Unit 1 Part 2 Blood Collection
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Transcript Unit 1 Part 2 Blood Collection
Unit 1 Part 2 Blood Collection
Terry Kotrla, MS, MT(ASCP)BB
MLAB 2431 Immunohematology
Blood Collection
Collection of Blood
Collection performed by well trained personnel.
Materials used are FDA approved sterile and single use.
Donor identification critical
Identify donor record with donor
Attach numbered labels
Label processing tubes
Final recheck before leaving donor
Preparing Site
Inspect BOTH arms for signs of IV drug abuse.
Select large firm vein in area free of scarring or skin lesions.
Vein selection priority same as for routine phlebotomy.
Most important step is preparing the site to a state of almost
surgical cleanliness.
Bacteria on skin, if present, may grow well in stored donor blood
and cause a fatal sepsis in recipient
Blood Collection
Gloves are optional, OSHA provides specific exemption for
drawing volunteer donors.
Gloves should be worn:
By personnel in training
Collecting autologous units
If employee has cuts, scratches or breaks in skin.
Use 16-17 gauge needle to collect blood from a single
venipuncture within 10 minutes.
First 30 to 45 mLs of blood diverted to pouch to collect skin
plug.
Mix blood bag frequently or use shaker.
Collect 450 or 500 mLs +/- 10% of blood
Blood Collection System
Donor Reactions
Syncope (fainting)
Remove needle immediately
Hyperventilation
Have donor rebreathe into paper bag.
Nausea/vomiting
Twitching/muscle spasms
Hematoma
Upper extremity deep vein thrombosis
Convulsions – rare, get immediate assistance
Cardiac difficulties – get emergency care
Record ANY donor reactions
Post-Phlebotomy Care
Donor applies pressure for 5 minutes with arm elevated.
Check and bandage site
Have donor sit up for few minutes
Have donor report to refreshment area for additional 15
minutes of monitoring
Post-Phlebotomy Instructions
Eat/drink before leaving
Wait until staff releases you
Drink more fluids next 4 hours
No alcohol until after eating
Refrain from smoking for 30 minutes.
If bleeding continues apply pressure and raise arm
Faint or dizzy sit with head between knees
Abnormal symptoms persist contact blood center.
Cautions about returning to work.
Let them know when to remove bandage
Post-Phlebotomy Instructions
In canteen provide donor refreshments and watch for signs of
a reaction.
Provide phone number for donor to call if:
bleeding recurs
feels donated unit should not be used
has any type of reaction.
experiences signs or symptoms of infection.
THANK DONOR
Processing Donor Blood
All reagents used for testing must meet or exceed
appropriate FDA regulations.
CANNOT rely on previous testing
Results recorded immediately.
Record system to track unit to final disposition.
Records must be retrievable.
Records must be kept for 5 years OR 6 months after product
expires.
General Considerations
Numbers on blood bag, processing tubes and donor
records should be rechecked prior to processing.
ABO group and D type, including weak D
Donor with history of transfusion or pregnancy should
be tested for unexpected antibodies.
Serological Testing
ABO/D typing
Antibody Screen – if positive, ID antibody, cannot make
plasma products
Antibodies to other blood group antigens which are present
in the donor may react with recipient red cells resulting in a
reaction.
Infectious Disease Testing Methods
ELISA to detect antigens or antibodies
Chemiluminescent to detect antigens or antibodies
Detection of syphilis antibodies by RPR
Nucleic Acid Test (NAT) detects viral nucleic acids, much
more sensitive, reduces window period
HIV from 22 to 12 days
HCV from 70 to 10-14 days
Antigen, antibody and NAT testing will allow positive results
through out disease process.
Disease Testing
Disease testing include:
Dectection of bacteria
HBsAG
Anti-HBc
Anti-HCV
Anti-HIV 1&2
Anti-HTLV I/II
RPR
Chagas disease antibodies
NAT for
HIV-1,
HCV
WNV
Results of Testing
Tests for disease markers must be negative or within normal
limits.
Donor blood which falls outside these parameters must be
quarrantined.
Repeat testing, if still abnormal must dispose.
Optional Tests
CMV testing
CMV devastating to premature infants and
immunocompromised
Removing leukocytes greatly reduces risk.
Some physicians still request CMV negative for select patients
Special antigen typing
Patients may develop antibodies against other RBC antigens.
Test donors to find antigen negative
Sickle cell testing
Exchange transfusion
Sickle trait may sickle in neonates
Labeling Donor Units
Component name
Unique donor number
ABO group, D type (not required for plasma)
Interpretation of tests
Type and volume of anticoagulant.
Storage temperature
Expiration date
Name/address of collecting facility
Reference to Circular of Information
http://www.aabb.org/Content/About_Blood/Circulars_of_Information/
Donor classification
Results of testing
Essential instructions
Pooled component information
Transfusion Service Testing
The only repeat testing required is:
ABO on red cell products
D typing (IS) on D negative red cell products
Plasma products (FFP, CRYO, PLTS) do not require any testing.
Donor samples must be stored at 1-6C for at least 7 days after
transfusion
ADSOL unit transfused today must save sprig for 7 days post-transfusion.
Many facilities will pull a sprig from each donor during processing and save
all sprigs for 49 days, regardless of expiration of unit
Red Cell Unit With Sprigs
Summary
Blood collection starts with screening of the donor to:
Ensure they are healthy enough to donate
Ensure they do not have transmissible diseases
Many organizations involved in setting standards and monitoring all aspects of
blood collection and administration.
Collection of blood must be done in such a manner as to ensure sterility of the
component.
Testing of donor blood includes serological testing for ABO/D typing, antibody
screening and testing for infectious disease markers.
The blood supply is NOT safe, only careful screening and testing can prevent, as
much as possible, disease transmission.
References
AABB Technical Manual 16th edition
http://www.fda.gov/cber/dhq/dhq.htm