Femoral Head Donation for SA Theatres

PLEASE FOLLOW THE BELOW STEPS OR DOWNLOAD :

Step 1 - IDENTIFYING A FEMORAL HEAD DONOR

  • Theatre departments are notified of Femoral Head Donors the business day before the patient’s surgery. A copy of the PlusLife Femoral Head Donor Notification and Checklist Interstate form pre-filled with the patient, hospital and surgeon details (Figure 1) is emailed 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 Interstate form.

Step 2 - EQUIPMENT SET UP

  • Collect a PlusLife supplied Femoral Head Donation Kit from the designated storage area. This kit contains the following inside a dust cover (Figure 2):
  1. 30ml jar for the dry bone specimen for culture
  2. Biopsy jar containing Formalin for histopathology, in a biohazard bag
  3. 250ml jar containing a plastic bag for the femoral head
  4. Pre-printed laboratory request form
  5. Kit batch label (attached to laboratory request form)
  6. Additional zip-lock bag for the FH jar
  7. Additional Biohazard bag for remaining specimens
  • Retrieve the following items from hospital stock and ensure they are within date. (Figure 3):
  1. 2 x Gold Top SST 5mL Tube
  2. 2 x EDTA Purple 9mL Tube
  3. 1 x Amies Charcoal Sterile Swab 
  • Check the expiration date on the femoral head donation 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 pre-filled 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 4 blood tubes. If possible, obtain blood prior to the administration of any IV fluids (e.g. at cannulation).
  • Record on the Femoral Head Donor Notification and Checklist Interstate form the batch number and expiry dates of the blood tubes.
  • Label the blood samples and record initial, date and time of collection.
  • Record on the Femoral Head Donor Notification and Checklist Interstate form the date and time that the blood was collected.
  • Indicate on the Femoral Head Donor Notification and Checklist Interstate 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

  • Record on the Femoral Head Donor Notification and Checklist Interstate form the batch number and expiry date of the Amies Charcoal Sterile Swab.
  • Once the femoral head is removed open sterile items (swab, micro and femoral head jars).
  • Aseptically swab all surfaces of the femoral head with the Amies Charcoal Sterile Swab.
  • Aseptically obtain two pieces of bone (+/- 1cm3) from the femoral head.
  1. Place the larger piece into the biopsy jar containing formalin, for histopathology.
  2. Place the other piece into the specimen jar for culture.
  • Label all 3 specimens with a patient label and record on each label your initials, date and time of collection.
  • Complete the pre-printed laboratory request form by:
  1. Applying a patient label
  2. Record the date and time the samples were collected

Step 6 - COLLECTION OF THE FEMORAL HEAD

  • Aseptically 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).
  • Record on the Femoral Head Donor Notification and Checklist Interstate form the date and time that the femoral head was retrieved.
  • Ensure the Femoral Head Donor Notification and Checklist form Interstate is complete i.e.:
  1. Patient addressograph attached
  2. Kit batch label attached
  3. Box ticked for each step
  4. Date and time of collecting blood sample
  5. IV fluid details
  6. Batch numbers and expiry dates for the blood tubes and swab
  7. Date and time of removal of femoral head
  8. 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 tubes, swab and dry bone chip are in a biohazard bag with the lab request form and Femoral Head Donor Notification and Checklist Interstate form are in the separate pocket.
  • Ensure that the femoral head jar containing the femoral head is inside a zip seal plastic bag.

Step 7 - COURIER

  • Place all donation items together in the designated 2-8 degrees Celsius refrigerator.
  • Call PlusLife on (08) 6144 3500 who will arrange courier of the Femoral Head Donation.

Step 8 - PACKING

  • Please follow the instructions as per Packing the Femoral Head Donation for Courier to Pluslife : 

For All Other Inquiries, Please Contact:

PLEASE DISPLAY THIS POSTER IN YOUR FEMORAL HEAD DONATION KIT STORAGE LOCATION: