Note: Responses reflect Canadian standards, which vary from location to location.

Question 1: At what temperature should the following components be transported?

  1. RBC -  2°C to 10°C
  2. Platelets  - 20°C to 24°C
  3. Fresh frozen plasma and cryosupernatant plasma - at a temperature that will keep them frozen

Question 2: Describe how RBC should be packed for shipping.

  • RBC (and other blood components) should be shipped in validated containers.
  • Packaging should  have a tamper proof seal.
  • To prevent hemolysis, a barrier (e.g., cardboard) must separate RBC and ice or gel packs.
  • Temperature monitors should be included, with regular temperature monitoring.

Question 3: What are the possible consequences of transfusing RBC that are hemolysing?

Hemolysed RBC can trigger an immediate life-threatening hemolytic transfusion reaction.

Question 4: At what steps should blood be examined visually in the transfusion service?

Steps requiring inspection include:

  • upon receipt of the product by the transfusion service
  • before the product is issued for transfusion from the transfusion service
  • before the product is shipped to another facility
  • when the product is returned from another location within the hospital
  • Note: Blood must also be inspected at the bedside immediately prior to transfusion.

Question 5: Provide 5 criteria for examining blood visually.

Criteria include examining that:

  • the component is in-date with an expiry date label present
  • at least one port is intact
  • the “Suitable for issue” sticker is present on the original bag label
  • For RBC, checking that:
    • the red cell mass is not discoloured (e.g., purple or black)
    • there are no observable clots
    • the colour of the red cells in the unit is the same as red cells in the segments
    • if visible, the plasma/supernatant is not discoloured (e.g., cloudy, bright yellow, reddish)
  • For plasma, checking that:
    • the plasma is not discoloured (e.g., cloudy, bright yellow, reddish)
    • if frozen, the bag has no signs of breakage

Question 6: How does a quality system deal with human errors?

With a quality system, the aim is to discover why the system or process failed, not to assign blame to an individual.