Donor Selection and Blood Collection

8/6/2019 Donor Selection and Blood Collection

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UNIVERSITY OF SANTO TOMASFaculty of Pharmacy

Department of Medical Technology

National Childrens HospitalBlood Bank Section

AQUITANIA, Mary Christelle G.

Donors record must be retained by the blood collection facility as mandated by FDA

and AABB. There must be a system to ensure the confidentiality of the donor is not

compromised and that the donor records are not altered. Policies on record

keeping and storage must be implemented and the blood bank staff should be well

trained on these policies.

*Donors blood type is done after the medical test.

2. CLASSIFICATION OF DONORS

Blood donors may be categorized into three:

a. VOLUNTARY, NON-RENUMERATED BLOOD DONORS

i. They give blood on their own free will and receive no money of any form of

payment

ii. The reasons for promoting regular voluntary non-renumerated blood donor

are:

1. Lower incidence and prevalence of transfusion transmissible infection

2. Absence of risks of anemia on the part of donors through depletion of

their own iron stores

3. Donors are more willing to donate blood regularly

4. Donors have expressed a commitment to donate blood during

emergency

b. FAMILY or REPLACEMENT BLOOD DONORS

i. Theyre required to give blood when a member of the patients family or

community requires it.

c. PROFESSIONAL or PAID or COMMERCIAL BLOOD DONORS

i. They are donors who give blood for money or other form of payment.

ii. The disadvantages of paid or professional blodd donation:


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1. High incidence and prevalence of transfusion transmissible infection

2. Often donors are undernourished and in poor health

3. Donor Screening

d. PRE-DEPOSIT

i. They are donors who donate blood to gain security on the availability

of blood in case of emergency

e. MBD: MUMBAI BLOOD DONORS

i. They are donors who have Rh negative blood

Donor screening is carried out by an adequately trained physician and/or qualified

staff under the supervision of a qualified physician to determine the sustainability of

the blood donor.

3. DONORS CONSENT

Figure 6.1. National Childrens Hospital Interview Sheet of Blood Bank (2011)

Donors Consent


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According to the Modern Blood Banking and Transfusion Practices, Donors

should be given educational materials informing them of the risks of the

procedure, signs and symptoms associated with the human immunodeficiency

virus (HIV) and acquired immune deficiency syndrome (AIDS), and the

opportunity to decline from the donation process. If they believe their blood is

not safe or they are not comfortable with the procedure. (Harmening, 2005)

4. PHYSICAL TEST - POTENTIAL BLOOD DONOR

A potential blood donor must have the following characteristics are the time of

donation:

Table 3.1. Criteria for Potential Donors

CRITERIA CHARACTERISTICS1. General Appearance No presence of excessive anxiety,

drug or alcohol influence or

nervousness2. Age Between 16-65 years old (parental

consents is required under 18 y/o)3. Body Weight At least 50 kg (500 ml blood unit)

At least 45 kg (250 ml blood unit)4. Pulse Rate 50 100 beats/minute (regular

rhythm)5. Blood Pressure Systolic: 90-160 mm Hg

Diastolic: 60-100 mm Hg6. Temperature 37 degrees Celsius

98.6 degrees Fahrenheit7. Skin Deferral : Evidence skin lesions

(puncture marks)

8. HEENT (Head, Ears,Eyes, Nose, Throat)

Observed donors facial expression,visual & hearing ability, andphysiology of the nose, mouth &tongue, etc.Look for symmetry, size, shape,


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masses, involuntary movements,presence of lesions & allergies, andform of disability or complications.

9. Heart & Lungs Permanent deferral if severe heartand lung disease is present

10. Hemoglobin 125g/L (12.5 g/dL)11. Hematocrit Male: 40 - 49

Female: 35 -49

Figure 3.1. National Childrens Hospital Interview Sheet of Blood Bank Section

(2011) Physical Exam


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5. MEDICAL TEST

Obtaining an accurate medical history of the donor is essential to ensure the benefit

to the recipient. The medical history questions have been developed and revised as

necessary.

Figure 4.1. A donor that is temporarily deferred.

i. Temporary Deferment of Blood Donor

Table 4.1. Conditions of donor that may be reasons for their deferment

CONDITION DURATION1. Previous Donation Three (3) months or longer

interval from previous donationof 450 ml

2. Pregnant Women 9 months after childbirth3 months after weaning(whichever is longer)


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3. Major Operation including:a. Dental Surgeryb. Blood transfusion includeadministration ofimmunoglobulins

12 months after operation ortransfusion

4. Acute Febrile Illness 2-3 weeks after febrile episodeor until full recovery

5. Malaria (diagnosed ortreated)

3 years after cessation of signsand symptoms of malaria ortreatment of malaria

6. Past exposure to a close

household contact with hepatitis

1 year after exposure

7. Past exposure tounhygienic skin, piercing,tattooing, ear holding, needlepuncture, etc.

1 year after exposure

8. Recent alcohol intake(positive for alcoholic breath)

12 hours after the last alcoholintake

9. Skin lesions atvenipuncture site

After skin have completelyhealed

10. Menstruation (for femalesonly)

1 week before menstruation

ii. Deferment of Blood Donation Following Vaccination (Table 4.2.)

TREATMENT DURATION1. Live attenuated vaccinesCategory 1: Measles (rubeola), Oralpolio, Mumps. Yellow fever vaccines,BCG

2 weeks after vaccination

Category 2: German measles (rubella)vaccine

1 month after vaccination

Category 3: Rabies vaccines 1 month after vaccination

2. Killed vaccines and toxoids (DPTand DT, polio injectable, HBV, Cholera,Typhoid and paratyphoid typhus andinfluenza vaccines

May donate any time ifwithout vaccine associatesymptoms like fever

iii. Deferment Due to Medications taken By the Donor (Table 4.3.)

MEDICATION DURATION


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1. Antibiotics other than anti-TBdrugs

5 days after the last dose

2. Anti-TB drugs Until TB is completelycured

3. Anti-Fungal drugs 5 days after completionof treatment

4. Allergic drugs such and penicillinand aspirin, isotretinoin, etretinat

1 day after the last dose(but blood is labeled NOTFOR THE PREPARATIONOF PLATELETS)

5. Oral Corticosteroids While on treatment

6. Anti-Acne drugs 2 months after treatment

iv. Permanent Deferment of Blood Donor

Persons with the following conditions shall not be allowed to donate blood at any

time.

1. Cancers

2. Cardiac diseases like arrhythmias, congestive heart failure

3. Severe lung diseases like complicated asthma with bronchiectasis oratelectasis

4. Viral hepatitis and jaundice of unknown origin and other severe liver disease

like cirrhosis

5. Use of prohibited drugs (past or present)

6. High-risk sexual behavior or continuing exposure to persons with hepatitis,

HIV/AIDS and other sexually transmitted diseases (STD)

7. High risk occupations (e.g. prostitution)

8. Sexually transmitted diseases (STD) (past or present)

9. Prolonged bleeding

10. Unexplained weight loss of more than 5 kg over six months

11. Chronic alcoholism


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Malarial Smear


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Laboratory Diagnosis1. Thick and Thin Smear (Gold Standard)

a. Stained with Giemsa or Wright Stainb. Blood smears should be prepared every 6-8 hours

Note: A properly prepared thin film isthick at one end and thin at theother. The thin, feathered end of thefilm should be centrally located onthe slide with free margins on bothsides; the feathered edge should beonly one layer thick. Streaks in theblood film indicate dirt on the slides;holes indicate the presence ofgrease on the slide.

Qualitative Reporting:+ : 1-10 parasite /100 thickField++ : 11-100 parasite/ 100 thickField+++ : 1-10 parasite/ thick field++++ : 10 parasites/ thick Field

2. QBC: Quantitative Buffy coata. - uses capillary tube with Acridine Orange

b. - (+) bright green & yellow under fluorescent microscopeQuantitative Reporting:

# of Malarial parasite/ L = # of parasite count/ 200 WBC * 80003. RDT: Rapid Diagnostic Test

a. uses the principle of immunochromatographyi. HRP II detection- Parachek P.f., Para HIT fecal Testii. LDH Detection- to differentiate falcifarum from non

falcifarum, DIAMED Optimal IT4. Culture Method

a. uses in vitro continuous culture in human Erythrocytesb. RPMI 1640 (Rosewell Park Memorial Institute)

5. Serological Test

a. IHA (Immunohepatoagglutanation)b. IFAT

Table 5.2. Differentiation of different agents of Malaria (Pallidium spp.)

Figure 5.3. Plasmodium

falciparum Presence of single

ring in the red cell (Parasitology

Figure 5.4. Thin & Thick Smear


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Point ofDifference

P.

falcifarum

P. malariae P. vivax P. ovale

Type of Malaria MalignantTertian

SubtertianQuartan

BenignTertian

Benign orovale

TertianLength of sexualCycle

9-10 days 15-20 days 8-9 days 14 days

Length of AsexualCycle

36-48hours

72 hours 48 hours 48 hours

Size of Infected RBC

Normal Normal Enlarged

Normal to

slightlyEnlarged

Type or RBCinfected

Young andold

Old /senescent Young Young

# of merozoites inSchizont 8-36 (12-

32)

6-12 (RosetteFormation/fruit pie/Flowerydaisy head)

12-24 (8-12)Usually 8

(6-12)

Ring Form Single/Multiple

Single Single Single

# of Chromatin Dots Single/

doubleSingles Single/dense Single

Accol/appliqu/Marginal Form

Present Not present Not PresentNot

PresentMultiple Infection ofSame RBC

CommonstickyRBC

Rarely Rarely Rarely

Gametocyte Crescent/BananaShape

Round/ oval Round/ OvalRound /

Oval

Asexual Stage in thePeripheral Smear

Not allStages

All Stages All Stages All Stages

Malarial Stipplings MauersDots/

Cuneiformdots

Ziemann dotsSchuffners

dotsJames

Dots


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6. DURING BLOOD DONATION

a. Identify the donor through his/her

identification card.

b. Let the donor lie on the bleeding bed

c. Apply the tourniquet to palpitate the

suitable vein for bleeding, then

release.

d. Cleanse the site for bleeding using alcohol, iodine then alcohol. Dry the

site.

e. Prepare your blood bag. Clip the blood bag cord to prevent the

anticoagulant to spill. Check the needle. If any problems are

encountered, change your blood bag.

f. Everything is set; apply the tourniquet and let the donor squeeze the

stress ball once. When the palpable vein is in sight, insert the needle

then release the clip to let the blood flow. Let the donor squeeze the

stress ball every 3 5 seconds for continuous flow. Mix the blood bag

continuously and label it (date & time of collection, donors blood type

& donors number). Always check for signs of blood flow.

g. Fill up the blood bag up to 450cc. Then, clip again the blood bag. Ask

the donor to halt squeezing the stress ball and relax.

h. Remove the needle in an upright position then cover it.


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i. Place pressure on the puncture site to stop the bleeding. Let him/her

rest for 10 15 minutes.

7. AFTER BLOOD DONATION

Drink plenty of fluids over the next 24-48 hours to replenish any fluids youlost during donation.

Avoid strenuous physical activity or heavy lifting for aboutfive hours after donation.

If you feel light headed, lie down, preferably with feetelevated, until the feeling passes.

In rare cases when bleeding occurs after removing thebandage, apply pressure to the site and raise your armfor 3-5 minutes. If bleeding or bruising occurs under theskin, apply a cold pack to the area periodically during thefirst 24 hours.

Enjoy the good feeling that comes with knowing that youmay have saved as many as three lives.

Documents

Donor Selection and Blood Collection