8 - BLOOD DONATION

Whole Blood Collection

Collection of whole blood itself

Bleeding

Art of Blood Collection

450mL-500mL

is the typical volume of whole blood collected from a single donor.

Apheresis

Collecting a selected blood component

Blood Bank

Stores blood, capable of screening donors, processing blood components, compatibility testing, and preparing blood components

Hospital-based, performs compatibility testing and prepares blood components

Blood Center

This is the Blood Collection Unit, wherein very limited procedures are done

Screens donors, draws donors, performs testing on donor blood (ABO typing and Rh typing), and delivers appropriate components to hospital blood bank

RA 1517

An Act Regulating the Collection, Processing, and Sale of Human Blood, and the Establishment and Operation of Blood Banks and Blood Processing Laboratories

63 mL

Anticoagulant for 450 +/- 10%

70 mL

Anticoagulant for 500 +/- 10%

525 mL of blood

Max amount of blood that can be donated

24 hours

Replenish the blood loss within?

2-3 months

Frequency of Blood Donation of Whole Blood

Autologous Donor

Allogeneic Donor

Therapeutic Bleeding

Types of Donors

Autologous Donor

Self

You donate blood, and that blood will be transfused to yourself

Safest but most expensive procedure

Allogeneic Donor

Other

When a donor and a recipient are not the same person

Therapeutic Bleeding

Patients with Polycythemia Vera (PCV)

Treatment for PCV because these patients have too many red blood cells in the body, and in order to reduce that the doctor advised the patients to donate blood

The removed blood is not used for blood transfusion, it is disposed of immediately

Autologous Donor

Donates for own use

Safer than allogeneic blood

No risk of disease association

Disadvantage: Higher cost

Unused autologous blood is discarded

Green

Distinct Color of Tag for Autologous Donor

Pre-operative

Acute Normovolemic Hemodilution

Intraoperative Collection

Postoperative Salvage

Types of Autologous Blood Collection

Pre-operative

Autologous Blood Collection

5-6 weeks preceding a scheduled surgery

No later than 72 hours before the scheduled surgery

Acute Normovolemic Hemodilution

Autologous Blood Collection

Collection of whole blood with a concurrent infusion of crystalloid or colloid solutions to maintain a normal blood volume

Purpose: Crystalloid and colloid solutions (volume expanders) are used to maintain the blood volume of the patient because at the start of the operation, blood will be collected and will be replaced with crystalloid and colloid solutions the blood that is collected. That blood will be transfused to you if and only if you need it

Responsible for the decrease of hematocrit level of the patient, because you have a colloid solution

Disadvantage of Acute Normovolemic Hemodilution

Colloids = 1:1; Crystalloid = 3:1

Ratio of Colloids and Crystalloids

Crystalloids

aqueous solutions; made of mineral salts and other water-soluble molecules

Colloids

contains large insoluble molecules such as gelatin; blood itself is a ?

8

Acute Normovolemic Hemodilution

The blood is reinfused in the patient during or immediately following surgery but within ? hours of collection

Intraoperative Collection

Autologous Blood Collection

Collecting shed blood from the surgical site, processing the blood, and reinfusing the blood

Usually blood is washed with saline to remove the debris and free the hemoglobin and plasma that may contain activated coagulation factors

Postoperative Salvage

Autologous Blood Collection

Collected from a drainage tube placed at the surgical site, reinfusing the blood

Reinfuse blood with or without processing

Blood collected is usually partially hemolyzed, diluted, and defibrinated

1400

It is recommended that no more than ? mL of postoperative salvage must be reinfused

Voluntary Non Remunerated Donors

Directed Donors

Paid Donors

Types of Allogeneic Donors

Voluntary Non Remunerated Donors

Nothing is given to the donor in exchange for blood donation

Voluntary

Directed Donors

The blood collected is directed to a specific patient

Usually blood relative

In the cases that the blood will be coming from the relative, you have to irradiate the blood. Irradiation prevents Graft vs Host disease

Yellow salmon

Distinct Color of Tag for Allogeneic Donors

RA 7719

National Blood Services Act of 1994

To promote voluntary blood donation

To provide a sufficient supply of safe blood and to regulate blood banks

Donor Registration

Medical History

Physical Exam

Informed Consent

Inclusions in Donor Screening (4)

Donor Registration

Documenting information that fully identifies the donor on an individual donation

Name

Date and Time of Donation

Address

Telephone

Gender

Age/Date of Birth

Donor Registration Information (6)

RA 10173 (Philippine Data Privacy Act of 2012)

“All personal information must be kept confidential”

Donor Interview

You will ask possible questions regarding the patient’s history and other important matters for blood donation

Donor History Questionnaire (DHQ)

Health history assessment document

Designed to be self-administered by the donor

Determine if the donor will be accepted or deferred for donation

Temporary Deferral

Permanent Deferral

Indefinite Deferral

Types of Deferrals (3)

Temporary Deferral

Donor is unable to donate blood for a limited period of time

Permanent Deferral

Donor will never be eligible to donate blood for someone else

Indefinite Deferral

Donor is unable to donate blood for someone else for an unspecified period of time due to current regulatory requirements

antibiotics

Donors currently taking ? for an infection or for prophylaxis after dental surgery may be deferred temporarily until the donor has completed the prescribed medication regimen and the infection has cleared up

acceptable

Donors who have taken tetracycline or other antibiotics used to treat acne are acceptable/not acceptable for donation

Proscar, Avodart, Propecia, Accutane, Soriatane, or Tegison

Causes birth defect (6)

Proscar

1 month

Used to treat prostate gland enlargement (1)

Deferral?

Avodart

6 months

Used to treat prostate gland enlargement

Deferral?

Propecia

1 month

Used to treat baldness

Deferral?

Accutane

1 month

Used to treat acne

Deferral?

Soriatane

3 years

Used for severe psoriasis (1)

Deferral?

Tegison

Permanently deferred

Used for severe psoriasis (2)

Deferral?

Growth hormone from human pituitary glands

Effect: Developed a rare nervous system condition called Creutzfeldt-Jakob Disease

Insulin from cows (bovine, or beef, insulin)

Effect: “Mad Cow Disease” is transmitted by transfusion

Hepatitis B Immune Globulin (HBIG)

Effect: Does not prevent Hepatitis B infection in every case

Feldene

Effect: Will not be able to donate platelets for 2 days

Plavix and Ticlid

Effect: Will not be able to donate platelets for 14 days

Experimental Medication or Unlicensed (Experimental) Vaccine

Effect on blood donation is unknown

Aspirin

Blood thinner

Not suitable for platelet apheresis

6 weeks following termination of pregnancy

First-trimester or second-trimester abortion or miscarriage is not cause for deferral

Deferral only applies if?

8, 56

The time interval between allogeneic whole blood donations is ? weeks or ? days

48 hours

Apheresis donation (hours)

24

FDA limits platelet apheresis procedures to no more than ? times in a calendar year

7, once

Apheresis donors may only donate twice in a period of ? days and only ? in 7 days for double or triple apheresis donation

4

Infrequent plasma apheresis requires a ?-week deferral

14-21 days (2-3 weeks)

Deferral for smallpox vaccination

2 weeks

Deferral for live attenuated or bacterial vaccine for measles (rubeola), mumps, oral polio, typhoid, or yellow fever

No deferral

Deferral for toxoids or killed or synthetic viral, bacterial, or rickettsial vaccines such as diphtheria, hepatitis A, hepatitis B, influenza, Lyme disease, pneumococcal polysaccharide, polio injection (Salk), anthrax, cholera, pertussis, plague, parathyroid, rabies, Rocky mountain spotted fever, tetanus, or typhoid injection

Close Contact

"Exposure to the vaccination site or bandages, clothing, towels, or bedding that have been in contact with the vaccination site"

HIV (+)

HBsAg (+)

Anti-HBc (+)

HCV (+)

Some sexual activity

Injected Bovine Insulin

Hormone Administration

Dura Mater Graft

Drugs Tegison

Hemophiliacs

History of Babesiosis and Chagas Disease

Permanently Deferred (11)

Hepatitis C

Most common post transfusion hepatitis

Surgery

Received blood components/tissue

Tattoo, body piercing

Needle prick

Had close contact with hepatitis B (+) or HIV (+)

In prison

Treated with gonorrhea or syphilis

Person returned from malarial endemic area

HB immune globulin, rabies

Rape victims

Leishmaniasis

12 Months Deferral (11)

3 years

Deferrals

Immigrant from malaria endemic area

Drug: Soriatane (Acitretin)

Diagnosis of malaria

4 weeks

Deferrals

Drugs: Accutane, proscar

Vaccine: German measles, Chicken pox

2 weeks

Deferrals

Vaccines: Measles, mumps, oral polio, yellow fever

48 hours

Deferrals

Aspirin and aspirin-containing drugs

4-week interval

Other Deferrals

Infrequent plasmapheresis

16 weeks

Other Deferrals

Double red cell apheresis

12 hours

Other Deferrals

Alcohol intake

indefinite deferral

Other Deferrals

Skin lesions (patient might have multiple puncture marks, might be drug addict)

poison ivy, rashes

Skin disorders that are not cause for deferral include ? and other ?

Age

Weight

Temperature

Pulse rate

Blood pressure

Hemoglobin

Hematocrit

Physical Examination (7)

No age requirement

At least 16 years old

Age

Autologous

Allogeneic

No weight requirement

110 lbs/50 kg

Weight

Autologous

Allogeneic

10.5 mL

AABB permits collection of ? of blood per kg

450 mL

50kg/110lbs can donate ? of blood

proportionately reduced

If the donor is less than 110 lbs, the amount of blood collected must be _ _ as well as that of the anticoagulant

Volume To Collect = (donor’s weight in kg/50) x 450 mL

Volume To Collect / 450 x 63 mL = reduced volume of anticoagulant

If underweight (2 formulas)

37.5 C/99.5 F

Temperature

50-100 beats per minute

Pulse rate

90-180 mmHg

50-100 mmHg

Blood pressure

Systolic

Diastolic

11.0 g/dL

13.0 g/dL

12.5 g/dL

Hemoglobin

Autologous

Allogeneic:

• Male

• Female

Copper sulfate

used for hemoglobin determination

33%

39%

38%

Hematocrit

Autologous

Allogeneic:

• Male

• Female

Hazardous Occupations

Shall normally entail an interval of not less than 12 hours between donation and returning to the occupation or hobby

Informed Consent

Received the necessary information

Arrived at the decision without having been subjected to coercion, undue influence, or intimidation

Informed Consent

Received the necessary information

Arrived at the decision without having been subjected to coercion, undue influence, or intimidation

Donor Identification

A numeric or alphanumeric system is used to link the donor to the donor record, pilot tubes, blood container, and all components made from the original collection

The phlebotomist should ask the donor to state or spell his or her name

16-17

Needle gauge used