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

Cooler Validation: Comparison of “Manual” Thermometer vs. “Automated” Data Logger Methods

In our March 2012 survey of over 70 blood banks, many respondents generally described cooler validation as a “pain,” characterizing it as time-consuming, frustrating and even primitive.

Most blood banks revalidate their transport coolers annually. And although it is only once a year, there never seems to be a good time or resource-efficient way to do it.


Using multiple data loggers allows more accurate temperature mapping of the cooler interior.

The three key factors we hear repeated most often are:
1. Time Efficiency (technician’s time)
2. Data Accuracy
3. Simplifying Documentation

At the SCABB/CBBS meeting last month, we entertained compelling discussions with blood bankers who have switched from manual cooler validations with thermometers, to using data loggers (electronic temperature recorders). Some of them are using the Val-A-SureTM Cooler Validation Kit.

If you’ve ever considered switching to an automated validation process, we thought it might be helpful to share what we’ve learned from blood bankers across the country. In the following table (next page) we compare the traditional “manual” thermometer method to the “automated” data logger method – and capture how it has changed their validation experiences.

This graph displays temperature of the top bag vs. the bottom bag. The data is downloaded from data loggers and printed for permanent validation documentation, eliminating handwritten and transcribed data.

We’ll be giving away a Val-A-Sure Cooler Validation Kit at AABB 2015, so if you’re interested in a “free” chance to change your cooler validation method, be sure to stop by and see us!

Jeffrey Gutkind
jeffg@temptimecorp.com

P.S. For more on Transport and Storage Coolers, check out our Tips, Helpful Ideas and AABB Standards References on www.williamlabs.com.

COMZ VUEPOINT – Cooler Validation-Comparison of Manual Thermometer vs. Automated Data Logger Methods – web version (doc. 2341)

Blood Bank Refrigerator Setpoints Matter

Learn about these important time/temperature correlations relative to your day-to-day blood bank operations.

Understanding the time pressures of busy blood banks, it would be fair to say that ANY time/temperature “advantages” – such as revisiting the refrigerator setpoint – might be worth consideration. Learn more in this VUEPOINT.

by Jeffrey Gutkind, Temptime

Over the past several months I’ve had the opportunity to visit some of the largest blood banks across the nation. In the course of talking with blood bankers about maintaining blood temperatures during storage, issue and transport, I observed a wide range of refrigeration setpoints, anywhere from 1.5oC to 4.7oC.

Reviewing my observations from these visits and reflecting on the AABB standard of 1.0oC to 6.0oC for storage, it brought me back to the “starting” temperature for blood when it’s removed from the refrigerator.

    • How does even a degree or two at a higher or lower storage temperature affect the blood temperature as it is dispensed and issued from the blood bank?
    • More importantly, how does the refrigerator setpoint affect how much TIME you have before the blood reaches 6oC?

To answer these questions, we asked Marielle Smith, Technical Service Scientist, to run a simple test in our lab.

How long does it take for refrigerated blood products to reach 6oC?

Blood Storage Temperature: 2°C vs. 4°C

The following table and graph show the time it takes for the core temperature of a refrigerated blood bag to warm to 6°C when removed from refrigerated conditions (2°C or 4°C) and placed on a counter-top at room temperature.1

The graph demonstrates that the lower the refrigerated storage temperature, the more time it takes for the blood bag to reach 6°C when warming at room temperature conditions. While these results are specific to the test method and setup used, they should be typical.

In terms of practical, day-to-day blood bank operations, what does this tell us?

Based on this test data, it suggests that blood bankers have over twice as much time to get blood issued and dispensed when the refrigerator setpoint is lower (2oC vs. 4oC). This represents a significant advantage for refrigerating blood at lower temperatures and longer times out of refrigeration before the blood goes out of specification.

Knowing that AABB guidelines state blood can be stored at 6oC for up to 42 days and transported between facilities below 10oC, and at the same time understanding the time pressures of busy blood banks, it would be fair to say that ANY time/temperature “advantages” such as revisiting the refrigerator setpoint might be worth consideration.

What do the blood refrigeration experts have to say?

After researching refrigerator setpoint specifications for a number of different vendors, we found that the factory setpoint is typically 4.0oC. Not being a refrigerator expert, I decided to reach out to Colleen Holtkamp Market Manager from Helmer® Scientific, to learn more. Colleen graciously provided these thorough answers to my questions, as well as thoughtful guidance for your consideration on setpoints, alarms and refrigerator specifications. (Colleen’s responses are in blue following the questions).

1. What is the typical factory setpoint temperature of your refrigerators when they go into the field? Are these setpoints easily changed, or does it have to be reset by the factory?

“The typical setpoint for Blood Bank Refrigerators is 4oC. Per AABB Standards, the acceptable temperature for storage of whole blood and most red cell components is 1oC to 6oC. Setting the temperature to 4ºC, close to the middle of the range, is standard practice for blood bank refrigeration.

It should be noted that the alarm setpoints are important, as well. AABB Standards state that alarms should be set to activate before blood components are exposed to unacceptable conditions. For example, since the lower limit for blood storage is 1oC, it makes sense to set the low alarm to 1.5oC (and since the upper limit is 6oC, a high alarm setting of 5.5oC is appropriate).

The ability to change the temperature setpoint depends on the manufacturer/brand of the refrigerator, as does the process for changing the alarm settings (instructions should be included in the refrigerator’s user manual).

Helmer Scientific Blood Bank Refrigerators enable the operating setpoint and alarm settings to be changed at the facility (they do not have to be reset by the factory). With temperature and alarm settings, it’s important to remember that while it should be reasonably convenient to modify them, it shouldn’t be so easy that they tend to be changed by mistake. A safeguard such as password protection for the refrigerator settings offers the best of both worlds – security and ease of use.”

2. Is there some type of statistic that you would use to say if the door is open for 3 minutes per hour; it will take XX minutes to get back down to the original setpoint?
As an example: If the refrigerator is set to 3.0oC and the door is open for 2 minutes, how long will it take for the refrigerator to get back down to the 3.0oC setpoint?

“There isn’t a standard method for measuring temperature recovery after a door opening. It can be impacted by variables such as ambient temperature and how much cold product is stored in the refrigerator at the time. What is important is that the unit has a heavy-duty, forced air refrigeration system and that the fan stops running while the door is open so that it does not blow out the cold air. In addition, the refrigeration system should be powerful enough to circulate the air inside the cabinet multiple times shortly after the door is closed, ensuring quick temperature recovery.

Another consideration is the importance of alarms. Having both a door open alarm and a high temperature alarm provides two layers of protection against temperature excursions due to door openings.”

3. What is the typical tolerance for blood bank refrigerators? (we found this information difficult to find in our online research).

“Blood Bank requires the tightest temperature uniformity of any cold storage application. The typical temperature uniformity specification for Blood Bank Refrigerators is +/-1oC. While not necessarily a regulatory requirement, many Blood Banks have written this specification into their internal protocols/SOPs. Therefore, it has become a community standard that drives performance expectations for Blood Bank Refrigerators.

Before a Blood Bank considers changing refrigerator setpoints from 4oC to 2oC, it is critical to think about the following information. If a blood refrigerator is set to 2oC, with uniformity of +/-1oC, the temperature inside the unit might reach the lower limit of the acceptable range (1oC). Also, if the low alarm is set to 1.5oC (which is advisable because AABB standards state that alarms should activate before blood is exposed to unacceptable conditions), it may be triggered by operation at 2oC. Helmer Scientific’s priority is to optimize the temperature of the blood bag while it is stored in our units. The setpoints and alarms are established to protect the blood while it is in the refrigerator.”

When it comes to blood bank refrigeration setpoints, what have we learned?

• The typical factory setpoint for blood bank refrigerators when delivered from the manufacturer is 4.0oC
• The ability to change the refrigerator setpoint at the blood bank varies by manufacturer
• Blood that is stored at 2oC takes over twice as long (approximate, based on our test) to reach 6oC at ambient, when compared to blood stored at 4oC
• Temperature recovery of refrigerators is affected by a number of variables (door opening, amount of stored cold product, ambient operating temperature)
• Low and high alarms, as well as open door alarms, are important and recommended by the manufacturers

If you have any recommendations, experiences, questions or ideas relative to refrigerator storage temperatures and your blood bank, we’d love to hear from you. Please POST A COMMENT or email us.

Jeffrey Gutkind
jeffg@temptimecorp.com

1Test Details
At each storage temperature, a total of six (6) simulated blood bags were tested. Each 600mL PVC blood bag (Charter Medical) was filled with 350mL of a mixture of 10% glycerol and 90% water, to simulate red blood cell volume. The bags were removed from refrigerated storage (at 2°C and 4°C) and then placed lying flat on a counter-top at room temperature (at approximately 21°C with 30% R.H). The temperature was measured by placing a calibrated temperature-sensing probe in the center of the simulated blood mixture inside the bag and the temperature was monitored using a calibrated Oakton Thermistor Thermometer. Temperature readings were recorded at 1 minute intervals. The data represents the time needed for the simulated blood mixture (10% glycerol with 90% water) to warm to 6°C.

All trademarks are the property of their respective owners.