c. Some form of temperature indicator or monitoring is desirable periodically
when shipping blood over a regular route. An easy method that every blood bank can
employ to ascertain the temperature in a shipping box upon receipt is as follows:
remove two bags of blood, position labels out, place a quality-assured mercury
thermometer bulb end between the bags, and secure the "sandwich" with 2 rubber
bands; after a few minutes, read the temperature. If the temperature exceeds 10C,
even though some ice is still present, such blood must be quarantined. Regular
temperature monitoring of whole blood and red blood cells may uncover a need for
better insulated containers or larger amounts of ice. Record forms, packaged in each
carton for completion and return by recipient blood bank personnel, provides written
evidence of sufficient ice and insulation. These records of shipping to usual recipients
can be used as guides for shipments to unusual recipients.
d. Other suitable methods for monitoring shipments are:
(1) Use time/temperature tags that indicate whether, at anytime during the
shipping process, the temperature has exceeded 10C.
(2) Place a "high-low" mercury thermometer in the shipping box. These
simple reusable thermometers record the highest and lowest temperatures achieved
during a time period.
(3) Use a temperature indicator in which the location of glass beads in an
ampule filled with wax-like material indicates whether or not the wax has reached its
10C melting point.
(4) Use other monitoring devices shown to be satisfactory. The accuracy of
any temperature-indicating device should be checked before it is placed in routine use
and periodically thereafter.
e. Local transport of blood or red blood cells from the blood bank to other parts
of the hospital must be controlled so that unused blood is returned within a set period of
time. Because blood stored at 1C to 6C will exceed 10C in approximately 30 minutes
at room temperature, blood or red blood cells should be used or returned within 30
minutes. When transportation will require a slightly longer time, each unit may be
placed in an insulated paper bag pre-cooled to 1C to 6C. Blood required by remote
facilities such as surgical operating theaters can be delivered in this manner, or
monitored refrigerators can be installed. Small styrofoam buckets with lids are useful
for a few hours storage in operating rooms. A bag of ice water blanketing the blood bag
assures a 1C to 6C temperature.
f. Whether blood is removed from the facility for transport or for remote holding,
as in a surgical suite, it must be maintained at less than 10C. Finally, it is the
responsibility of the shipping or issuing facilities to ascertain that the shipping container
is satisfactory with respect to its ability to maintain the temperature of the blood or red
blood cells below 10C during the time of transportation.