Temperature excursions

How to find out if units should be retained or discarded in the event of fridge, freezer or incubator failure

Equipment failure from the Red Book on the Tranfusion guidelines website

Exceptionally, ie due to equipment failure at a Blood Centre, red cell components which have been prepared in a closed system and exposed to a core temperature not exceeding 10 degrees Celsius and not less than 1 degree Celsius may be released for transfusion provided that: 

• the component has been exposed to such a temperature change on one occasion only (if the unit has not had an excursion within NHSBT, your hospital can follow this guidance to retain blood components following equipment failure)
• the duration of the temperature change has not exceeded 5 hours
  
  
• a documented system is available in each Blood Centre to cover such eventualities
  
  
• adequate records of the incident are compiled and retained
  
  

Action for hospitals

• After quarantining the components, the hospital should call the hospital services department at their stock holding unit to request a list of PCS13 flagged units. They must specify which report they require: red cell, platelet or frozen. Hospitals must provide an email address at the time of the call
  
  
• Hospital services will email the list (in excel format) to the email address provided within 3 hours of the phone call
  
  
• The hospital can use the list to determine if any units have been previously ‘flagged’, in which case they must be discarded
  
  
• The decision to discard or retain any units is the hospitals. If units are retained, obviously a system needs to be in place to record the excursion
• For more advice (e.g if it’s a product required immediately) we suggest a conversation with your own medic initially
  
  
• If insufficient information is available, our duty consultant may be able to offer advice
  
  
• NHSBT does not require feedback on the units you discard or retain
  
  
• There will be no refund for units that you elect to discard
  
  

Limits used to set the PCS13 flag

Cold chain requirements for red cells: store at 2-6 degrees Celsius, the flag will be set for one excursion to 10˚ degrees Celsius less than 5 hours.

Cold chain requirements for platelets: store at 20-24 degrees Celsius the flag will be set if there is a temperature deviation of 18-20 degrees Celsius.

Cold chain requirements for frozen components: store at less than minus 30 degrees Celsius, the flag will be set for temperature deviations up to minus 25 degrees Celsius.