BLOOD TRANSFUSIONS

DONOR CRITERIA

Physical Examination General Appearance

Age Haemoglobin or (Haematocrit)

Weight Blood Pressure

Temperature Pulse

Donor Skin Examination of various systems

Medical History Pregnancy

Abortions Alcohol or any drug abuse

On medications Infectious disease

transmissible infections Vaccinations

Aspirin Surgical Procedures

Donation Interval History of receiving transfusion

INFORMATION TO THE DONORS- Counseling and Referral

Objectives :

• ensuring that unsuitable donors are deferred eithertemporarily or permanently;

• ensuring patient safety by collecting blood only fromsafe donors;

• optimizing donor safety by collecting blood onlyfrom healthy donors;

• reducing unnecessary deferral of safe and healthydonors and

• minimizing wastage of resources resulting from thecollection of unsuitable donations.

Major steps of the blood donation process :

1. Donor education and recruitment leading toregistration/enrolment

2. Pre-donation information

3. Completion of the donor questionnaire

4. Pre-donation counselling

5. Pre-donation advice

6. Medical interview on a one-on-one basis

7. Health check

8. Informed consent

STAGES OF DONOR COUNSELLING

Pre-donation information before an individual registers as a blood donor;

Pre-donation counselling during the confidential interview for health assessment;

Information during blood donation and

Post-donation information and counselling, and referral.

‘SMART’ Counseling Process

Specific

Measurable

Appreciative

Realistic

Time-sufficient:

COLLECTION OF BLOOD FROM DONORS [REQUIREMENTS]

Blood should be collected only by a licensedblood bank. Blood should be drawn from the donorby a qualified physician or under his/her supervisionby assistants trained in the procedure.

Method: A strict standardized procedure should be inuse to achieve surgical cleanliness for preparingvenipuncture site to provide maximum possibleassurance of sterile product.

Equipment: The blood bags for collection of bloodshould be sterile, pyrogen free and disposable, witha closed system of collection.

Anticoagulant solutions: The anticoagulant solutionshould be sterile and pyrogen free.

• Citrate-Phosphate-Dextrose (CPD) Solution.

• Citrate-Phosphate-Dextrose-Adenine (CPDA-1)

solution.

Volume of blood: Volume of blood collected shouldbe proportionate to the volume of anti-coagulant,and should not exceed 10 ml/kg body weightlimited to a volume of 500 ml.

Samples For Laboratory Tests: blood samples in thepilot tubes (clotted and anticoagulated) should becollected at the time of collection of blood by thesame person who collects blood.

Identification: Each container of blood/bloodcomponents /pilot tubes should be identified by anumeric or alpha numeric at the time of collectionof blood, so that it can be traced back to the donorand also to the recipient

Temperature: the blood should be placed at 400 C

LABELLING FOR WHOLE BLOOD/COMPONENT

• Name of the product i.e., whole blood orcomponent or intended component.

• The numeric or alphanumeric identification.

• The date of collection and expiry.

• The name and amount of anticoagulant and theapproximate volume of blood collected.

• For platelet concentrate, plasma and for componentobtained through apheresis, the approximatevolume of the components should be indicated.

COLOUR SCHEME:

• Blood group O - Blue

• Blood group A - Yellow

• Blood group B - Pink

• Blood group AB – White

INSTRUCTIONS FOR TRANSFUSION

• Do not use if there is any visible evidence of

deterioration.

• Keep at 40 C +20 C before use.

• Shake gently before use.

• Do not add any other medication to the

blood/blood component.

• Check blood group on label and that of the

recipient before administration

• Use a fresh, clean, sterile and pyrogen free

disposable transfusion set with filter to transfuse

blood.

• Do not dispense without a prescription.

• Rh(D) type is not required to be mentioned for

plasma but it is necessary for platelet and

granulocyte concentrates especially in case of red

cell contamination of the product.

• Storage temperature should be indicated

• Expiry date/time for use should be recorded.

• If the plasma is intended for use of fractionation,

suitable documentation and labelling should be

done.

• Label should indicate whether the component is

prepared by apheresis method.

• Label should indicate the addition of any adjuvant

or cryoprotective agents used.

APHERESIS

PLASMAPHERESIS

CYTAPHERESIS

PLATELETPHERESIS

LEUKAPHERESIS

COMPONENTS- Blood & Blood Products

Whole blood

Red Blood Cell Components

Red blood cells

Frozen red cells

Washed and deglycerolized red blood cells

Leucocytes depleted red blood cells

Platelet concentrate

Granulocyte concentrate

Fresh frozen Plasma

Albumin

BLOOD REQUEST FORM

• Recipient's name

• Age, Sex, ward and bed number

• Blood group of recipient if done earlier

• For error prevention it is preferable to get bloodgrouping done before the request for cross match isreceived

• Name of the head of treating unit

• Amount of blood/component needed

• Date and time of blood component requirement

• Routine/emergency

• Diagnosis

• Reason for transfusion- Hemoglobin / platelet count

• History of previous transfusion

• Obstetric history in the case of female patient

• Name of the hospital/ Hospital Registration number

• Signature of the medical officer

• Name and signature of the phlebotomist collecting patient's sample

ISSUE OF BLOOD FOR TRANSFUSION

• Donor unit identification number,

• Segment number,

• ABO and Rh(D) type and

• Expiry date of the blood.

• Interpretation of cross matching report and

• the name of the person performing the test and issuing the blood should be recorded.

• A label or a tag with patient's name, hospital, identification number, blood unit number assigned by the collecting/intermediary facility, interpretation of the cross matching test, should also be attached to the blood bag container before it is released from the blood bank.

TRANSFUSION OF BLOOD AND COMPONENTS

• INFORMED CONSENT

• IDENTIFICATION OF RECIPIENT AND DONOR UNIT

• SUPERVISION[Transfusion should be prescribed and administered under medical direction.]

• ADMINISTRATION OF BOOD & BLOOD COMPONENTS

• GUIDELINES FOR TRANSFUSION PRACTICES

COMPLICATIONS

•ACUTE REACTIONS

•DELAYED REACTIONS

ACUTE

Acute hemolytic

Febrile non hemolytic

Mild allergic

Anaphylactic & severe allergic

Circulatory overload

Sepsis

DELAYED

• Delayed hemolytic

• Hepatitis B *

• Hepatitis C*

• HIV

• Iron overload

• Graft- versus – host disease

• Other infections

PREDEPOSIT AUTOLOGOUS DONATION

Pre-deposit autologous donation refers toremoval and storage of blood or blood componentsof donor-patient's own blood for intendedtransfusion to that person when required at laterdate.

Autologous pre-deposit procedure requiresconsent of the donor-patient and a request fromtreating physician.