18 - donor selection

gen considerations

* donor area pleasant and clean
* personnel friendly/well trained
* screening designed to protect donor and recipient
* donor confidentiality must be protected
* qualifications established by AABB, FDA, state

gen donor requirements

* photo ID, 17 yrs, 110 lbs
* hydrated, sensible meal 4 hrs prior
* general good health

donor screening

* encompasses medical Hx, physical exam, sero testing of donor blood
* designed to answer:
* will 450ml donation harm donor?
* could blood transmit disease at this time?
* any donor may be excluded by any of the 3

donor registration (donor card)

* info must be obtained to pos ID donor and link to previous donations
* should be able to contact in future if needed
* name, date, time, address, phone, gender, age/DOB
* consent to donate

consent to donate

* donors should be informed of procedure and potential risks
* given education on HIV, risky behavior, and not to donate in order to get tested for HIV
* must sign form

are you feeling healthy and well today?

* should be free of infectious diseases (colds) on day of donations
* if not feeling well, determine if reason is cause for deferral

are you currently taking an antibiotic?

the reason for taking the antibiotic needs to be evaluate to determine if person has bacterial infection that could be transmissible by blood

are you currently taking any other medication for an infection?

the reason for taking the med needs to be evaluated to determine if person has viral, fungal, parasitic or other infection transmissible by blood

have you taken medications on the medication deferral list in the indicated time frames?

if yes, they will be deferred for the appropriate period of time

have you read the educational materials today?

donors must read prior to donating

in the past 48 hrs have you taken aspirin or anything with aspirin?

* ==aspirin irreversibly inactivates plt function== so donor cannot be sole source of plts


* solely donating plts: deferred for 72 hrs
* whole blood: can still donate but bag will say ASA

in past 8 wks, have you donated blood, plts, plasma?

* whole blood donor can donate every ==8 wks==
* plasma, plts, leukocyte donors by apheresis can donate every ==2 days==
* no more than 24 plt donations/yr

in past 8 weeks, have you had any vaccines or other shots?

certain vaccines have live agents; should not donate for specified period of time

* deferral period for live, attenuated vaccines
* no deferral for killed, synthetic vaccines

in past 8 wks, have you had contact with someone vaccinated for smallpox

all donors who received smallpox vaccination are deferred for a minimum of 56 days regardless of when the scab fell off

in past 16 wks, have you donated a double unit of red cells using an apheresis machine?

donor should not donate more than once every 16 wks

in pas 12 months have you had a blood transfusion?

receiving an allogeneic blood transfusion of blood, plts, plasma or other component increases risk of transmitting infectious diseases so deferred for ==12 months==

in past 12 months, have you had a transplant (organ, tissue, BM) OR had graft such as skin or bone?

exposure to allogeneic tissues thru transplant = ==12 months deferral==

in past 12 months, have you come into contact with someone else’s blood?

* contact with open wound, non intact skin or mucous membrane with blood of person, a needle stick, or other sharps injury has inc risk of transmitting infectious disease
* ==12 month deferral==

in past 12 months, have you had an accidental needle stick?

* exposure to someone else’s blood thru a needle stick has inc risk of transmitting infectious disease
* ==12 month deferral==

in past 12 months: have you had sexual contact with anyone who has AIDS/HIV or had pos test for HIV/AIDS virus?

sexual contact w person with clinical/lab evidence of HIV infection has inc risk of transmission = ==12 month deferral==

in past 12 months, have you had sexual contact with a prostitute or anyone else who takes money/drugs for sex?

sexual contacts have ==12 month deferral==

in past 12 months, have you had sexual contact with anyone who has used needles to take drugs/steroids or anything not prescribed by their doctor?

needle drug users are at high risk of transmitting diseases so their sexual contacts are also at high risk = ==12 month deferral==

in past 12 months, have you had contact with another male or someone who had contact with another male?

a male having sexual contact with a male increases risk of transmitting HIV = ==12 month deferral==

in past 12 months, have you had sexual contact with someone with hepatitis?

sexual contact with someone hepatitis positive can have increased risk of transmitting = 12 month deferral

in past 12 months, have you lived with someone who has hepatitis?

living with someone hepatitis positive can increase risk of transmission = ==12 months deferral after last contact==

in past 12 months, have you had a tattoo?

tattoo = 12 month deferral ==unless applied by a state regulated entity== with sterile needles and non reused ink

in past 12 months, have you had an ear or body piercing?

ear or body piercing = 12 month deferral ==unless done with single use equipment==

in past 12 months, have you been treated for syphilis or gonorrhea?

syphilis/gonorrhoeae treatment, or confirmed reactive screening syphilis test = ==12 month deferral==

in past 12 months, have you been in juvenile detention, lockup, jail, prison for more than 3 days?

detained or incarcerated in a facility for 3+ days has an increased risk of transmitting diseases = ==12 month deferral==

in past 3 yrs have you been outside the US/canada?

* residents of a malaria endemic country = ==3 yr deferral== w/ no symptoms
* prior residents of endemic countries who live in non endemic countries for 3 years who do not travel to malaria endemic area = ==12 month deferral after subsequent travel==
* prior residents of endemic countries who have not lived in non endemic countries for 3 yrs who travel to an endemic area = ==3 yr deferral==

from 1980 -1996 did you spend 3 months in the UK?

indefinite deferral from risk of developing vCJD from eating beef in UK

from 1980-1996, were you in the military, civilian military employee or a dependent of a member?

* indefinitely deferred if they spent 6+ months on a base
* 1980-1990: belgium, netherlands, germany
* 1980-1996: spain, portugal, turkey, italy, greece

from 1980 to present, did you spend 5 yrs in europe?

5+ yrs in europe = ==indefinitely deferred== from risk of vCJD

from 1980 to present, did you receive a blood transfusion in UK or france?

anyone receiving blood products in the UK or france = ==indefinitely deferred== from vCJD risk

have you ever been pregnant?

pregnancy = deferred for safety of donor (risk of HLA Abs can cause TRALI)

have you ever had positive test for AIDS/HIV?

clinical or lab evidence of HIV/AIDS has an increased risk of transmitting = indefinite deferral

have you ever used needles to take anything not prescribed by your doctor?

needle users have increased risk of transmitting = indefinite deferral

have you ever received money, drugs, other payment for sex?

taking money, drugs as payment for sex has inc transmission risk = indefinite deferral

have you ever had malaria?

a person who has had malaria and received appropriate treatment = ==3 yr deferral== after becoming asymptomatic and living in non endemic country

have you ever had chaga’s?

chaga’s = ==indefinite deferral==

have you ever had babesiosis?

babesia = ==indefinite deferral==

have you ever received a dura mater graft or xenotransplantaion product?

* dura mater transplant/graft has inc risk of vCJD = ==perm deferral==
* xenotransplantation = ==indefinitely deferral==

have you ever had a type of cancer?

must be evaluated to determine eligibility

have you ever had any problems with your heart/lungs?

* must be free of resp diseases
* must evaluate any Hx of heart/lung diseases

have you ever had a bleeding or blood disease?

hemophilia or clotting disorder that requires treatment = deferred to prevent harm by the needle used for donation

have any of your relatives have CJD?

relative of someone w CJD = ==indefinite deferral==

collection areas w/o active transmission of zika - question

in past 4 wks have you been to any places on the list?

collection areas with active transmission of zika - questions

* in past 4 wks:
* have you had zika infection
* have you had 2+ of fever, joint pain, rash, conjunctivitis, headache
* have you had sexual contact w a man who has zika or symptoms within 3 months of your contact

arm inspection

look for rash, lesions, needle tracks at potential venipuncture site

hazardous/strenuous activity

if yes, donor advised to refrain for 8 hrs after donating

eaten within 4 hrs

lightheadedness may occur if not

weight

< 110lbs; must get approval for less than 100 and adjust anticoag used if less than 300mls drawn

temperature

< 99.5F

pulse

between 50-100

blood pressure

systolic top: 90-180

diastolic bottom: 50-100

==copper sulfate test (H/H)==

* acceptable: blood drop sin 15 sec
* hgb < 12.5 OR hct 38% will float (> will sink)
* if donor fails = rejected
* autologous criteria: minimum hgb 11
* SpG of copper sulfate should be 1.053

formula for reducing anticoag

63ml - ((donor wt/110) x 63) = amt of anticoag to be removed

(donor wt/110) X 63 = amt of anticoag needed

formula for amt of blood to be drawn

donor wt/100 x 450

mild donor rxn

* fainting, nausea, vomiting, hyperventilation, muscle spasms
* from sight or blood or unk

instructions for fainting

* remove needle, tourniquet
* cold compress on forehead
* raise feet above heat
* loosen clothing, secure airway
* monitor vitals

instructions for nausea

* breathe slowly
* cold compress
* turn donor head to side, provide receptable
* give water after vomiting

moderate donor rxn

* mild + loss of consciousness, dec heart rate, hyperventilation, systolic BP falls below 60
* check vitals, administer O2

severe donor rxns

* previous + convulsions, cerebral ischemia, marked hyperventilation, epilepsy
* call 991, prevent donor from sustaining injury, ensure adequate airway

hematoma

* blood collection under skin
* remove needle, tourniquet
* apply pressure while raising arm above heart
* apply ice for 5 min