind that either. Also, I don't understand the cooler thing, because that is an uncontrolled environment where the temperature isn't regulated. So I don't understand how that is safe, or am I missing something?

kachidekuyua

22 Posts

Specializes in industrial and hospital nursing.

If you are going to administer more than 1 unit of blood, why will you take it all if you can only infuse 1 at a time? Why don't you just take 1 unit of blood from the bank, infuse it for 4hrs, then just get another one again. In that case, we don't need to return the blood again and no bacterial contamination will happen. And at least, you had follow the policy of administering the blood before 20mins, unless your hospital is far from the blood bank, that will be the problem... This is just an opinion from me...

iluvivt, BSN, RN

2,774 Posts

Specializes in Infusion Nursing, Home Health Infusion.

Ok here is some more...blood must be stored in monitored blood bank refrigerator or an approved blood transportation refrigeration system..never store it in a nursing unit unless it is a special one for blood only.......so really I do not see the point of the ice chest.b/c no matter what after 20min they will not take it back.. and hang within 30 min t ..I can see needing more than one unit and/or one blood product...ie..hanging platlets on one lumen and packed RBCs on another...in that case you say yes I am going back to my unit to hang these now...one unit of packed RBCs at a time...yes you will have to make a few trips to tjhe blood bank....keep in mind that in many hospitals you do not need to be an RN to sign out the blood...In Ca..we can send our ward secs to go get the blood product...and we often do...yes and max infusion time is 4 hrs....not all in........... you have to stop the infusiion and discard the rest....Remember blood products that are infusing are dripping in and not just sitting unrefrigerated..stagnating...warming up....and growing some bugs...plan ahead and make sure you have a good venous access device

Bahrain

10 Posts

I am still nursing student (3rd year in Bs programme), but what I have been taught and see while i'm practicing in the hospital. We should get the blood 1 unit at a time and infuse it within 30 mints, if we didn't infuse it within 30 mints return it quickly to blood bank, so they could use it to another patient.

I have also practiced in another hospital, I saw that nurses got multible bags of platlets for one patient, but I didn't see if they are infused together or not, but I think they are infused together, as the patient was having luckemia and needed alot of platlets, he died at the end.

In conclusion, blood should be administered within 30 mints, failing to do so you cannot use this bag again as you said bacterial growth will start.

But I have a question, when we adminster blood over 4-6 hours, isn't there a risk for bacterial growth or the risk only on the 30 mints before infusing it?

Virgo_RN, BSN, RN

3,543 Posts

Specializes in Cardiac Telemetry, ED.
We're required to administer the product within 30 minutes but I have never had a problem with returning it to the bank if I ended up not needing it at that time.

Same here.

Specializes in Hospital Education Coordinator.

Per AABB standards blood cannot be stored on the nursing unit (coolers in certain areas may be permitted) and cannot be too warm and cannot just lie around waiting to be infused into the wrong person. So yes, your BB is right. It is a pain but not as much as watching someone die from a reaction.

nrsang97, BSN, RN

2,602 Posts

Specializes in Neuro ICU and Med Surg.

If I am transfusing FFP I will get 2 units at a time, but you can run them in quickly. If I am transfusing blood then I only get 1 unit at a time because you can only run one unit at a time. (Unless of course the pt is profusely bleeding out and will be blasting the blood in as fast as the pt is losing it.)

ello7

41 Posts

Specializes in ICU.
If I am transfusing FFP I will get 2 units at a time, but you can run them in quickly. If I am transfusing blood then I only get 1 unit at a time because you can only run one unit at a time. (Unless of course the pt is profusely bleeding out and will be blasting the blood in as fast as the pt is losing it.)

That's what I usually do. But I still have to convince these blood bank people that without a doubt that I would administer BOTH units of FFP within 20 minutes. I spend more time down there convincing than walking there and back.

I just feel that if the blood bank is so strictly enforcing this, then maybe it needs to be added to our hospital's policy.

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