PROSEDUR PERMINTAAN DARAH, DISTRIBUSI

RANTAI DINGIN DAN PENYIMPANAN INVITRO

dr Errisa Maisuritadevi Mara., M.Sc., Sp.PK

 Cold Chain Logistics
" cold chain system "
 temperature-controlled supply chain.
 sistem penyimpanan dan transportasi untuk
mempertahankan suhu tertentu.
 Cold Chain Logistics Infrastructure

End
Supply Transport Storage Transport
Costumer
 Why have the Cold Chain?
• “cold chain system” pada UTD penting karena:
 kegagalan mempertahankan suhu penyimpanan akan
berakibat terjadinya kerusakan produk komponen darah.
 Untuk menjaga produk darah dan komponen darah tidak
rusak
Blood Supply Chain Management
 STORAGE EQUIPMENT
QUARANTINE equipment
1. Blood bank refrigerator(s) to hold
blood undergoing processing before
it is released for use.
2. Blood plasma freezer(s) for storing
plasma components cryoprecipitate
or serum.
3. Platelet agitator(s) AND incubator
blood stock STORAGE Equipment
1. Blood bank refrigerator(s) and or cold
room to storing blood product.
2. Blood plasma freezer(s) for storing
plasma components, cryoprecipitate or
serum.
3. Platelet agitator(s) and incubators for
storing platelet concentrates (+20 °C to
+24 °C).
4. Temperature recording devices/alarms.
 Cold Chain Equipment
• REFRIGERATORS • PLASMA FREEZERS
• COLD ROOM
• PLATELET AGITATORS
 moves a flat tray/shelf in a gentle horizontally oscillating motion
(side to side) at approximately 70 cycles per minute.
• PLATELET INCUBATOR
 20-24O C
Temperature monitoring devices
Temperature recorders/thermographs
Cold Chain Equipment
Equipment for TRANSPORTATION
blood
1. Blood transport boxes.
2. Ice packs.
3. Temperature monitoring devices
COOLER BOX
Desain Ideal blood transport box
• Ringan
• Kuat
• Aman dan mudah dikunci
• Suhu dingin (2 - 4°C) dapat bertahan
sampai 30 jam
Ice packs, cooling plates and cooling pouches
• memungkinkan penyimpanan dan transportasi darah atau trombosit yang
belum diproses sampai 24 jam di antara +20° C s/d +24° C.
• Dapat pempertahankan suhu antara +2° C s/d +6° C selama minimal 3 jam
• Dapat mempertahankan suhu (+4 ° C) sampai 30 jam.
Monitoring temperature blood bank
 TRANSPORTATION
OF BLOOD AND BLOOD COMPONENTS

Perhatikan SUHU !

– cara mempertahankan suhu ketika transportasi

– perlu agitasi atau tidak??
 Packing and transportation of blood and blood components

• Red blood cell components must be kept at a temperature of +2 °C to +10 °C during

transportation.

• All components routinely stored at +20 °C to +24 °C should be kept at these

temperatures during shipment.
 Red cell components:

• At no point should ice be allowed to come into direct contact with the blood as the
red cells nearest to the ice may freeze and haemolyse.
• Appropriate materials and packing arrangements are therefore necessary. In boxes
shipped long distances or at high environmental temperatures, the volume of ice
should at least equal that of the blood.
• In an insulated container, the temperature can be considered to be in the +2°c to+10
°c range as long as un melted ice is still present on arrival at destination.
 Platelets

• Platelets: containers for transporting platelets should be equilibrated at a

temperature of +20 °C to +24 °C before use.
• If outdoor temperatures are extremely high, special chemical, coolant pouches are
available that may be shipped with platelets and will maintain temperatures of
approximately +20 °C to +24 °C for up to 12 hours. Also available are containers with
a power source that maintains temperatures between +20 °C and +24 °C.
• Platelets should reach their destination within 24 hours, which is the maximum time
allowed without agitation
 Trombosit  suhu dijaga antara 20° - 24° C selama pengiriman.
 Penghentian agitasi selama transportasi tidak boleh melebihi 24 jam.
 Plasma:

• Plasma: there should be at least as much wet ice in the cold box as there is plasma.
It is important to protect the frozen plasma units during transportation.
• If possible, they should have been placed in cardboard boxes before freezing to
protect the bags from developing small cracks.
• A simple method to determine if plasma units have thawed and refrozen is to place a
rubber band around the unit at the time of preparation.

• Once the unit freezes it leaves an indentation at the sides. If the unit has thawed, or
thawed and refrozen, the indentation will not be there.
TRANSPORT
Maintenance
 Pengembalian Komponen darah
• If a unit of blood is returned to the blood bank, the following checklist should be
used to decide whether it should be put back into stock or discarded.
• Check that the unit has been returned to the blood bank within 30 minutes of issue.
• If the “tagging” system was used, check the seal.
• Verify that the unit has not been opened, by squeezing it gently and looking for
blood at the entry port.
• Check the temperature by hand or by folding the unit around a thermometer.
• After mixing the unit gently, keep it in the upright position while it ‘settles out’ in the
refrigerator and look for signs of haemolysis or other signs of deterioration in the
plasma and red cells.
TRANSPORTASI
STORAGE
SOP Distribusi Darah
TEMPORARY STORAGE OF COLLECTED BLOOD

 The cold chain should begin as soon as blood is collected. Donor clinic
 staff are responsible for ensuring that blood reaches the blood bank in
 a suitable condition by following the procedures that are designed to:
 􀂄 maintain the viability and functions of the constituents of
 the blood
 􀂄 prevent physical changes that may be detrimental to the
 constituents of the blood
 􀂄 minimize bacterial contamination of the blood.
 The blood packs should then immediately be put in a refrigerator or a
 precooled blood transport box. Sturdy, well-insulated cold boxes can
 maintain a temperature of +2°C to +6°C if they contain sufficient
icepacks;
 dry ice or supercooled ice should not be used. The ice should
 never be allowed to come into direct contact with the blood bags or
 sample containers since this may cause haemolysis of the red cells.
 If possible, put a maximum/minimum thermometer inside the cold box
 so that the maximum and minimum temperatures reached inside the box
 can be recorded when the blood reaches the blood bank. The thermometer
 should not touch the ice-packs. If the temperature is outside the range
 of +2°C to +6°C, a decision will have to be taken about whether to discard
 or keep the blood. If there is no thermometer, the temperature has
 probably remained within this range if there is unmelted ice remaining in
 the box.
Selamat
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