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Clot in the Blood Bag: A Case Report
Arthi Rajkumar1, Soundharya Vetriveeran1, Suresh Kumar Iyyapan1
1Transfusion Medicine, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, IND.
Cureus
|October 16, 2024
Summary
Clot formation in blood bags is a rare but serious risk. Root cause analysis revealed improper vein selection, delayed tube stripping, and faulty monitors contributed to coagulation, necessitating corrective actions for blood safety.
Area of Science:
- Transfusion Medicine
- Hematology
- Patient Safety
Background:
- Clot formation in blood bags compromises the safety and quality of transfused blood products.
- Ensuring the integrity of blood components is critical for effective transfusion therapy.
Observation:
- A large clot was discovered in a blood bag during routine component preparation.
- This incident prompted a thorough root cause analysis to identify contributing factors.
Findings:
- Improper vein selection leading to low flow rates.
- Delays in the tube stripping process.
- Use of a faulty blood collection monitor.
- These factors collectively contributed to coagulation activation and clot formation.
Implications:
- Corrective actions include enhanced staff training, revised phlebotomy techniques, and equipment calibration.
- Updated standard operating procedures (SOPs) aim to prevent recurrence.
- Continuous monitoring and protocol adherence are vital for maintaining blood product integrity and transfusion safety.
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