1. Transfusion Medicine Transport of Blood, Blood Components and Derivatives within a Facility DSM Educational Resource Materials for the Training of Facility Transport Personnel

2. Objective To provide transport staff with a detailed guide to safely and effectively transport blood products to clinical units for patient use

3. Table of Contents Transfusion Standards Blood Product FYI Clinical Requests Product Pick Up Transporting Blood Self Assessment Questions & Answers

4. Transfusion Standards

5. Facility policy must be in place that clearly defines individuals who may transport blood, blood components or derivatives Staff training in the handling and transportation of blood, blood components or derivatives shall be completed and documented.

6. Blood Product FYI

7. As a member of the transport team it is important to know that blood products require special storage and handling. This is to ensure patients receive the safest possible blood product for their treatment and care. All blood products have time limits when they are removed from storage Important: RBC units, Platelets and Plasma products MUST be returned ASAP to the blood bank/laboratory if you are requested to do so by the clinical ward

8. Blood Product FYI Red Blood Cell (RBC) Units Are fragile, can be easily damaged and are an excellent medium for bacterial growth Must be stored between 1°C and 6°C, in special temperature-monitored blood fridges RBC units must not be placed into a ward fridge, vaccine fridge or any other fridge that is not a designated blood fridge or left on heating or cooling systems Platelets Must be stored between 20°C - 24°C Must never be placed into a fridge Plasma Products Are stored frozen and must be thawed for clinical use Once thawed must be used ASAP or stored between 1°C - 6°C Derivatives Must be stored according to manufacturer criteria (room temperature or fridge) Typically are in glass bottles within a box and are easily broken if shaken or dropped

9. Clinical Requests

10. All clinical requests shall be written using the DSM Request for Release of Blood and Blood Products Verbal orders are not acceptable practice Requests are considered a priority All clinical orders for blood products shall positively identify the intended patient and blood product required. This includes: Patient name (first & last names) PHIN/PHN (Personal Health Number) or other unique identifier (Hospital #) Date of Birth (DOB) Order (type of product/how much) Physician Location Documentation must be presented at the hospital blood bank/laboratory when picking up a blood product. Written requests may be faxed directly from the clinical ward to the hospital blood bank/laboratory or transport personnel may bring it with them.

11. Product Pick Up

12. When picking up blood product from the hospital blood bank/laboratory ensure you are: Picking up the right product for the right patient to go to the right location Confirm your transport order matches the location & patient information on the DSM Request for Release of Blood and Blood Products If unsure ask! Clinical requests for different blood products for one patient must: Be placed in separate protective bags, not be mixed in one bag nor come into contact with one another Clinical requests for multiple patients at one pick up time must: Clearly separated and identified with patient and location, placed in separate protective bag, not mixed in one bag nor come into contact with one another Note: This practice is not recommended but may occur in clinically urgent situations

13. Product Pick Up Once all information has been confirmed and blood product is ready for transport: Sign the Lab Log Book on the transporter signature line and/or the DSM Request for Release of Blood and Blood Products as per facility policy Transport the blood product carefully and directly to the intended location Do not aggressively handle blood products Do not stop to perform additional pick ups or transporter tasks prior to delivering a blood product

14. Transporting Blood

15. Transporting Blood Product During transport of a blood product it is important to: Directly transport from the blood bank/laboratory to the ordering clinical ward without interruption or delay Not rest or place blood product on any heating or cooling equipment Not roughly handle (i.e. shake, swing, bang, drop) Ensure delivery is to the correct location Physically give the blood product to a clinical ward staff person The delivery must be acknowledged by the clinical ward staff person Blood products must never be dropped off and left unattended at a nursing station/clinical ward desk.

16. Self Assessment Questions & Answers

17. According to transfusion standards transport of blood products within a hospital can be done by: a) Any hospital staff member available to transport, training optional b) Only by trained, defined hospital staff members c) Patient family members d) None of the above

18. Answer The correct answer is: b) Only by trained, defined hospital staff members

19. Red blood cell units must be stored: a)Between 1°C - 6°C in a special temperature monitored blood fridge. b)In a fridge, room temperature, cooler, whatever is convenient. c)In a ward refrigerator as long as it contains a thermometer. d)On top of an air conditioner in warm weather or at room temperature during cold weather

20. Answer The correct answer is: a) Between 1°C and 6°C in a special temperature monitored blood fridge

21. When picking up blood from the blood bank, confirming the patient information and order is: a)Essential to ensure the right blood product is picked up for the right patient b)Not required if the blood has been ordered in advance by the ward c)Only required if they have been provided by the requesting ward. d)Not the responsibility of the person transporting the blood

22. Answer The correct answer is: a) Essential to ensure the right product is collected for the right patient

23. When transporting a red blood cell unit to the ward it is important that: a)It is shaken during transport to ensure adequate mixing prior to drop off at clinical location b)All orders for that clinical location are picked up even if it means stopping at multiple locations before dropping of the red blood cell unit c)It is handled carefully, not shaken and is transported directly to the ward and physically give to a clinical ward staff member d)If it is tossed up and down, that it is not dropped

24. Answer The correct answer is: c) It is handled carefully, not shaken and is transported directly to the ward and physically given to a clinical ward staff member

25. Thank You Questions? Contact your site Blood Bank DSM Contacts Brenda Herdman, Transfusion Medicine Technical Director bherdman@dsmanitoba.ca 237-2707