Authors (including presenting author) :
Ho SC(1), TF Leung(1), KW Chu(1), Wong YH(1)
Affiliation :
(1)Operating Room, Department of Anesthesiology, Pain management & Operating services, United Christian Hospital
Introduction :
It is a common practice for Operating Room (OR) to warm the blood products using blood warmers to avoid hypothermia of patient during blood transfusion. However, air bubbles would be accumulated in the blood warming tubing during blood transfusion. Literatures showed that a large quantity of infused air may cause obstruction of the outflow tract of the right ventricle followed by reduction of pulmonary blood flow and circulatory collapse.
Objectives :
To enhance patient safety for blood transfusion at Operating Room (OR).
Methodology :
1. Perform preventive maintenance for all blood warmers at OR.
2. Seek advice from Cluster Biomedical Engineer to attempt using tubing without bubble trap chambers under different blood warmer. It was proven that the defect came from the bubble tubing rather than blood warmers.
3. Source alternatives of bubble trap chamber of warming tubing from different suppliers.
4. Purchase new warming tubing with bubble trap chambers and install tube holder into all blood warmer at OR
5. Demonstrate the new warming coli sets to all OR’s staff.
6. Inform to all Anaesthesiologists of the new warming coli sets.
7. Transit to use new warming tubing with bubble trap chamber after training.
Timeframe:
March 2019 - Blood warmer preventive maintenance
Source new tubing
May 2019 - Purchase new tubing
Demonstration and training
June 2019 - Evaluation J
Result & Outcome :
No bubbles at distal end were formed when using new warming tubing with bubble trap chamber sets.
More importantly, no bubbles were infused into the patient along with the blood during blood transfusion.
All Anaesthesiologists agreed to use bubble trap chamber tubing in view of the promising outcome.
