scholarly journals Blood Product Supply for a Helicopter Emergency Medical Service

2021 ◽  
pp. 1-10
Author(s):  
Kathleen Selleng ◽  
Marcel Baschin ◽  
Berthold Henkel ◽  
Gregor Jenichen ◽  
Karl-Christian Thies ◽  
...  
Keyword(s):  
Product Quality ◽  
Blood Product ◽  
Air Transport ◽  
University Hospital ◽  
Clotting Factor ◽  
Routine Practice ◽  
Severe Bleeding ◽  
Blood Products ◽  
Transport Container

<b><i>Background:</i></b> Long patient transport times to trauma centers are a well-known problem in sparsely populated regions with a low hospital density. Transfusion of red blood cell concentrates (RBC) and plasma improves outcome of trauma patients with severe bleeding. Helicopter emergency services (HEMS) are frequently employed to provide early advanced medical care and to reduce time to hospital admission. Supplying HEMS with blood products allows prehospital transfusion and may help to prevent exsanguination or prolonged hemorrhagic shock. We have investigated the maintenance of blood product quality under air transport conditions and the logistical steps to introduce a HEMS blood depot into routine practice. <b><i>Methods:</i></b> A risk analysis was performed and a validation plan developed. A special, commercially available transport container for blood products was identified. Maintenance of temperature conditions between 2 and 6°C in the box were monitored at ambient temperatures up to 35°C over 48 h. Quality of blood products before and after helicopter air transport were evaluated including (1) for RBCs: hemoglobin, hematocrit, hemolysis rate; (2) for thawed plasma: aPTT, INR, single clotting factor activities. The logistics for blood supply of the regional HEMS were developed by the transfusion service of the Greifswald University Hospital in collaboration with the in-hospital transport team, the HEMS team, and the HEMS operator. <b><i>Results:</i></b> The transport container maintained a temperature below 6°C up to 36 h at 35°C ambient temperature. Vibration during helicopter operation did not impair quality of RBC and thawed plasma. To provide blood products for HEMS at least two transport containers and an additional set of cooling tiles is needed as the cooling tiles need a special temperature priming over 20 h. The two boxes were used at alternate days. To reduce wastage, RBCs and thawed plasmas were exchanged every fourth day and reintegrated into the blood bank inventory for further in-hospital use. <b><i>Conclusions:</i></b> Supplying HEMS with RBCs and plasma is feasible. Helicopter transport has no negative impact on blood product quality. The logistic challenges require close collaboration between the HEMS team and the blood transfusion service.

Identification of Wasted Blood Products at Staten Island University Hospital in 2020 and Institutional Efforts to Reduce Wastage

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S156-S157
Author(s):  
M Toprak ◽  
I M Asuzu ◽  
G Morvillo ◽  
F Kiran ◽  
B Chae ◽  
...  
Keyword(s):  
Shelf Life ◽  
Blood Product ◽  
Low Cost ◽  
Fresh Frozen Plasma ◽  
University Hospital ◽  
Blood Component ◽  
Blood Products ◽  
Staten Island ◽  
Team Members ◽  
Fresh Frozen

Abstract Introduction/Objective Blood products are precious resources obtained from donors who donate with the intention to help people. These blood products however do not always go to the patients, instead sometimes ending up in the waste. It is inevitable to have some degree of the wastage due to limited blood product shelf life, the inherent need to have stock on hand at all times, and the often unpredictable demand of these products. However, it is possible to minimize the wastage of blood products with careful management of inventories, proper documentation, and education1. In this study, we aim to identify the amount and cost of wasted blood products at Staten Island University Hospital in 2020, the reasons behind the wastage, and solutions to reduce the wastage. Methods/Case Report A retrospective statistical analysis of blood product waste data in 2020 was performed manually with Microsoft Excel. Wastage rate and average cost was calculated, the reasons behind the wastage were identified, and low cost interventions to reduce wastage were planned. Results (if a Case Study enter NA) Total number of the wasted blood product is 425 which represents 3.8% of the total inventory at a total cost of $ 97,309.46 which does not include the hours spend by the lab personnel for the wasted products. The most wasted blood component is fresh frozen plasma (FFP) (Table 1). Thawing the frozen blood products (FFP and cryoprecipitate) significantly shortens the shelf life and triggers a lot of wastage through expiration (Table 2). 32.5 % of the wasted products are wasted due to expiration on the shelf (Diagram 1). Other reasons for the wastage includes patient unreadiness, patient refusal, late return of unused products etc. (Graph 1). Conclusion Educating clinical and laboratory team members about the reasons for wasted blood products and strategies to reduce it might significantly reduce the wastage. Appropriate activation and immediate deactivation of massive transfusion protocol (MTP) would be one of the most important aspect of this education. Expired thawed blood product is the largest contributor to wastage, and MTP is the main reason for thawing. Preventing unnecessary MTP activation minimizes over-thawing and therefore minimizes the expiration and wastage. Documentation of the wasted blood product should be improved to better identify the reasons behind wastage.

scholarly journals Evaluation of the Use of Blood Products in ICU Hospitalized COVID-19 Patients

Surgeries ◽  
2021 ◽  
Vol 2 (4) ◽  
pp. 391-398
Author(s):  
Branislava Vasiljević-Jovanović ◽  
Marija Milenković ◽  
Lidija Mijović ◽  
Zoran Bukumirić ◽  
Milena Šantrić-Milićević ◽  
...  
Keyword(s):  
Median Time ◽  
Blood Product ◽  
Medical Center ◽  
Severity Of Illness ◽  
University Hospital ◽  
Blood Products ◽  
Product Usage ◽  
The Public ◽  
The University ◽  
Second Wave

(1) Background: The COVID-19 pandemic tested the public health system’s readiness for crises and highlighted the importance of knowing the demand for blood products and the maintenance of the blood supply chain. The aim of this study was to evaluate blood product usage in a series of patients that were hospitalized due to COVID-19 and to analyze their demographics and clinical characteristics. (2) Methods: In this retrospective cohort study, we analyzed data from transfused COVID-19 patients that were treated in the University Hospital Medical Center Bezanijska Kosa in Belgrade, Serbia during the second wave of the epidemic. (3) Results: This study included 90 patients. The median age of the patients was 72 (range 23–95) years. The median time of hospitalization was 23 days (range 3–73 days). In intensive care units (ICUs) the median time of hospitalization was 9 days (range 0–73). One or more comorbidities were observed in 86 individuals (95.6%). The total number of transfused red blood cell concetrates (RBC) was 304 (139 in ICU, 165 in other wards), with a mean of 3 units/patient (range 1–14). Comorbidities, severity of illness and hospital duration in the ICU were statistically significant predictors of higher RBC use. (4) Conclusion: Knowledge of the transfusion profile of COVID-19 patients allowed better management of the hospital’s blood stocks during the COVID-19 pandemic.

scholarly journals AUDIT SYSTEM FOR USAGE OF BLOOD PRODUCT IN SANGLAH GENERAL HOSPITAL DENPASAR BALI

2019 ◽  
Vol 25 (3) ◽  
pp. 257
Author(s):  
Kadek Mulyantari ◽  
Teguh Triyono ◽  
Usi Sukorini
Keyword(s):  
Internal Medicine ◽  
General Hospital ◽  
Intervention Study ◽  
Blood Product ◽  
Blood Products ◽  
Prospective Audit ◽  
Audit System ◽  
Before And After ◽  
Post Test

Blood transfusion is one of very important therapy components. One indicator of the blood services quality in Sanglah  General Hospital Denpasar Bali Indonesia is achieving the target of unused blood order ≤ 10% per month. However, these targets have not been achieved. The number of unused blood orders reached 6,719 bags per year (600 bags per month or 21.5%). Unused blood orders is mostly from Department of Internal Medicine (40.9%), followed by Department of Surgical (35.6%),  Department of Obstetrics and Gynecology (15.5%) , and Department of Pediatrics (8%). The high number of unused blood orders can causes several problems such as the disorder of blood supply, inefficiency of pre-transfusion testing and decreased quality of blood product. Considering the consequences of high unused blood order, it is necessary to conduct a research on audit system for usage of blood product in Sanglah Hospital.The aim of study are to analyze the influence of audit system to reduce unused blood order and to decrease the number of C/T ratio. The study design was a pre and post test intervention study. The population in this study were all forming of blood requests in Sanglah Hospital. The sample is blood request form Department of Internal Medicine of the last two months. Intervention in this study was the development and dissemination of guidelines for usage of blood products, followed by concurrent audit and prospective audit of the sample.The study show there are decline of unused blood orders and C/T ratio before and after implementation of the audit system for usage of blood products. Reduction of unused blood order in Sanglah Hospital is 5.4%, and in the Department of Internal Medicine is 5.2%. The causes of unused blood orders were patient died, overestimation of blood order, transfusion delays because waiting for the schedule of hemodialysis, the patient has a fever, blood product has expired, and the occurrence of administration errors. Reduction of C/T ratio in Sanglah Hospital is 0,094 and in the Department of Internal Medicine is 0,072. Audit system for usage of blood products can reduce unused blood orders and decrease C/T ratio.

scholarly journals The key complications of hemophilia and recent advancements in their management: an update

2021 ◽  
Vol 9 (6) ◽  
pp. 1800
Author(s):  
Afrisya Adlina Mohd Azhar ◽  
Alicia Ann Raj ◽  
Filzah Izam ◽  
Muhmammad Danial Mokhtar ◽  
Nur Asfarina Izzati Aziz Zakaria ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Financial Burden ◽  
Clotting Factor ◽  
Severe Bleeding ◽  
Coagulation Disorder ◽  
Psychosocial Effects ◽  
Hemophilic Arthropathy ◽  
Emerging Treatments ◽  
Life Therapy

Hemophilia A is an X-linked recessive disorder which is due to factor VIII deficiency. It is a life-threatening coagulation disorder leading to complications including hemophilic-arthropathy, development of inhibitors, transfusion-related infections and profound psychosocial impact on the life of the patients. The aim of this study is to analyze the challenges in complications and the latest advancements in managing those complications. A thorough and systemic literature review was done to fulfill the objective of this study. The emergence of hemophilic arthropathy due to repeated symptoms of hemarthrosis is the most frequent complication found in haemophiliacs. Another critical complication, mainly seen in resource-poor settings is the development of lethal and severe bleeding episodes including episodes of intracranial hemorrhage. The development of inhibitors is another major challenge which often adds profoundly to the financial burden faced by hemophilia patients. Another major challenge is acquiring various transfusion-transmitted infections which was particularly more common few decades back. Studies also have revealed that there are myriads of significant psychosocial effects affecting the quality of life of hemophiliacs. Emerging treatments such as gene therapy, non-clotting factor concentrate products and extended half-life therapy can usher a new era in the management and the quality of life in hemophilia patients.

Inhibitor treatment by rituximabin congenital haemophilia A

2009 ◽  
Vol 29 (02) ◽  
pp. 151-154 ◽  
Author(s):  
Escuriola Ettingshausen ◽  
R. Linde ◽  
G. Kropshofer ◽  
L.-B. Zimmerhackl ◽  
W. Kreuz ◽  
...  
Keyword(s):  
B Cell ◽  
Immune Tolerance ◽  
High Titre ◽  
Clotting Factor ◽  
Severe Bleeding ◽  
High Morbidity ◽  
Haemophilia A ◽  
Concomitant Treatment ◽  
Bleeding Tendency ◽  
Severe Haemophilia

SummaryThe development of neutralizing alloanti-bodies (inhibitors) to factor VIII (FVIII) is one of the most serious complications in the treatment of haemophiliacs. Inhibitors occur in approximately 20 to 30% of previously untreated patients (PUPs), predominantly children, with severe haemophilia A within the first 50 exposure days (ED). Immune tolerance induction (ITI) leads to complete elimination of the inhibitor in up to 80% of the patients and offers the possibility to restore regular FVIII prophylaxis. However, patients with high titre inhibitors, in whom standard ITI fails, usually impose with high morbidity and mortality and therefore prompting physicians to alternate therapy regimens. Rituximab, an anti-CD 20 monoclonal antibody has been successfully used in children and adults for the management of B-cell mediated disorders. We report on the use of a new protocol including rituximab in two adolescents with severe haemophilia A and high titre inhibitors, severe bleeding tendency and high clotting factor consumption after failing standard ITI. Both patients received a concomitant treatment with FVIII according to the Bonn protocol, cyclosporine A and immunoglobulin. Treatment with rituximab resulted in a temporary B-cell depletion leading to the disappearance of the inhibitor. FVIII recovery and half-life turned towards normal ranges. In patient 1 the inhibitor reappeared 14 months after the last rituximab administration. In patient 2 complete immune tolerance could be achieved for 60 months. Bleeding frequency diminished significantly and clinical joint status improved in both patients. In patient 1 the treatment course was complicated by aspergillosis and hepatitis B infection. Conclusion: Rituximab may be favourable for patients with congenital haemophilia, high-titre inhibitors and a severe clinical course in whom standard ITI has failed. Prospective studies are required to determine safety, efficacy and predictors of success.

PENGARUH KUALITAS PRODUK DAN RELIGIUSITAS TERHADAP KEPUTUSAN NASABAH PRODUK SIMPANAN PADA BSM CABANG PURWOKERTO

2017 ◽  
Vol 4 (1) ◽  
pp. 189-215
Author(s):  
Yoiz Shofwa Shafrani
Keyword(s):  
Regression Analysis ◽  
Product Quality ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Analytical Tool ◽  
The Other ◽  
Financial Assets ◽  
Islamic Bank

Perkembangan dunia perbankan syariah tidak lepas dari peran para nasabah yang memberikan kepercayaan terhadap pihak perbankan untuk penyimpanan asset keuangannya. Faktanya banyak kelompok nasabah yang memutuskan untuk menjadi nasabah di perbankan syariah karena faktor religiusitasnya. Faktor lain yang dapat ikut mempengaruhi keputusan nasabah adalah kualitas produk. Di mana kualitas produk merupakan karakteristik yang melekat dari suatu produk. Kemungkinan yang terjadi bahwa kebanyakan nasabah pada perbankan syariah juga masih merupakan nasabah perbankan konvensional.Tujuan yang ingin dicapai dalam penelitian ini adalah untuk mengetahui pengaruh kualitas produk dan tingkat religiusitas nasabah terhadap keputusan nasabah untuk menyimpan dananya atau tidak di BSM Cabang Purwokerto. Alat analisis yang digunakan adalah analisis regresi linier berganda, dengan jumlah sampel 100 nasabah. Diperoleh hasil Y = 5,046 + 0,101X1 + 0,218X2. Berdasarkan uji F yang sudah dilakukan maka dapat diketahui bahwa variabel kualitas produk dan religiusitas secara bersama – sama berpengaruh terhadap keputusan nasabah untuk menyimpan dananya di BSM Cabang Purwokerto. Berdasarkan uji t yang sudah dilakukan dapat diketahui bahwa secara partial baik variabel kualitas produk maupun variabel religiusitas berpengaruh terhadap keputusan nasabah untuk menyimpan dananya di BSM Cabang Purwokerto. The progress of the Islamic bank cannot be separated from the role of its customers who give trust to the bank to deposit their financial assets. It is a fact many groups of customers decide to be the customers of the Islamic bank because of their religiosity. The other influences factor of a customer’s decision is the quality of the product. The aim of this research was to determine the effect of product quality and level of customers’ religiosity towards customers’ decision whether to keep their funds in Syariah Mandiri Bank, Branch of Purwokerto, or not. The analytical tool used was multiple linear regression analysis, with a sample of 100 customers. The results indicate Y = 5,046 + 0,101X1 + 0,218X2. Based on F, it can be seen that both variables of product quality and religiosity simultanously affect the customers’ decision to keep theirfunds in BSM Branch of Purwokerto. Based on t test, it can be seen that independently, either variable of product quality or variables of religiosityinfluences the customers’ decision to keep their funds in BSM Branch of Purwokerto.

PENGARUH CITRA MEREK DAN KUALITAS BENIH TERHADAP KEPUTUSAN PEMBELIAN PADA PT.PRABU ARGO MANDIRI (Studi Kasus Penjualan Benih Tomat Merk Maya di Purwkarta)

2017 ◽  
Vol 6 (2) ◽  
Author(s):  
Ahmad Iskandar
Keyword(s):  
Product Quality ◽  
Brand Image ◽  
Hypothesis Test ◽  
Descriptive Analysis ◽  
Linear Regression Analysis ◽  
Coefficient Of Determination ◽  
Decision Variable ◽  
Purchasing Decisions ◽  
Business World

In the era of globalization, the competition in the business world becomes very tight. Companies vying to be able to continue to compete and survive in the business world. Each consumer must have had the expectation that the products they buy are able to provide satisfaction for them to be making purchasing decisions. Consumer purchasing decisions of companies to seeds virtual brand still low due to the brand image and quality of seeds that are still unsatisfactory.This study aims to determine the responses of respondents regarding brand image, product quality, purchasing decisions and how big an impact on the brand image itself against purchase decisions on the PT. Prabu Argo Mandiri Bandung and how much influence the quality of products on the purchase decision.The method by which the samples is Simple Random Sampling consists of 80 respondents. The method of analysis in this research using descriptive analysis and verification which is composed of multiple linear regression analysis. Product moment correlation analysis, and the coefficient of determination used to measure the level of influence of brand image and product quality on purchasing decisions.The results based on descriptive analysis of brand image variable is in good enough category, variable quality of the product is in the unfavorable category, and the purchase decision variable is in the unfavorable category. The results based on correlation test showed that the brand image is partially significant effect on purchasing decisions by 68% and the product quality is partially significant effect on purchasing decisions by 13%. Hypothesis test results suggested that the increased purchasing decisions partially and simultaneously influence through brand image and product quality.

PENGARUH KUALITAS PRODUK, HARGA, MEREK DAN SALURAN DISTRIBUSI TERHADAP VOLUME PENJUALAN PADA PT. GELANG GEMILANG JAYA BELLA SPRING BED SEMARANG

2020 ◽  
Vol 15 (1) ◽  
pp. 217-230
Author(s):  
Untung Widodo
Keyword(s):  
Data Analysis ◽  
Product Quality ◽  
Sampling Technique ◽  
Distribution Channels ◽  
Sales Volume ◽  
Independent Variables ◽  
Variable Distribution ◽  
Data Analysis Methods ◽  
Variable Quality

This research was conducted in order to test how much influence product quality, price and brand to the volume of sales at PT. Gemilang Jaya Bella bracelets Spring Bed Semarang. Independent variables include variable product quality, price and brand while the dependent variable is the volume of sales.In determining the data to be studied sampling technique used is the census. Census is a sampling technique when all members of the population used as a sample .. Respondents were selected is the consumer stores PT. Gemilang Jaya Bella bracelets Spring Bed Semarang. Thus obtained sample was 50 respondents. Data analysis methods used to perform hypothesis testing is multiple linear regression analysis.Based on the results of research that has been conducted on all data obtained, the importance of the research that 1). There is a positive and significant effect of the variable quality of the product (X1) to sales volume (Y). 2). There is a positive and significant impact on price variable (X2) to sales volume (Y). 3). There is a positive and significant impact on brand variables (X3) to sales volume (Y). 4). There is a positive and significant effect of the variable distribution channels (X4) to sales volume (Y)

The Practice of Solving Product Quality Problems Obtained through the Use of Design Activities at Car Assembly Plants

2020 ◽  
Vol 27 (3) ◽  
pp. 52-61
Author(s):  
V.N. Kozlovsky ◽  
◽  
D.I. Blagoveshchensky ◽  
A.V. Kritsky ◽  
U.V. Brachunova ◽  
...  
Keyword(s):  
Product Quality ◽  
Project Teams ◽  
Design Approach ◽  
Design Activities ◽  
Assembly Plants

The paper presents the results of the development and implementation of design approach tools for solving quality problems of new cars in operation. The generalization of the experience of the project teams in solving problems in the field of the quality of new vehicles in operation.

PENGARUH HARGA DAN KUALITAS PRODUK TERHADAP LOYALITAS PELANGGAN ALUMUNIUM

2019 ◽  
Vol 7 (2) ◽  
Author(s):  
Widodo Widodo ◽  
Marshelly Chandra Kumala
Keyword(s):  
Data Collection ◽  
Product Quality ◽  
Customer Loyalty ◽  
Significant Influence ◽  
Secondary Data ◽  
Primary Data ◽  
Research Results ◽  
Is Research ◽  
Quality Of Products

<em>The objective of this is research was conducted to find out how the influence of the price and quality of products against customer loyalty at PT. Alakasa Extrusindo Jakarta. This research was conducted in Alakasa Extrusindo PT by doing data collection, through the primary data and secondary data.  The research results showed that the simultaneous price variables  and product quality  has a positive and significant effect against the variable customer loyalty. partially showed that price variables has a positive and significant influence towards customer loyalty. And partially showed that product quality variables  has a positive and significant influence towards customer loyalty</em>

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