Blood banks need to understand patterns of use and ordering practices to provide the blood donor centers with the best information with which to develop daily scheduled deliveries of blood products. Blood use is a large component of this process through maximizing physician education about appropriate ordering practices and use of appropriate tools. Simple measures can help provide guidance on the number of available components and the need to order more from the blood donor center. Special product requests in pediatrics, such as fresh blood, leukoreduction, irradiation, and antigen-negative units can also drive inventory practices and use patterns.
• Inventory management in pediatric blood banking involves the balance between keeping an adequate supply of blood in the hospital for clinical care needs and reducing the wastage of expired products not transfused.
• Pediatric patients require special manufacturing of aliquots because of the smaller size of transfusions needed. These patients also require special considerations for freshness, leukocyte reduction, irradiation, and product selection compared with adult patients.
• Simple methods can be adopted to ensure that daily inventory is kept at the appropriate levels, and these steps involve close coordination with the blood bank and clinical teams as well as daily reconciliation of the inventory at hand with new orders and requests.
Inventory management for pediatric blood banking involves multiple manufacturing steps that ensure that the right product and the right volume is delivered to the patient at the right time. It is a complex process that involves comparison of blood issued with blood in inventory, making certain that units issued and units in storage are accounted for in the blood bank. Usually a manager or supervisor is responsible for this task and reviews daily reports and compares these reports with daily blood counts of stored inventory. As a result of these reconciliations, the blood bank staff know what amount of blood to order from their blood supplier to maintain average daily inventories. In most blood banks, pediatric and adult alike, there are minimum inventories established for each major ABO blood group (A+, A−, B+, B−, AB+, AB−, O+, O−) and for each available component type: red blood cells (RBCs), fresh frozen plasma (FFP), cryoprecipitate (CRYO), and platelets. The amount of available blood drives ordering practices and, because most blood banks try to avoid stat delivery requests and charges, these orders are regularly scheduled and transported throughout the day. An example of a minimum RBC inventory and process steps for daily inventory management for a 500-bed tertiary pediatric hospital with a level 1 trauma center, with approximately 20,000 RBC annual transfusions, is given in Table 1 .