What is an easy-to-use blood transport bag for different temperature control levels?

輸血用バッグの持運び・輸送に重要な温度管理が出来る血液輸送バッグ。バッグを選ぶうえで肝心なことは「適正な温度で運べるかどうか」です。

しかし、患者の増加で多忙な看護師や医師の皆様にとっては「もっと使い勝手のいい血液輸送バッグが欲しい」ということが本音だと思います。

そしてあなたが気になるところは、温度管理を維持しながら「どこまで使い勝手を高められるか」でしょう。

インターネットを閲覧すれば保冷性能やサイズ、価格が書かれている血液輸送バッグのページはありますが、「温度管理のレベルに応じた使い易い血液輸送バッグ」を紹介・提案するページはなかなかありません。

この記事では「温度管理と使い勝手の両立」に悩む方向けに温度別に使い勝手の良い血液輸送バッグに関する情報を提供します。

1. What is a difficult-to-use blood transport bag?

When using blood for transfusion in hospital wards or operating rooms, the blood bags must be used as soon as possible after they are taken out of the hospital, and it is a race against time to go to the transfusion department to pick up the blood bags. In addition, doctors and nurses have to be very careful to inspect the appearance of the blood in the bag before transfusion and to check for damage to the blood bag. Under such circumstances, it can be very stressful if the blood bag is difficult to use, carry, and load and unload blood for transfusion. In this section, we will introduce you to some of the “hard-to-use blood transfer bags” that you are likely to regret after purchasing a blood transfer bag.

1-1. Blood transport bag is too heavy or too large

血液輸送バッグを買うなら「たくさん入る方がいい」、「保冷・保温効果」がより高いものがいい。と思われるかもしれません。しかし、それらの性能は「使い易さ」とはトレードオフの関係になることが多々あります。なぜなら内容量＝血液輸送バッグのサイズであり、保冷・保温効果＝断熱効果(断熱材の重量）という関係が成り立つためです。

必要以上に血液輸送バッグが大きいと、一人で持ち運べなくなったり、通路を行き交う人や壁・機材などにぶつからないよう気を配る必要が出てきますし、血液輸送バッグが重すぎると持ち運ぶことに意識が集中し、視野が狭くなったり、体への負担も大きくなります。

血液センターから車輌で各病院に輸送する際には、大きさを重視してもよいかもしれませんが、病院内の持運びに関しては適切なサイズ・重量の血液輸送バッグを選ぶことが非常に重要な要素になります。

1-2. Both hands are occupied when holding the blood transport bag.

「1-1.大きすぎる血液輸送バッグ」のパターンでよくある仕様が、バッグの両側面のみに短い取っ手がついているタイプです。これは両手持ちのタイプになり、持運びの際には両手がふさがるため何かと不便な仕様でもあります。

1度に複数のことをこなす医師・看護師の方々は血液バッグをとりにいくついでに他の器具をとりに行くこともあるかと思います。そういったタイミングで両手がふさがっていることは非常に不便。病棟内を往復する回数が増え、余計な手間と体力を消耗してしまいます。

1-3. Blood transport bags that take up space for storage

血液輸送バッグと言っても要は「箱モノ」です。使用しないときには場所を取るものになってしまいます。保管に必要なスペースが広くなればなるほど、場所の確保が難しくなってきます。

輸血用血液を一括管理する部門に広々とした保管スペースがあれば気にする必要は無いかもしれませんが、収納効率が悪い血液輸送バッグを前提として考えると、保管場所の関係で必要なバッグ数をそろえることが出来なかったり、作業の流れに添わない保管場所にせざるを得なくなったりと運用の際の不便が生じてくるでしょう。

1-4. Difficult to remove the blood bag inside

To control the temperature when transporting blood bags for transfusion, cool and heat storage materials are required in combination with the blood transport bag. Since both of these materials need to be pre-chilled (or warmed) in the blood bag, the following operations are naturally required during transportation.

1. Place blood bag inside blood transport bag
2. Cold (heat) storage material in the blood transport bag
3. Carry blood transport bags to the site
4. Remove blood bag for transfusion from blood transport bag

If the cold (heat) storage material is only placed on top of the blood bag in step 2, the time required to remove the cold (heat) storage material from the blood bag will be added to step 4. This is also a small step if the work is done in a timely manner, but if speed is required, it is best to be able to remove the blood bag for transfusion as soon as the lid of the blood transport bag is opened.

1-5. Contents are not known until the blood transport bag is emptied.

輸血用血液といっても、赤血球や全血、新鮮凍結血漿と複数種類があります。
それにも関わらず、見た目やサイズが同じような血液輸送バッグに入っていると見分けがつきません。都度血液輸送バッグのフタを開けて確認するのは面倒ですし、かといって、現場まで持って行った後で、中身が違っていたとなっては更に手間が掛ります。

仮に、透明な血液輸送バッグがあったとしても、患者からの目もありますので、「しっかりした血液輸送バッグで運んでくれてるので安心だ」と思われるような外観のバッグということも表面的には大事です。こちらの対策については、「2-5.中身に応じた血液輸送バッグの色分け・目印」で説明致します。

1-6. Blood transport bag box is hard and hurts when it hits the body

外気温と維持したい内気温の温度差が30℃を超える場合に使われる血液輸送バッグには、その断熱材にポリスチレン樹脂を発砲させたフォームがよく使われます。

建材用の断熱材にも使われるこの断熱材は非常に断熱性能が高いことが特徴ですが、形状がボード状で非常に硬い材料になります。バッグというよりボックス、つまり「箱」に近いイメージです。

求める温度帯や維持する時間によっては上記の仕様にする必要がある場合もありますが、病棟内で短時間、血液輸送バッグ内を２〜６℃程度に維持する程度であれば、オーバースペックなものとして、その優れた断熱性ではなく、硬くて持ち運ぶときに腰や脚に当たって痛いなど、物理的なマイナス面に意識が行ってしまうかもしれません。

2. How to make an easy-to-use blood transport bag

So far we have looked at blood transport bags that are difficult to use. We would like to emphasize that there is nothing wrong with the quality of the underlying blood-transport bag. The materials and specifications of the “blood bag” vary widely, and each has its own advantages and disadvantages. However, selecting a blood bag is not difficult. Blood Transfusion Bags

• Characteristics by Type
• Additional Options

Once you have a clear understanding of these two types of bags, you will naturally be able to determine the best blood transfer bag for your site operation. We will now explain the characteristics of each type and the options available for each type.

3. Check before considering blood transport bags.

The axis of the blood transport bag typing is the temperature inside the blood transport bag that you want to keep. This is the most important part of bag selection, and it is very important to understand the following four points

1. outside temperature
2. Temperature to be maintained in the blood transport bag
3. Time to maintain temperature
4. Space required in blood transport bag (~ liters, etc.)

Now that you have a clear idea of the above, the next step is to consider what the main structural part of the blood transfer bag will be. The main structural components are the lid and walls of the blood bag. The base for maintaining the internal temperature of the blood bag is the insulation material used for the lid and walls, and the refrigerant (cold storage material, heat storage material, dry ice, etc.) that is placed inside the bag. The image is similar to that of a house. If the roof and walls of a house are made of flimsy boards, the hot air from outside will be immediately transmitted into the house, making it hotter. However, simply improving the performance of insulation materials will not necessarily result in a cooler house. All objects, including air, have a force that tries to reach a uniform temperature. A house with superior insulation can certainly prolong the time it takes for the indoor temperature to equalize with the outdoor temperature, but eventually it will reach the same temperature. Therefore, we turn on the air conditioner to lower the indoor temperature. Naturally, cool air with a lower temperature setting will be cooler than a lukewarm blast of air. Use superior insulation in the roof walls to reduce the force of uniform temperatures and increase the efficiency of the air conditioner indoors. In this way we ensure a cooler home from the summer heat. In a house, the exterior walls, roof, and floors are the “lid, side surfaces, and bottom” or main structural parts in a blood transport bag. And the air conditioner part is the “cold storage material,” “heat storage material,” “dry ice,” or other cold agents.

4. Comparison of blood transport bags by main structure (insulation)

前置きが長くなりましたが、ここから主要構造(断熱材)別に血液輸送バッグを比較したいと思います。
断熱材の性能は「熱伝導率」という熱の伝わりやすさで表します。そして断熱材はその中に空気の層を作ること熱を伝わりにくくする仕組みです。 この空気の層である気泡がより小さくたくさんあれば、断熱性が高くなり、また空気よりも断熱性の高いガスなどを閉じ込めた気泡であればより断熱性は高くなります。 そして、血液輸送バッグに使われる断熱材は主に以下の4種類に分類されます。

1. Foamed polyethylene foam insulation
2. Soft thermal insulation made of urethane material
3. Thermal insulation of expanded polystyrene resin foam
4. Combination of expanded polystyrene resin foam and vacuum insulation material

A list of the characteristics of each is shown in this image. Insulation with higher insulation performance tends to be harder and heavier.

*In order of best insulation performance (AAA, AA, A, B) As a guide by internal temperature,

15°C to 0°C (20°C to 35°C difference in ambient air temperature)

• Foamed polyethylene foam
• Urethane soft insulation

Below 0°C (difference in ambient air temperature of 35°C or more)

• Urethane soft insulation
• Expanded polystyrene resin foam
• Expanded polystyrene + vacuum insulation

The distinction between the two is as follows. It is important to note that it is not only the performance of the insulation material that determines the internal air temperature. The internal air temperature is affected by several factors, including the “outside temperature,” which is the temperature of the location where the bag is transported, the amount of “refrigerants” such as cold and heat storage materials, and the “size” of the blood transport bag. In particular, the “size” of the blood bag is an important factor. If the bag has a smaller internal volume, it is easier to obtain a cooling effect than if it has a larger internal volume, and may be more effective than the above temperature range guideline.

5. additional options for the blood transport bag

インターネットで表示される血液輸送バッグ見ながら、「惜しいっ」と思われることは多々あるかと思います。低価格の量産品などは規格が決まっていて、「ここをもう少し変えられたらな」という要望を諦めてしまうこともあるかもしれません。

ですが、規格化された血液輸送バッグとは違い、実際に運用される看護師や医師の方々の事情は千差万別です。なので、求めるものも異なるのが一般的です。

既に出来上がってしまったものを改造することは、バッグをバラす必要があるため難しいですが、３０個を超えるなど一定のボリュームでなら、要望に応じたカスタマイズが可能です。

以下の内容をもとに、理想的な血液輸送バッグをイメージしてみてください。

5-1. Free your hands with a shoulder bag type

「1-2.血液輸送バッグを持つと両手がふさがる」という問題を解決する方法として、ショルダーベルトを付ける方法があります。肩からぶら下げれば、両手も使えるようになり、ついで作業もこなせるようになります。

注意してもらいたいのは、血液輸送バッグ自体のサイズです。あまり大きすぎたり、重すぎたりすると、通路ですれ違う人や機材にぶつかってしまうかもしれませんし、肩で背負える重さでなければ結局両手もちになってしまうかもしれませんので、あくまで少量の持運び用として考えてください。

小型のものなら、長めの取っ手を二つつけて、ハンドバッグタイプにして、片手で持つ方法も便利です。

5-2. Collapsible blood transport bag

「1-3.保管に場所をとる血液輸送バッグ」の解決策としては「折りたたみ式のバッグ」があります。

血液輸送バッグを無理やり折りたたもうとしても、断熱材そのものが反発して上手く折りたたむことは難しいですが、製造過程の縫製作業で折り目を作ることで、折り畳みが出来るタイプにすることが出来ます。

より収納スペースを減らすためには、折り畳んだ後に固定しておくマジックテープなどを付けておくのが便利です。これにより持上げた際に勝手にバッグが開いてしまうことも防ぐことが出来、手軽な持運びが可能になります。

5-3. Attach a cold-storage pocket

「1-4.中の血液バッグが取り出しにくい」場合には蓄冷(熱)ポケットを付けることがお勧めです。蓄冷(熱)を固定するためのポケットを予めつけておけば、輸血用バックを血液輸送バッグに入れる際の段取りも統一化され、人によるばらつきも無くなりますし、輸血用バッグを取り出す際に邪魔にならない位置に蓄冷(熱)をセットすることが出来ます。

蓄冷(熱)ポケットの位置は蓋の裏側が一般的です。冷気は上から下に流れるので、側面内側などにつけるより、冷気がバッグ内全体に流れるようになります。

それに、上蓋の内側に蓄冷(熱)材を固定していれば、蓋を開けた際に中の輸血用バッグをすぐに取り出すことが出来、とても便利です。

5-4. Color coding and markings according to contents

For the “1-5. You can’t tell what’s inside until you empty the blood transport bag” issue,

①中に入れる種類別に血液輸送バッグの色味を変える
②血液輸送バッグの外側にシールを貼る
③血液輸送バッグに透明ポケットを付ける

There are several ways to do this. 5-4-1.①Change the color of the blood transport bag according to the type of blood to be placed inside.

This is effective when the type and volume of blood transport bags to be placed inside are fixed to some extent. For blood bags that are carried outdoors, it is common to cover the exterior with aluminum to prevent heat absorption from direct sunlight, but if the bags are carried in a hospital ward, it is easy to tell the difference at a glance by clearly color-coding the bag exterior “blue” or “yellow.

当社でもこのような血液輸送バッグはラインナップがあります。採用できる断熱材の種類には制限がありますが、「パッと見てすぐにわかる」点ではとても優れています。

5-4-2.②血液輸送バッグの外側にシールを貼る

As with (1), this is also effective when the type and volume of blood transport bags to be placed inside are fixed. As long as the exterior material can be sealed, it can be used for any type of bag and can be laid out freely. The seal can be labeled with the type of blood to be transfused, such as “red blood cells,” “whole blood,” or “fresh-frozen plasma,” and can also include optional information such as the temperature range to be maintained and the name of the hospital.

5-4-3. 3) Transparent pockets on blood transport bags

This is an effective method of marking the contents of the blood bag when the type of contents changes from case to case. A transparent pocket is attached to the top of the blood bag, into which a card or other document can be inserted to identify the contents of the bag without opening the lid. The advantage of the transparent pocket is that it can be flexibly adapted to changes in the contents by changing the text of the inserted card.

5-5. Focus on exterior and interior details

As a countermeasure for “1-6. The blood transport bag box is hard and hurts when it hits the body,

• Foamed polyethylene foam
• Urethane soft insulation

This can be reduced by using a blood transport bag with insulation of While the exterior is important, even more important is how the contents, or blood bag, is kept “safe. In addition to temperature control, it is also important to protect the transfusion blood bag from external shocks. For example, if a blood bag is made of expanded polystyrene foam (a rigid insulating material), another layer of cushioned insulation can be placed inside the bag to increase its impact resistance. The inside of the bag can also be covered with an antibacterial fabric to maintain hygiene.

6. Recommended specifications of blood transport bags by temperature

If you want to keep it around 6-1.5°C

*Size is external dimensions

>Click here for product details of blood transport bag for keeping the temperature around 5℃.

This is a convenient type of bag for carrying around in a hospital, made of cushioned urethane soft insulation material.

This is a standard product with two pockets for cold storage (heat material) inside the lid and antibacterial fabric inside. The urethane is 25 mm thick, and this blood transport bag is designed to ensure safety in terms of impact resistance and hygiene. This small bag can be carried as a handbag or as a shoulder bag with a belt attached.

The bag can be carried as a handbag or as a shoulder bag with a belt attached.

There are several types of cold storage materials, including those that maintain a negative temperature range, room temperature, and high temperature (+20°C or higher). It is recommended to use different types depending on the temperature to be maintained.

If you want to keep the temperature below 6-2.0°C

If temperatures below 0°C are to be maintained, we recommend blood transport boxes with “expanded polystyrene resin foam” insulation for the main structural parts.

If the highest priority is placed on high insulation performance, polystyrene foam + vacuum insulation material is the best, but while vacuum insulation material has high insulation performance, it is a heavy material. If the transportation does not extend over a long period of time in the hospital, expanded polystyrene resin foam is the material that is best suited for both ease of use and temperature control.

As with the blood transport bag described in “To keep the temperature around 6-1.5°C,” a size around

(external dimensions) 400 mm wide x 300 mm deep x 350 mm high

is a good size for a one-handed or shoulder bag type, and is also highly efficient at keeping the cold.

There are several temperature grades of cold storage materials, such as 0°C, -5°C, -11°C, etc. We recommend that you select one that is appropriate for the internal temperature you wish to keep.
>Click here for details of bag specifications (Jet Shipper) for keeping temperatures below 0°C.

7. Summary

The primary purpose of this article is to help you make a regret-free selection of a blood transfer bag. To that end, first,

1. Characteristics by Type
2. Additional Options

We have presented a wide range of specifications and options for blood transport bags from the perspective of The wider the range of options, the less likely we are to unintentionally distort our own needs and the more likely we are to make the right choice. I will describe it again, but first we need to clarify,

1. outside temperature
2. Temperature to be maintained in the blood transport bag
3. Time to maintain temperature
4. Space required in blood transport bag (~ liters, etc.)

The four points are as follows. If these axes are clarified at the beginning, communication with the requesting manufacturer will proceed smoothly, and you can go back to them when you have any doubts about the selection. We would be happy if you would keep these four axes in mind and find the “easy-to-use blood bag that meets your level of temperature control” that you are looking for from a wide range of options.