Transfusion Medicine

1. Transfusion Medicine Transport of Blood, Blood Components and Plasma Protein Products within a Facility BBM Educational Resource Materials for the Training of Facility Transport Personnel

2. Objective * Eligible staff who may transport blood may differ in each WRHA facility, please check your policy. To provide transport staff* a detailed guide to safely and effectively transport blood , blood components and plasma protein 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 • A facility policy must be in place that clearly defines individuals who may transport blood, blood components or plasma protein products. • Staff training in the handling and transportation of blood, blood components or plasma protein products shall be completed and documented annually.

5. 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 fridge • RBC units must not be placed into a regular fridgei.e. med room fridge, lunch fridge or left on any 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 • Plasma Protein Products • 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

6. Blood Product FYI • 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. Know your time limits! Red Blood Cells, Platelets and Plasma Protein Products MUST be returned ASAP to the blood bank/laboratory fridge if you are requested to do so by the clinical ward

7. Clinical Requests • DSM Form: All clinical requests shall be written using the correct DSM form : “Request for Release of Blood and Blood Products” - Verbal orders are not acceptable practice - Requests are considered a priority • Patient Identification: All clinical orders for blood products shall positively identify the intended patient and blood product required. This should include: • Pick Up Documentation: The transporter may present documentation at the hospital blood bank/laboratory when picking up a blood product orwritten requests may be faxed directly from the clinical ward to the hospital blood bank/laboratory

8. Product Pick Up • When picking up blood product from the hospital blood bank/laboratory ensure you are: - Pick up the right productfor the right patientandgo to the right location. • Confirm your transport order matches the location & patient information on the DSM Request for Release of Blood and Blood Products form. If you are unsure just 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: - Be clearly separated and identified with patient and location, placed in separate protective bags, 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

9. 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 formas 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.

10. Transporting Blood During transport of a blood product it is important to: 1. Directly transport product from the blood bank/laboratory to the ordering clinical ward without interruption or delay. 2. Not rest or place blood product on any heating or cooling equipment. 3. Not roughly handle (i.e. shake, swing, bang, drop, poke) blood product. 4. Ensure delivery is to the correct location. 5. Physically give the blood product to a clinical ward staff person. 6. The delivery must be acknowledged by the clinical ward staff person. Be Seen! 7. Blood products must never be dropped off and left unattended at a nursing station/clinical ward desk.

11. Self Assessment Questions & Answers

12. Q 1. According to transfusion standards transport of blood products within a hospital can be done by: a) Any hospital staff member available to transport, training optionalb) Only by trained, defined hospital staff membersc) Patient family membersd) None of the above

13. Q1. Answer The correct answer is: b Only by trained, defined hospital staff members

14. Q2. 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

15. Q2. Answer • The correct answer is: a Between 1°C and 6°C in a special temperature monitored blood fridge

16. Q3. When picking up blood from the blood bank, confirming the patient information and order is: • Essential to ensure the right blood product is picked up for the right patient to the right location • Not required if the blood has been ordered in advance by the ward • Only required if they have been provided by the requesting ward. • Not the responsibility of the person transporting the blood

17. Q3. Answer • The correct answer is: a • Essential to ensure the right product • right patient • right location

18. Q4. When transporting a blood product to the ward it is important thata) It is shaken during transport to ensure adequate mixing prior to drop off at the clinical locationb) All orders for that clinical location are picked up even if you must make other stops before dropping off the blood productc) It is handled carefully, not shaken and is transported directly to the ward and physically given to and acknowledged by the clinical ward staff memberd) You toss it around to mix it, just do not drop it!

19. Q4. Answer The correct answer is: c It is handled carefully, not shaken and is transported directly to the ward and physically given and acknowledged by the clinical ward staff member

20. Thank YouIf you have any questions please explore the BBM website for other blood education topics and contact information.www.bestbloodmanitoba.ca