The Hospital Services department of United Blood Services distributes blood products to hospitals and other transfusion facilities for patient use. Hospital Services is also responsible for handling patient specimens requiring testing at the blood center and blood products returned to the blood center. Derivatives and reagents may be delivered by Hospital Services personnel at some centers.
Each transfusion facility must sign a “Hospital Services Agreement Letter” detailing expectations and requirements for delivery and storage of blood products, return privileges when applicable, and special services provided by United Blood Services or Blood Systems Laboratories.
This section of the Web site covers topics related to the order and delivery of blood products, in addition to other issues covered in the Agreement Letter. Contact Hospital Services for routine communications or the Hospital Services Director for other questions you may have. Certain topics are dependent on specific United Blood Services center processes. For questions, contact the Hospital Services department or Director for the center supplying your blood.
If you utilize United Blood Services for compatibility testing services, please go to the Transfusion Medicine section of the Web site for placing orders and delivery of these components.
Regular orders of components are for ones that United Blood Services keeps in stock. Time frame of delivery (for stock, routine, ASAP, STAT) depends on the distance from the blood center to your facility.
The following guidelines are used by United Blood Services for time frames to ship regular orders. Stated time is from the order time to when the shipment leaves the center.
Time frames may vary by location, so contact your blood center for clarifications. They may also vary due to other factors (e.g., blood shortages, 3 day weekends, high usage).
A blood stock level, as determined by United Blood Services and the transfusion facility, is rotated on a scheduled basis as agreed upon. When possible, United Blood Services requests the use of shorter dated units first, and the timely release of untransfused, crossmatched blood for other patient use or return to the blood center.
When placing an order, indicate type(s) of blood component(s), quantity and time frame for delivery.
Special Orders are for components that require special handling, testing, or components not available in stock at United Blood Services. Not all blood centers may provide the complete list of options.
|PEDIATRIC COMPONENTS||Units requested for pediatric use may be aliquoted by United Blood Services (plasma) or supplied with a satellite bag (or bags) attached to the primary unit for aliquoting at the Transfusion Facility.|
|WASHED||Red Cells or Platelets requested as washed have a reduced outdate (24 hours and 4 hours respectively).|
|IRRADIATED||Cellular components can be requested as irradiated. Directed Donor units from blood relatives require irradiation.|
|DIRECTED DONOR/ AUTOLOGOUS||These reserved units must be ordered to be drawn prior to transfusion need by the patient’s attending physician. (See Special Collections.)|
|ANTIGEN NEGATIVE||Red cell units can be supplied as confirmed or unconfirmed depending on transfusion facility request and blood center policy. Rare units may be available as liquid or frozen, but may need to be imported from another center. If frozen, United Blood Services will deglycerolize the unit prior to delivery; this shortens the shelf life of the units to 24 hours.|
|CMV SERONEGATIVE||Cellular components can be requested as CMV seronegative.|
|HGB S NEGATIVE||Red cell components can be requested as Hgb S negative.|
|GRANULOCYTES||Collected only after discussion with the United Blood Services Medical Director.|
|WHOLE BLOOD||Available at special request.|
|Special platelet considerations:|
|REDUCED VOLUME||Platelet pheresis components can be prepared to remove plasma volume. This process shortens the shelf life to 4 hours from when the process starts, and allows only a very short time for administration at the Transfusion Facility.|
|LOW PLATELET YIELD||Transfusion Facilities may choose to accept platelet pheresis components with a platelet yield less than 3.0 x 1011. Platelet units containing <3.0 but >2.5 x 1011 will be charged as normal units. Platelet units containing >1.5 but <2.5 x 1011 will be charged at a lesser fee.|
|UNAVAILABLILITY OF BACTERIALLY SCREENED UNITS||Platelets are screened for bacterial contamination which takes approximately 48 hours from collection. If required for transfusion prior to this time, Hospital Services initiates the approval from the Transfusion Facility. Once testing is completed, the Transfusion Facility will only be notified if testing is positive.|
|HLA MATCHED||(refer to BSL instructions for the HLA lab found at this link)|
|CROSSMATCHED||(refer to BSL instructions for the IHS lab found at this link)|
Contact your blood center for center-specific procedures for ordering these components.
A discussion with Hospital Services and/or the United Blood Services Medical Director may facilitate the process for delivery of these special units.
Units that are not yet completely tested require release following the United Blood Services Emergency Release Process. Whole blood and blood components may be issued only when such issue is essential to allow time for transportation to ensure arrival of the blood by the time it is needed for transfusion. Contact your blood center representative for the proper documentation for Emergency Release.
Certain components that cannot be completely tested may also be released upon approval by the attending physician (and our receipt of a signed Emergency Releasae Document, BS 341, available from your blood center representative). Rare, unlicensed frozen units fall in this category.
Certain components are only available as unlicensed by FDA. The requesting physician must supply a medical need statement for delivery of these products.
There are several shipping containers configurations used for each required shipping temperature and container design. Centers may use all or only certain types of containers for transport. Containers have been validated for the transport times listed in the following table.
|Temp.||Component Type||Coolant||Container Designation||Transport Time|
|1-10C||Red Cells/ Whole Blood||BSI Blue Ice||
< 48 hours/
|20-24C||Platelets/ Granulocytes||Gel Coolant||E-38UB||
< 24 hours
|<-20C||Plasma/ Cryoprecipitate||Dry Ice||CF45/CF89||Dependent on amount of dry ice. Shipment is acceptable if dry ice is still present.|
A packing slip will accompany each shipment.
To return components to United Blood Services, they must be packed in the shipping container with appropriate coolant determined for the type of product. If you have any questions concerning packing units for return, contact the Hospital Services department at you blood center.
The CF-45 and CF-89 shipping containers may be used for temporary storage of blood products in the case of a storage unit failure. Proper packing and temperature measurement and recording every 4 hours is required. Contact Hospital Services to arrange to return units, when applicable, or provide adequate shipping containers and packing materials for short term storage.
Packing supplies are available from United Blood Services. RBCs may be returned to United Blood Services when the following packing configuration is followed:
Packing supplies are available from United Blood Services. Platelets may be returned to United Blood Services when allowed by the Service Agreement and the following packing configuration is followed:
Packing supplies (except dry ice) are available from United Blood Services. Frozen Plasma Products may be returned to United Blood Services when allowed by the Service Agreement and the following packing configuration is followed:
|If using a||
And the shipment
|Then add this
|CF-45||>3 or <38 hours||12 lbs.|
|<3 hours||2 lbs.|
|CF-89||>3 or <38 hours||15 lbs.|
|<3 hours||3 lbs.|
United Blood Services supplies couriers for transfusion facilities and hospitals within driving distance (determined by blood center distribution locations). Schedule of routine runs is dependent on the transfusion facility or hospital. Other couriers not currently in contract may be used in certain situations. Discuss these options with your blood center.
Couriers may facilitate transfer of components between transfusion facilities or hospitals. In very limited circumstances, the Transfer Document form, (BS 5150) may not be required for transfers within the same healthcare organization in the same service area, sharing the same computer system and having a method in place to document transport time and temperature. Please check with your UBS Hospital Services Director.
To transfer components between hospitals or transfusion facilities using the BS 5150, the sending facility must inspect each blood component, sign the blood storage and handling statement, document the date and time of component inspection/packing and identify, on the BS 5150, the person performing the inspection and packing. Place the original BS 5150 in the shipper and retain a copy at the hospital.
The receiving hospital must inspect the packing configuration and document acceptability, measure and record the receipt temperature of the shipment, verify shipper contents and sign the “Received By” section of the BS 5150, recording the date and time of receipt. Send a completed copy of the form to the local United Blood Services center and retain a copy at the facility.
Out of town delivery depends on the location of the Transfusion Facility. Contact Hospital Services for specific details.
When a shipment is delivered by a non-United Blood Services courier, evaluate appropriate packing configuration and temperature for type of component. Contact the Hospital Services department at your blood center if you have any questions concerning deviations or questionable storage conditions.
Returning short-dated units for use by another facility benefits everyone; ensuring an adequate blood supply is everyone’s responsibility. Return privileges are defined in the Agreement Letter. Units must be properly packed in appropriate shipping containers for return, and red cells must have a minimum of 2 segments remaining on the unit. Units must have been stored at the Transfusion Facility following required storage conditions, and monitored during the storage period. Your United Blood Services center conducts visits to your facility to ensure acceptable storage is maintained (see section on Facility Inspection and Shipping Quality Control).
Units that are returned for quality issues or at the request of United Blood Services are automatically credited.
Hospital Services may request return of a component for several reasons (e.g., recall, market withdrawal, positive bacterial detection of a platelet, shortage of a particular blood type at another facility). In some cases, United Blood Services will request destruction of the unit on site if not transfused, and will provide credit if this is done.
Units of questionable quality identified at the transfusion facility are returned to United Blood Services for evaluation. Contact Hospital Services to report the specific situation. The unit must be appropriately “flagged” and Hospital Services staff must be notified prior to returning the shipment to prevent re-distribution.
Complete applicable sections of the Transfer Document form (BS 5150) for a unit returned to United Blood Services. This form is completed when transferring a unit to another Transfusion Facility. In very limited circumstances, the BS 5150 may not be required for transfers within the same healthcare organization in the same service area, sharing the same computer system and having a method in place to document transport time and temperature. Please check with your UBS Hospital Services Director.
To complete the BS 5150 when returning components to a United Blood Services center, the sending hospital must inspect each blood component, sign the blood storage and handling statement, document the date and time of component inspection/packing and identify, on the BS 5150, the person performing the inspection and packing. Place the original BS 5150 in the shipper and retain a copy at the hospital.
Complete applicable sections of the Credit Request form (BS 340) for requesting credit for a unit disposed of at the Transfusion Facility. (Contact your local blood center representatiave for credit request forms.)
As stated in the Hospital Blood Services Agreement, the Transfusion Facility (“facility”) must furnish specific storage units, restricted to storage of blood and other biologicals, which are capable of maintaining required storage temperatures, as specified in Title 21 of the Code of Federal Regulations, Standards of the AABB and these United Blood Services policies and procedures.
Storage units approved for storage of blood or blood components at the facility must be equipped with a system that monitors continuously and records temperatures at least every 4 hours and with an alarm that sounds if temperature limits are reached.
The facility must notify United Blood Services within 24 hours of any occurrence of temperature deficiencies in the storage of blood and blood components and agrees not to return units subjected to temperatures outside the required ranges, unless approved for return by United Blood Services.
Documentation of storage temperatures may be required during inspections by regulatory agencies, and the facility agrees to provide records to United Blood Services upon request.
|Whole Blood, Red Blood Cells||1-6C|
|Plasma, Cryoprecipitated AHF||-18C or colder|
|Platelets||20-24C, with gentle agitation|
|Granulocytes||20-24C, without agitation|
In the event of a storage unit failure, components must be moved to appropriate alternative storage. If alternative storage is not available with a temperature monitoring system that alarms for out of range temperatures, contact United Blood Services Hospital Services to discuss alternative storage at United Blood Services, the use of United Blood Services shipping containers as alternative storage or other suitable solutions.
Please follow the table below if using shipping containers as alternative storage.
|Red Blood Cells (RBCs)||
United Blood Services Hospital Services and our Quality Source consulting group stand ready to help your facility with questions or concerns about new equipment validation, recording chart issues, alarm checks and related concerns. Please contact your local blood center or send email to Qsource@bloodsystems.org.
Refer to Storage and Record Keeping Requirements for Transfusable Blood Components for valuable information regarding component temperature requirements, storage of blood components, identifying and documenting deviations, reporting requirements, and hospital inspections by the blood center. This presentation may be used for training new staff.
Blood product derivatives and serologic reagents are available from BioCARE through your United Blood Services center. Contact the Hospital Services department to obtain information on ordering the derivatives/reagents. The Hospital Services department may deliver the supplies to your facility. BioCARE personnel deliver directly to some locations.
Refer to the Blood Components and Derivatives section of this Handbook for information relating to commonly ordered derivatives.
Blood center component service (processing) fees should be listed on patients’ bills separately from hospital blood related charges.
Contact your Blood Center Hospital Services department with questions related to product or service fees, requests for credits or billing issues. They may refer you to the Blood Systems corporate Finance department.
Upon request by the FDA, CAP, AABB or United Blood Services, its agents and employees, the transfusion facility shall allow reasonable on-site inspection of blood storage facilities during normal business hours. They shall also allow the review and copying of the storage facility’s SOP for blood component storage and quality assurance records relating to blood component storage and handling.
Inspection of storage records is performed by United Blood Services on an annual basis, unless the facility has current AABB certification and two consecutive years of satisfactory inspections. In these cases, the inspection is performed every two years. Results of the inspection are shared with the transfusion facility.
During the inspection, United Blood Services employees will complete an inspection checklist when observing storage devices. There is one checklist for each temperature range: