1 Contingency Blood Collections MSgt Rick Berg TSgt Magdalena Trujillo Lackland Air Force Base Blood...

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Contingency Blood Contingency Blood CollectionsCollections

Contingency Blood Contingency Blood CollectionsCollections

MSgt Rick Berg

TSgt Magdalena Trujillo

Lackland Air Force Base Blood Donor Center

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Contingency Blood Collections

• Getting started

• Collection of Acceptable Unit of blood

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Getting started

• What do I need to do, how do I begin!

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Getting Started

• What else will I need to begin a blood drive?

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Conducting the drive!

• Donor Prep

• Prescreen, DD 572

• Vitals

• Interview

• Whole Blood collection

• Processing

• Infectious Disease Testing

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Donor Prep

• Use your list!

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Pre-screen, DD 572

• Quick Pre-screen

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Vitals

• WEIGHT: – > 110 lbs, (50Kg)

• APPEARANCE:– Generally healthy

• ARM INSPECTION– No skin lesions at

site of venipuncture (Leishmaniasis)

– Small Pox

• TEMP: < 37.5 C (< 99.50 F)

• PULSE: 50-100 BPM 40-49 If athletic

• BP:

< 180 mm Hg systolic < 100 mm Hg diastolic

**Know Manual B/P**

• HGB: >12.5 g/dL .

• HCT: >38%

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Interview

• Private Interview– Ensure all questions are properly answered/documented to ensure donor is eligible

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Whole Blood Collection – Arm Prep

• ARM PREP• Place tourniquet or

BP cuff on arm & inflate to 40-60 mmHg

• Select a vein• Donor is allergic to

iodine – Choraprep• Scrub site vigorously

30 seconds

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Whole Blood Collection – Arm Prep

• Second iodine prep– Begin in center of

phlebotomy site– Move outward in a

circular manner– Never overlap

• Allow to stand for at least 30 seconds prior to phlebotomy

• Do not retouch area, if so, MUST repeat arm prep

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Whole Blood Collection - Venipuncture

• Hemostat the tubing near the needle or use clamp on auto scale

• Perform venipuncture• Once the needle is in

the arm remove the hemostat or clamp

• Blood should flow freely

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Whole Blood Collection

Inadequate blood flow:• Gently reposition needle • If unable to establish adequate

blood flow, discontinue

Adequate blood flow:• Once blood flow is established,

secure:– Tape needle down at the hub – Tape tubing to arm

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Whole Blood Collection

• Collect pilot tubes• Strip the tubing at

donor bed• Take unit to Lab

– Confirm Blood type– Major & Minor

Crossmatch – HEP/HIV/RPR

screening tests

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Unit Collection

• Monitor blood volume:

450 + 45 ml• Max collection-20 min• Correct amount reached,

place hemostat on line after the Y-connection

• Use metal clamp to seal line (to stop flow into bag)

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Unit Collection

• Collect pilot tubes• Strip the tubing at

donor bed• Take unit to Laboratory

– Confirm Blood type– Major & Minor

Crossmatch – HEP/HIV screening

tests– Complete

paperwork to issue unit to OR/ER

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Post Donation Care

• Record:– There is always time

for documentation• Monitor the donor for

any delayed reactions

• Recovery

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Unit Processing

Blood can be kept at room temperature for up to 8 hours from time of collection

- NOTE: Do NOT use ice if whole blood is to be used in emergency situation during contingency operations. Ice will destroy platelets.

- If unit is not used within 8 hours- Keep unit in fridge for 24 hrs until it expires

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Unit Testing

Test each unit for:- ABO / Rh

• Pilot tube or Unit Segment

Infectious Disease Testing- Normally, screening

tests MUST be done prior to issuing the blood

- Refrigerate serum or plasma & ship to FDA licensed testing facility/Lackland Blood Donor Center

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QUESTIONS?

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Sample submission requirements for sending samples to Lackland BDC

Administrative requirements for shipping

&

Collecting sample requirements for testing per CENTCOM

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Sample submission requirements

•For each blood/platelet donor, submit 3 bar-code labeled plastic transfer tubes, capped, then Para-filmed, containing:

•3 ml plasma

•3 ml plasma

•3 ml serum

•Attach a small ISBT barcode label to each transfer tube. Place lengthwise near the top of the tube.

•Label each transfer tube as “serum” or “plasma”.

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Sample submission requirements

•Storage requirements:

•All samples must be shipped frozen

•Plasma/serum must be removed from the cells within 3 days of collection

•Samples may be stored at 1-10 C for up to 8 days before freezing

•Samples must be frozen within 8 days of collection

•Do not freeze PPT/SST tubes. When freezing samples, freeze the serum/plasma portion only – and only after centrifugation and separation

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Sample submission requirements

•Shipping requirements

•Ship in a Collins box

•Ship on fresh dry ice - using as much dry ice as will fit in the box, leaving as little air in the box as possible. Frozen samples should arrive at <-20 C

•Follow up with your shipping company to make sure the shipment has left the terminal

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Sample submission requirements

•Notification

•E-mail and fax notification of shipments to LBDC the day of the shipment departure

•Attach the shipping invoice listing each sample number to the e-mail, as per current practice

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Sample submission requirements

Tracking #

Facility Id/ Year SAMPLE IDDATE

COLLECTEDSpecimens Frozen? Date Frozen COMMENTS Facility Id/ Year SAMPLE ID

DATE COLLECTED

Specimens Frozen? Date Frozen COMMENTS

______________________________________   ______________________________________ _________________

SIGNATURE OF SHIPPING OFFICIAL SHIPPING DATE SIGNATURE OF RECEIVING OFFICIAL RECEIVED DATE

______________________________________  

SIGNATURE OF 2ND VERIFIER  

* No action required if specimens were not frozen prior to shipping. RECEIVING TEMPERATURE_____________°C

* If specimens were frozen within 8 days of collection, circle 'Yes'.

* If specimens were frozen > 8 days of collection, circle 'Yes' and annotate Total # of Samples/Specimens Shipped:

in comment section '> 8 days'.

* Provide additional comments as necessary to communicate integrity of specimens.

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Sample submission requirements

•Rejection Criteria

•If less than 3 tubes submitted, or less than 3 ml submitted per tube, the sample will be rejected for all testing

•Non-frozen samples >8 days old will be rejected for NAT testing. All other tests will be performed

•Non-frozen samples >14 days old will be rejected for all testing

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Sample submission requirements

•Rejection criteria

•Frozen samples >60 days old will be rejected for all testing

•Samples must have been separated from cells within 3 days of collection and frozen within 8 days of collection and remained frozen throughout transit and arrive frozen

•If samples are shipped via Landstuhl Regional Medical Center (LRMC), LRMC should denote sample acceptability on arrival at their facility and relay that information to LBDC

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Sample submission requirements

•Rejection criteria

•Grossly hemolyzed, contaminated or broken samples will be rejected

•Samples in glass will be rejected. PPT/SST tubes will be rejected

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Sample submission requirements

Shipment arrival Taking temperature

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Sample submission requirements

Specimen shipment Sorting out tubes

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Sample submission requirements

Putting specimens in order Waiting for testing

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Sample submission requirements

Shipment Paperwork

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Sample submission requirements

•Rejection criteria

•Responsibility

•LBDC will notify submitting site of rejected samples via e-mail within one duty day of receipt of samples. The COLLECTION SITE is responsible to re-collect the donors ASAP and re-submit proper samples to LBDC

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Testing requirements for CENTCOM regulations

•No ABO/Rh and CMV will be completed

•Antibody screens performed on Galileo

•HBsAg, HBcAb, HTLV 1/2, HIV 1/2, and HCV on Prism

•WNV and Ultrio (HIV, HCV, HBV) done on Tigris

•RPR performed on Olympus (PK 7300)

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LBDC Testing area

Olympus Galileo

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LBDC Testing area

Prism Tigris

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332 EMDG

Aerial View of 332 EMDG

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332 EMDG

Trauma Bay Blood Bank/Trauma Bay

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332 EMDG

Aphaeresis Collection Blood Bank

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332 EMDG

Chemistry Microbiology

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332 EMDG

Main Lab Main Lab

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332 EMDG

Emergency Room Shipping Department

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QUESTIONS?