INVENTORY MANAGEMENT

OF BLOOD COMPONENTS
DR THULASIRAM
INTRODUCTION
A sufficient number of units of varying ABO and RhD
specificities should be available to meet routine
hospital needs.

An unanticipated increases in utilization from

emergency situations, and minimize component
expiration and wastage
Factors that influence determination of blood bank
component inventory levels include

historic usage patterns

expiration/wastage rates
and distance from suppliers.
Inventory levels should be periodically evaluated in
response to institutional changes that may affect
component usage,
Including expansion of inpatient beds or operating
rooms,
Implementation of new surgical procedures, or
changes in hospital guidelines or medical practice that
may influence transfusion behavior.
The blood bank should also maintain a reserve of
universally compatible RBCs for emergency use

And have a reliable emergency delivery system to

ensure adequate availability of blood components in
unexpected situations when demand exceeds supply.
In platelet inventory shortage, medical directors may
approve the splitting of apheresis platelet units or
pooling of 3 whole blood-derived platelet units (vs the
usual adult dose of 4-6 pooled units) for prophylactic
transfusion orders to conserve inventory.
Routine inventory levels should be monitored daily to
facilitate timely ordering from blood suppliers and
maintain adequate inventory levels.

This can be particularly challenging for platelets

because of their limited shelf life.
Surgical Blood Ordering Practices
Component outdate rates are influenced by surgical
ordering practices.
For example, when RBC units are cross matched for
surgical recipients,
they are unavailable to other recipients and have a
greater likelihood of expiring
if the component is not returned to the uncross
matched inventory
The crossmatch-to transfusion (C:T) ratio is the
number of RBC units cross matched divided by the
number of RBC units actually transfused

And is most useful in determining individual

physician or specialty specific ordering practices.
When C:T ratios are monitored, a C:T ratio of >2.0
may indicate excessive ordering of cross matched
blood .

And may identify instances when a preoperative type

and screen order is more appropriate.
One approach to reducing excessive C:T ratios is to
identify procedures that do not typically require blood,

and use this information to develop guidelines for the

use of type and screen orders or hold-sample orders

(samples that are received in the transfusion service

but do not have any testing orders) instead of cross
match orders.
The Maximum surgical blood order schedules MSBOS
serves as a guideline not only for how many units
should be available, but also for which surgical
procedures require a type and screen or not.
The electronic cross matching have decreased the
utility of the MSBOS, and this practice is useful now
primarily in hospital transfusion services that lack the
ability to perform electronic cross matching.
A discussion with the clinician and the blood bank
staff should occur to determine how many units to
crossmatch for recipients

undergoing elective surgery who are known to have

clinically significant allo antibodies and require cross
match-compatible, antigen negative blood.
Return of Blood Components and Reissue
The transfusion service may receive back into
inventory units that meet acceptance specifications.
These conditions include the following

 The container closure has not been disturbed.

 The component has been maintained at the
appropriate temperature.
 At least one sealed segment remains integrally
attached to the container, if RBCs.

 Documentation indicates that the component has

been inspected and is acceptable for reissue
Individual-unit temperature indicators or
temperature-reading devices can be used to
determine the acceptability of components for return
to inventory.
Blood and blood components may also be transported
or stored in qualified containers using a validated
process that has been shown to maintain acceptable
temperatures for a defined interval.
Acceptable time frames for returning blood
components to inventory after issue should be
validated by individual facilities.

Individual-unit temperature indicators or

temperature-reading devices may be used to
determine component acceptability for return to
inventory.
Components meeting the acceptance criteria may be
returned to the general blood inventory and reissued.

Components not meeting the acceptance criteria must

be quarantined for further investigation or discarded
in a biohazard container to prevent inadvertent return
to inventory
Key points
Human Resources and Training
Stock Levels and Order Patterns
Transparency of Inventories and Simple Procedures
Focus on Freshness of Stock
Internal Collaboration within the Hospital
THE END