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L7 17 TSIS armband will be attached to the ice chest in the event the first one must be removed during surgery. Applicable surgical procedures are based on the Maximum Surgical Blood Order (MSBO) Schedule (AABB Technical Manual, 10th Edition, 1990, pp. 516-17) for those procedures listed as averaging transfusion levels of >4 units: Aneurysm Resection Trauma -Exploratory Laparotomy Trauma -Thoracotomy Pancreatectomy Cardiothoracic Bypass Aortic Bypass Thoracotomy with Pneumonectomy Radical Prostatectomy with Node Resection Femoral -Popliteal Graft Renal Artery Repair If the surgical procedure is unlisted or the quantity of blood requested for delivery is less than the minimum, Transfusion Service will proceed with unit crossmatching and will contact the Medical Director prior to releasing the blood for storage in surgery. In consultation with the Medical Director, the anes- thesiologist may individualize specific requests to accommodate special needs. Following surgery, unused blood will be picked up and returned to the Transfusion Service refrigerator. The temperature of the ice chest thermometer is recorded on the Log Sheet. Each bag monitor is checked for correct temperature. Out of range units will be discarded. Consigned Blood Components Unused, unexpired blood, stored on consignment from Delta Blood Bank, is returned to its custodian for use at other facilities. All returns are entered in the computer disposition file under procedure code "RDBB" (Return-DBB). Expired Blood Components 1. Expired blood products are entered in the computer disposition file under procedure code "DEST" (Destroy). 2. Expired homologous blood products (red cells, platelets, cryoprecipitate, fresh frozen plasma, plasmapheresis) will be disposed of by incineration through a contracted service. Units are to be placed in the department's container identified for that purpose for temporary storage at room tem- perature. Periodically, the contents of this container are to be transferred to containers in the Histopathology Laboratory for scheduled pickup and disposal as medical waste. 3. Expired homologous plasma (removed from whole blood units) will be returned to Delta Blood Bank for recovery. Units are to be placed in the department's container identified for that purpose for temporary storage at room tem- perature prior to pickup by Delta Blood Bank. 4. Expired autologous blood products (red cells and plasma) will be disposed of by incineration through a contract service. (See item 2 above) Director, Clinical aboratory Supero' r, Transfusion Service Chief Technologist Date of Approval Section: 1.125 Distribution: Transfusion Service Procedure Manuals Page 2 of 2