Allograft Handling for Theatres
PLEASE FOLLOW THE BELOW STEPS OR DOWNLOAD :
Step 1 - IDENTIFYING A FEMORAL HEAD DONOR
- Theatre departments are notified of Femoral Head Donors either the business day before or the morning of the patient’s surgery. A copy of the PlusLife Femoral Head Donor Notification and Checklist form pre-filled with the patient, hospital and surgeon details (Figure 1) is emailed or faxed (as per specific hospital arrangements).
- Proceed with femoral head donation only when you are in possession of a PlusLife Femoral Head Donor Notification and Checklist form.
Step 2 - EQUIPMENT SET UP
- PlusLife provides hospitals with eskies and Femoral Head Donation Kits (Figure 2) which contain the following inside a dust cover:
- BD Vacutainer blood tube
- Amies Culture Swab
- 30ml jar for the dry bone specimen for culture
- Biopsy jar containing Formalin for histopathology, in a biohazard bag
- 250ml jar containing a plastic bag for the femoral head
- Pre-printed laboratory request form
- Kit batch label (attached to laboratory request form)
- Additional zip-lock bag for the FH jar
- Additional Biohazard bag for remaining specimens
- Collect a Femoral Head Donation Kit from the temperature-controlled storage area (Kits must be stored under 25 degrees to maintain the integrity of the components).
- Check:
- Temperature tag under the lid of the esky against the picture taped next to it. If all 3 dots are completely red use another kit and contact PlusLife. Partially red is acceptable (Figure 3).
- Expiry date on the kit.
- In the event that components of the kit are damaged, expired and/or missing, use another kit and notify PlusLife.
Step 3 - FEMORAL HEAD DONOR NOTIFICATION & CHECKLIST
- Check that the patient, hospital and surgeon details match the theatre case.
- Affix a patient label and check that details are correct.
- Affix the Kit Batch Label (located in the Femoral Head Donation Kit, stapled to the laboratory request form).
- Work through the checklist to collect the specimens and femoral head as below.
Step 4 - BLOOD SAMPLE COLLECTION
- Collect blood aseptically into the blood tube provided. If possible, obtain blood prior to the administration of any IV fluids (e.g. at cannulation).
- Label the blood sample.
- Record on the Femoral Head Donor Notification and Checklist form the date and time that the blood was collected.
- Indicate on the Femoral Head Donor Notification and Checklist form whether the donor has received any IV fluid in the 48 hours prior to the collection of the blood sample.
- If yes, record the volume of IV fluid administered and the patient’s weight. This allows PlusLife staff to determine the plasma dilution of the sample to ensure it is suitable for testing.
Step 5 - SPECIMEN COLLECTION
- Once the femoral head is removed open sterile items (swab, micro and femoral head jars).
- Using the swab provided, swab all surfaces of the femoral head.
- Obtain two pieces of bone (+/- 1cm3) from the femoral head.
- Place the larger piece into the biopsy jar containing formalin, for histopathology.
- Place the other piece into the specimen jar for culture.
- Label all 3 specimens with a patient label.
- Complete the pre-printed laboratory request form by:
- Applying a patient label
- Record the date and time the samples were collected
Step 6 - COLLECTION OF THE FEMORAL HEAD
- Place the femoral head into the sterile bag which is inside the 250ml screw topped jar and then place into the 250ml screw topped jar, ensuring both the zip-seal bag and the jar are sealed well.
- Attach a patient addressograph label to the jar.
- Note that if the jar is not labelled, the donation cannot not be accepted.
- Put the jar inside the spare non-sterile zip-lock plastic bag (to avoid the patient addressograph label being damaged) and then onto ice/ice-bricks ASAP.
- Record on the Femoral Head Donor Notification and Checklist form the date and time that the femoral head was retrieved.
- Prior to packing the donation ensure the Femoral Head Donor Notification and Checklist form is complete i.e.:
- Patient addressograph attached
- Kit batch label attached
- Box ticked for each step
- Date and time of collecting blood sample
- IV fluid details
- Date and time of removal of femoral head
- Name and signature of Circulation Nurse
- Check all items are labelled with a patient addressograph (Figure 4).
- Ensure that the formalin jar is in a separate biohazard bag.
- Ensure the blood tube, swab and dry bone chip are in a biohazard bag with the lab request form and Femoral Head Donor Notification and Checklist form are in the separate pocket.
- Ensure that the femoral head jar containing the femoral head is inside a zip seal plastic bag (Figure 5).
Step 7 - PACKING THE FEMORAL HEAD ESKY
- Place the femoral head in the bottom of the esky and cover with ice or between at least 2 ice bricks (Figure 6)
- Place the biohazard bags containing specimens on top of the ice paperwork side down to ensure that the blood tube is not in contact with the ice which will compromise the sample (Figure 7).
- Secure the esky firmly with tape all the way around.
- The esky is pre labelled with the destination, sender, and contents (Figure 8).
- Record the time the donation was packed in the esky on the label.
Step 8 - FEMORAL HEAD COURIER TO PLUSLIFE
- Contact PlusLife as soon as possible on (08) 6144 3500
- PlusLife will advise if the esky will be collected that day or the following morning.
- PlusLife will arrange the courier. Do not use any other means of transport.
Step 9 - HOSPITALS WITH ALTERNATIVE ARRANGEMENTS
Due to specific circumstances, there are some hospitals whose process will deviate from the above. This is detailed below:
ARMADALE HOSPITAL
- Due to storage availability Femoral Head Kits are supplied to theatre separate to the esky, eskies are stored at PathWest.
- The temperature tag (step 2) is located on the dust cover of the femoral head kit.
- On completion of the femoral head retrieval immediately transport the donation, specimens and paperwork to PathWest for packing and courier to PlusLife. Record the time the donation was packed in the esky on the label.
BUNBURY HOSPITALS
- Following packaging of the femoral head donation into the esky (step 7) deliver the esky to PathWest Reception, located in Bunbury Regional Hospital.
- Contact PlusLife as soon as possible on (08) 6144 3500 to advise that the donation has been collected and transferred to PathWest.
