The Results are in: Platelet Indicator Survey

65% would definitely use a platelet indicator, and another 12% said “maybe” or in special situations

Thank you to the 115 of you who participated in our October survey about platelet management and provided your feedback on a platelet temperature indicator. We’re excited to share what we learned….. and even more excited to tell you what we plan to do about it!

A few fast facts from the survey:

  • 65% would definitely use a platelet indicator and another 12% said “maybe” or in special situations

  • 80% of those who would use an indicator want a dual range indicator (20-24oC)

  • Reasons for not returning unused platelets to inventory (most common comments): (1) Time out of blood bank, (2) Uncontrolled/unmonitored environment, including temperature and lack of agitation and (3) Spiked bags, defaced labels

  • 75% of respondents take platelet temperature on return to the blood bank (but few have temperature monitoring during the time period the platelets are out of blood bank control)

The complete Survey Results are presented at the end of this VUEPOINT post.

Interest confirmed at AABB

To further explore the topic, we had a chance to talk about platelet management with many of the blood bankers at AABB. What they told us only validated what we learned in the survey – with patient safety always at the forefront, blood bankers need a better way to both (1) assure temperature compliance and (2) preserve precious platelet supplies. A temperature indicator would monitor platelet “temperature history” for the entire period it is out of blood bank control.

You’ve spoken and we’ve heard you

These recent interactions have revealed a potential new product need in the market. At Temptime, we have initiated the first steps of our new product development process focusing on a dual-range indicator for platelets. We are working to develop a deeper understanding of your needs and identifying potential product and technology solutions..

Get involved!

Temptime’s product development process depends on user input and field trials. If you’d be interested in providing input to the initial design and specifications for this new product development, we welcome your participation. Please email us and we will be in touch with you.

Survey Results

Q1: “Comments” Summary

  • 5-6 responses relative to time away from blood bank, lack of monitoring
  • 3 responses specific to agitation

Q1: “Other” Summary

  • 11 relative to time out of blood bank
  • 7 storage/uncontrolled environment
  • 7 spiked or modified bag/label
  • 5 “no swirling” observed
  • 4 noted “agitation” concerns

Q2: “Other” Summary:

  • 13 relative to time away and/or lack of monitoring/controlled environment (some specified >30 mins, > 2 hours)
  • 11 expired

Q3: Most common Text Responses summary:

  • 36 take temp with thermometer or temperature plate
  • 20 take temperature with IR thermometer
  • 16 “take temperature” (unknown how)
  • 13 use “touch/feel”
  • 7 report platelets returned in cooler, on ice or from fridge
  • 5 report that temp is monitored every 4 hours or constantly, or kept in temperature controlled chamber
  • 4 discard due to time

Q6: Most common Text Responses summary:

  • 6 report low usage or returns
  • 5 reference cost
  • 3 indicate would take temperature if unsure, indicator not needed 

Q8: Most common Text Responses summary:

  • 17 expired/outdated
  • 10 wrong/poor storage, including use of coolers
  • 7 time away from blood bank/control
  • 3 agitation concerns
  • 3 spiking bag and returned

SURVEY: Temperature Indicators & Platelet Bacterial Contamination

“Sepsis from a bacterially contaminated platelet unit represents the most frequent infectious complication from any blood product today.”1

Would a temperature indicator help your blood bank improve quality control, patient outcomes and platelet discard rates?
Take the Survey: Click Here

Because platelets are stored at room temperature, their shelf life is limited to 5 days due to the risk for bacterial growth during storage. Bacterial contamination of platelets is a major concern because of the rich plasma environment at room temperature. All apheresis platelets are sampled and cultured for bacteria growth prior to issue. Platelets that have exceeded the AABB guideline temperature range (20 – 24°C) are at greater risk for elevated bacterial counts. When this happens, not only is the patient risk high, but there are also intense challenges on the blood bank to maintain adequate platelet supplies AND assure patient safety.

As a major manufacturer of temperature indicators for healthcare applications, we are interested to hear from you about the possible application of a temperature indicator for platelets (PLTs). For that reason, we’re conducting a survey.

Publications on Platelets

Just this past November, AABB published clinical guidelines on appropriate use of platelet transfusion in adult patients, developed by a panel of twenty-one experts (named in the article). These guidelines appear in the February 2015 issue of Annals of Internal Medicine. While the article provides six recommendations specific to platelets and transfusions, it states early in the article that:

“Sepsis from a bacterially contaminated platelet unit represents the most frequent infectious complication from any blood product today.”1

In a 2011 article in Transfusion, the author noted that “…outdating PLTs is a financial burden and a waste of a resource.”2

In response to this recent attention to platelets, we’ve considered whether an irreversible temperature indicator for platelets would help protect patients AND reduce the financial burden associated with outdated PLTs.

Please CLICK HERE to take our survey
and share your thoughts.

In this short survey, we’d like to learn more about your blood bank’s platelet inventory management – and to get your ideas on the possible value of a platelet temperature indicator.

After the survey closes, we’ll publish the responses so you can learn from each other. Survey participants will receive a pre-release of the results – and also be entered in the AABB drawing in Anaheim to win a FREE Val-A-Sure Cooler Validation Kit!

Thank you for taking time to participate in the survey. We look forward to your input, and are happy to provide a forum for sharing ideas in VUEPOINT.

Jeff Gutkind
jeffg@temptimecorp.com

For the entire AABB Guidelines: A Clinical Practice Guideline From the AABB.

Sources:
1 Stramer SL. Current risks of transfusion-transmitted agents: a review. Arch Pathol Lab Med. 2007; 131:702-7.

2 Fuller AK, Uglik KM, Braine HG, King KE. Transfusion. 2011 Jul;51(7):1469-76. doi: 10.1111/j.1537-2995.2010.03039.x. Epub 2011 Feb 8.

COMZ VUEPOINT (doc. 2371)

Simulating Platelets for Validations

Guidance in using an average density to simulate platelets for validations

After reading our VUEPOINT post – “Simulated Blood Products: 10% Glycerol in water may NOT be “One Size Fits All” – that presented “recipes” for simulated blood products (Red Blood Cells, Whole Blood and Plasma) – one of our VUEPOINT readers recently  posted a comment on our website. The question was about platelets, asking for the water-glycerol mixture for simulating them, just like we had done for the other blood products. Great question and we’re glad you asked!

How do we calculate an accurate mixture based on varying platelet densities?

Because of the density range of platelets, if you were striving to be highly, highly accurate, you would need to know what group the platelets fall into. Various professional papers discuss high, low and other density groups. Here is a reference from the University of Virginia School of medicine that classifies platelets into three Density Classes, with an average density for each class.

Another platelet density analysis reported “…normal platelets layered onto Percoll formed a band extending from 1.0625 g/ml to 1.0925 g/ml, with a mean platelet density of 1.0775 g/ml:…”.1

In response to our VUEPOINT reader’s inquiry, we have modified our graph and recommended water-glycerol mixture (1.066, 26%) to include a formula for platelets. This graph plots the % Glycerol (y-axis) to Density / Specific Gravity (x-axis), which reflects density, for Plasma, Whole Blood, Platelets and RBCs.

Recommended “Recipes” for simulated blood products

Based on the data presented in this VUEPOINT, we recommend that you consider using the following mixtures for blood product simulation.

Stir for a few minutes to assure a homogeneous solution. Be sure to follow any precautions supplied by the glycerol manufacturer for handling pure glycerol.

Other Sources for Platelet Density Information

For those of you who are interested in digging a little deeper into platelet density, here is a link to another reference that reports blood density determination:
Blood. 1977 Jan;49(1):71-87. Heterogeneity of human whole blood platelet subpopulations. I. Relationship between buoyant density, cell volume, and ultrastructure. Corash L, Tan H, Gralnick HR.

Please Share Your Questions and Feedback

We always appreciate questions like these that give us an opportunity to do some research and share more valuable information, with the goal of making your job a little easier if we can. Please don’t hesitate to post a COMMENT to any of our VUEPOINT articles if you have something to share, or would like to us to “dig a little deeper” for our mutual learning.
info@williamlabs.com
1-800-767-7643

1 Platelet-Density Analysis and Intraplatelet Granule Content in Young Insulin Dependent Diabetics, A. Collier, H.H. K Watson, D.M. Matthews, L. Strain, C.A. Ludlam, and D.F. Clarke, Diabetes, Vol. 35, October 1986.