A bit over a gallon, or approximately 5 liters of blood flows through the average human body. There are occasions when some of that blood must, however, be taken out of the body and transported somewhere else. This may mean donated blood that will be used in surgeries, delivery rooms and other places where human life is at stake. Or it could be something as small as blood samples that are analyzed for indications of diseases or other conditions. Whichever it is, when blood gets stored or transported, it is imperative that it remains within proper conditions to ensure viability. Changing seasons make this task a lot more complicated.
Summer has finally arrived, and with it come warmer days and more sunlight. But this doesn’t just mean a nice change of weather and an opportunity to take up cycling again. For both donated blood and blood sample transportation, the seasonal variation creates a perennial headache: trying to maintain stable environmental conditions within the temperature-controlled supply chain while the outside conditions fluctuate. Here are four season-affected things that a blood transportation operator must take into account:
1. The Temperature
So why are stable environmental conditions so important in the transportation of blood, whether sample or donated? Generally speaking, donated blood that’s been outside temperature limits for too long gets thrown away. This happens because it cannot be guaranteed to be safe for transfusion anymore due to changes to blood composition. This is a very specific mode of blood waste traceable to temperature exceptions, but there are others that are less readily recognizable. With blood samples, there is no direct danger to human health from temperature fluctuation, but indirect effects can be just as dangerous and costly.
With blood samples the problems also arise from the fact that temperature affects blood chemical composition. One way this announces itself is seasonal pseudohyperkalaemia. A 2003 study found that During colder winter months, blood sample potassium levels rose because temperature would dip in transit, leading to erroneous diagnoses of hyperkalaemia and possibly dangerous medical interventions. Similar deterioration effects can be observed with other analytes, such as phosphate, ALT, GGT and LD.
If the samples could be transported a few degrees above 20°C, however, the risk of deterioration would be minimized. There is another method for ensuring blood sample quality, which is to centrifuge the samples at the clinic where they are drawn, but this can be labor-intensive and expensive. Compared to that, ensuring correct temperatures is much cheaper, but making this work naturally has its own challenges, such as…
2. The Equipment
Generally, winters are cold, while summers are warm. Your average Joe knows this and knows to act accordingly. But if Joe puts on too much or too little clothing for the season, he’ll quickly get uncomfortable. For blood transportation, the problem is similar but the consequences more dire, at worst resulting in wasted blood and unviable blood samples. But how to know what is the correct choice in equipment?
The issue of maintaining stable environmental conditions in blood logistics is globally recognized. For example, in European context the EU demands that donated blood is transported and distributed under such conditions that maintain the integrity of the product. These are different for different kinds of blood products, making the job of the logistics operator a challenging one. When the outside temperature varies from -30°C to +30°C this gets even trickier. It stands to reason that ambient temperature fluctuation can affect the environmental conditions in blood transportation operations. Therefore, you need the sort of thermal packaging and storage facilities that are capable of maintaining the correct temperatures on the way from vein to vein or vein to laboratory.
But how to know what is the correct choice in equipment? Well, the obvious answer is that they must be shown to perform as they are meant to. The WHO blood GMP asks for validation before and during blood transportation operations to ensure the procured equipment are suitable for the task. And considering the seasonal variations in ambient temperatures, this validation ought to be performed for all possible temperature configurations that the transport operation may encounter. This may seem a lot of effort, but it pays off not only in compliance, but in being able to procure equipment which will be able to demonstrably handle the range of required temperatures without exception.
3. The Date
Of course, the time of year has other effects beyond merely being hotter or colder. For example, have you ever been on a vacation and thought to yourself: “I should donate some blood right now”? If you answer no, you are not alone. A detail that concerns particularly donated blood is how holidays and vacation times affect the blood supply.
It is a fact that during national holidays the blood donation stations are very rarely open – this means there are fewer possibilities of renewing the blood supply. The same problem arises around seasonal vacation periods like summer, when people are less likely to remember to donate blood. Because blood is not a substance that can be stored for very long, the supply can fall even dangerously low, starting with type O negative, which can be used to substitute other blood types.
Of course, this can be prepared for when it is a recurring occurrence, and collecting more blood prior to vacation period is one way to do this. There are certain problems with this, too, however, because longer storage can cause the blood’s chemical composition to change in ways that may make the blood less suitable for transfusion. Ensuring sufficient blood supply throughout the year is then a bit of a juggling act between storage times and attracting enough donors.
4. The Weather
Maybe the most apparent change related to the seasons is weather, which, depending on the geographical region, can vary between clear skies, rain, snow and all possibilities in between. This does of course affect the temperature, but in transportation it also affects road conditions. And there is a lot of difference when you have to drive long distance in nice weather or in a snowstorm on icy roads.
Which is to say that transportation times can vary by hours depending on how far the blood donation station or clinic is from the ultimate finish line. As mentioned previously, longer times for sample transportation affect laboratory test results, and the ability of thermal packaging to sustain correct temperatures may deteriorate as more time passes. Planning for differing transportation times is therefore also an important aspect when handling blood.
Choosing the correct transportation containers or logistics operators with sufficient equipment for temperature control is a priority when transporting and storing blood in changing seasonal situations. Validating the different equipment and transportation routes for all possible temperatures is the best way to ensure success. And the easiest way of doing this would be with remotely readable sensors which record transportation conditions permanently in a digital archive, where the validation data can be easily analyzed.
When the sensors are easy to reposition in different kinds of containers and vehicles, the same sensors can be used for different kinds of validation, saving money on multiple system procurement. Blood transportation also demands continuous real-time visibility to actual operations in order to ensure product viability. With Sensire’s TempNet® sensors both the validation activities and the actual monitoring of transportation can be done easily with the same devices.
Because the sensors are automatic and wireless as well as connected to an online cloud, the mapping activities provide actionable validation data for pre-operational planning as well as providing the possibility of corrective and preventative actions in the actual transport operations. Data visualization also saves time when transportation temperatures can be validated at a glance and only those with exceptions need to be inspected closer. With better sensors, choosing the best containers, logistic operators and facilities also becomes much easier. Continuous monitoring ensures compliance with GDP regulations and our digital archive, the TempNet® Cloud, stores the monitoring data for the time required by EU regulation and UK BSQR. And most important of all, patient safety can be guaranteed.