Transcript الشريحة 1

Ahmad Shihada SIlmi Msc, FIBMS
IUG
■ Introduction
■ The donor: Why Does One Donate?
■ Donor Screening: Purposes & Outcomes
■ Components of Donor Screening
■ Donor Categories
■ Donation Area
■ Summary

Donor Deferrals

Whole Blood Donation

Post Donation Care

Donor Adverse Reactions

Donor Serological Testing

Results of Testing
Introduction
Blood Bank (BB) Vs Blood Centre
• Hospital BB known as transfusion service
– Do Compatibility Tests
– Prepare Components
• Blood Centre is a Donation facility
– Screen and Draw Blood
– Performs Testing on Donor’s Blood
– Deliver Components to Hospitals
Introduction
• BB and blood centres depend on voluntary
donors to provide blood for patients they serve
• Correct use of blood will benefit & save lives
• Two Crucial Factors for Save Blood
– Accurate Donor Screen
– Accurate Laboratory Testing
• Governing Bodies (AABB & National STDs)
• BB must have SOPs that meet national STDs
The donor: Why Does One Donate?
•
Four Reasons
1) Volunteer Donation*
2) To Replace Blood Provided
3) To Cover Family (insurance program)
4) Donation For Pay (NOT USED)
*
Because they are healthy & want to share this
with their community
Donor Screening
Purposes & Outcomes
• Donors are screened for two purposes
1. Assess health of potential donor
2. Protect recipient from transfusion reactions
• Has 1 of 3 Outcomes
1. Acceptance
2. Temporary deferral
3. Permanent deferral
(Continue on donation)
(Advised to wait)
(Can’t be accepted)
Donor Screening
THREE MAJOR COMPONENTS
1. Registration
2. Medical History
3. Physical Examination
• If successfully completed, the donor advances
to actual phlebotomy
• Privacy and confidentiality of process
Donor Screening Components
Registration
1) Complete & accurate demographic informations
•
– To notify donors with clinical problems
– Retrieval donor information for future donation
It include Qs about:–
Name/address//sex/donation/consent/ID/race/age
–
Serological tests to be performed
2) Information provided to donor
 HIV education (Risks and Symptoms)
 Tests to be done on blood
 Possible donor Rxs & provide care instructions
Donor Screening Components
Medical History
• Trained health care staff
• Discuss & interview Qs relevant to donor health
▪ Facts finding and diagnostic
▪ Donor’s health status and suitability
▪ Questions phrased with “Y” or “N”
▪ Include questions about:▪ Jaundice, Hepatitis, Malaria, Surgery, Cancer,
Bleeding, Syphilis, Weight loss & Pregnancy
I AM FED UP
WITH YOUR
DOCUMENTS
Pleasant, professional staff
who can ask appropriate Qs
Donor Screening Components
Physical Examination
• Same day and should role out donors
• Begins by observing donor’s
* Appearance
* Pulse (50-100) beats/min
* Temp (not>37.5ºC)
* Weight (not<50 Kg)
* Hemoglobin (>12.5 g/dl)
*Blood Pressure (Syst not >180: Diast not >100)
• Venipuncture sit (skin lesions, IV drug use)
Calculations for Donors weighing
<50 Kg
• A=volume to draw=(donor weight÷50)x450
• B=amount of anticoagulant needed= (A÷100) x14
• C=amount of anticoagulant to remove from
collection bag= 63 ml- B
• Example (Donor weight 47 Kg)
– Volume to draw (A)= (47÷50)x450=423mls
– Anticoagulant needed (B)= (423÷100)x14=59.2 mls
– Anticoagulant to remove (C)= 63-59.2=3.8 mls
Frequency of Donation
• Whole blood or RBC every 8 weeks
• Platelet apheresis– Up to 24 times/year
• Plasmaapheresis– Up to 15 litres/year
Donors Categories
 There are five donor types:
1) Allogenic donors (Random donor)
2) Autologous donors
3) Directed donors
4) Hemaphersis donors
5) Therapeutic bleeding
Donor Categories
1) Allogenic donors

Donations by individuals for anyone’s use
2) Autologous donors

Donate blood for patient’s self use
3) Directed donors

Patient select their own donors
4) Hemaphersis donors
5) Therapeutic bleeding

Blood removed for medical reasons
Blood donation Area and Staff
• Donation Area MUST be:
– Pleasant, comfortable and convenient
– Clean, safe and well let ventilated
5. Blood Donation Procedure
Remember!
The Donor Must ….
• have had good rest
• have had light meal
• be mentally prepared
The real heroes……
Donor Deferrals
Three Types
1.
Acceptance

2.
Proceed to the donation area
Temporary Deferrals

Two Weeks
Two Months

12 Months
Three Years
3.
Permanent Deferrals

Self-Exclusion
Temporary Deferrals
(Two Weeks

Two Months)
Certain Immunizations

Yellow fever & Typhoid
(2 weeks)

Rubella & Chicken Pox
(4 weeks)

Small Pox
(2 months)

Pregnancy-upon conclusion

Some medications (Aspirin) (2 weeks)
(6 weeks)
Temporary Deferrals
(12 Months
Three Years)
 Persons had sex with HIV pos, HBV pos,
hemophiliacs, drug users or receiving drugs
 Blood/components recipients (Coag factors)
 Visited malaria endemic areas
 If treated for malaria (36 months)
Permanent Deferrals
 HIV, HBV or HCV confirmed positive
 Chaga’s disease
 Received pituitary growth hormone
 Had cancer except minor skin cancer
 Severe heart disease, liver disease
Self-Exclusion

May be done pre or post donation
 Two stickers

Yes (use my blood)

No (don’t use my blood)

“No”, unit is collected, tested but not used

Allows donors who know they are at risk to
“save face” if pushed to donate by family
IT IS NOT JUST A SPECIEMEN
IT IS A PATIENT
Whole Blood Donation

Materials used are sterile and single use

Prepare the venipuncture site (important)

Skin’s bacteria grow in blood & cause TRx Rx

Use 16-17 gauge needle to collect blood
from single venipuncture within <10-12 min

450mls in blood bag ±30mls blood (serology)
Post-Phlebotomy Care

Donor applies pressure for 5 mins

ID check, apply bandage to phlebotomy site

Have donor sit up for few minutes

Refreshments & observe for 15 min
Post-Phlebotomy Instructions

Eat/drink, wait until release & Drink more fluids

 1 hr post bleeding; apply pressure, raise arm

Faint/dizzy: lay back, lower head & raise knee

Abnormal symptoms persist, call donation area

Remove bandage
Post Donation Advice
• Drink lots of fluids for next 24 hours
• Avoid smoking for one hour & alcohol till after a meal
• Don’t use elevator to go up immediately after donation
as it will make blood rush to your feet & make you dizzy!
• Avoid highly strenuous exercises & games for a day
• If you feel dizzy, lie down & put your feet up. You will be
alright in 10-20 mins.
• Remove band-aid after 4 hours. If it bleeds, apply
pressure & reapply band-aid. If bruised and painful,
apply cold-pack 4 to 5 times for 5 mins each. The bruise
is due to blood seeping into the surrounding tissue. It will
take a few days to get reabsorbed.
Donor Adverse Reactions
 Blood donation usually has no side-effects
 2-5% donors will have adverse reactions

Due to physiological factors (blood sight, fear)
 RXs grouped into 3 types based on severity
1. Mild
2. Moderate
3. Severe
Donor Adverse Reactions
1) Mild Reactions
 Signs: of Shock without losing consciousness
 Symptoms: Nervous, anxiety, nausea, vomiting, feel
warm, pallor, sweating, hyperventilation,  BP &
pulse
 Treatment:
 Stop donation, remove tourniquet & needle
 Breath into paper bag (CO2) & loosen tight clothes
 Ensure donor has clear airway and pull his knee up
 Cold towel, aromatic spirits &  doctor (reduce stress)
Donor Adverse Reactions
2) Moderate Reactions
 Signs: similar to mild RXs + loses consciousness
 Symptoms: periods of un consciousness, dec pulse
rate, rapid respiration, hyperventilation,  BP
 Treatment:
 Re-check BP, pulse until it return to normal
 Administer 95% O2; 5% CO2
 Move donor to another room?
Donor Adverse Reactions
2) Severe Reactions
 Symptoms
 Convulsions due to cerebral ischemia & hyperventilation
 Complain stiffness in the fingers
 Spasm fingers & thumbs, assume unnatural position
 Treatment
 Remain calm, have donor breath into paper bag
 Call BB doctor & don’t leave the donor
So.. WHAT’s NEXT?
Serological Testing
 ABO grouping (Forward & Reverse) & Rh typing
 Ab screen- Pos, ID Ab (No plasma products)
 Clinical significant Abs in donor’s blood may
react with recipient’s RBCs causing TRx RXs
 Transfusion Transmitted Diseases
Serological Testing
TRx Transmitted Diseases
 Viral
– HIV and HTLV-1,2, HB (A→G), CMV & EBV
– All measured using ELISA
 Bacterial
– Syphilis
– using syphilis test, pos confirmed by TPHA
 Parasitic
– Malaria, Toxoplasmosis
Results of Testing
 Must be Negative or within normal limits
 Donor blood falls outside limits must be ignored
 Repeat testing, if still abnormal disposed
Transfusion Service Testing
 The only repeat testing required is:
– ABO (F & R) on red cell products
– D typing (IS) and D negative red cell products
 Plasma products (FFP, Platelets,
Cryoprecipitate) don’t require any testing
 Donor samples must be stored @ 2-6ºC for
~ 7 days post transfusion
Summary
• Factors for Safe Blood
• Reasons for Donations
• Donor Screening Components
• Purposes and Outcomes
• Donors Weighing < 50Kgs
• Donors Categories
• Donation Area
BLOOD Facts
• Blood flows everywhere
through the human body.
• We cannot live without it.
• The heart pumps blood to all
our body cells, supplying them
with oxygen and food.
• Blood also carries proteins and
cell fragments called platelets
that let blood clot where there
has been an injury.
The real heroes……
Did You Know?
 450ml of blood can save as many as three lives.
 Every two seconds, someone in India needs blood.
 One out of every three of us will need blood in our
life time.
 Even with all of today’s technology, there is no
substitute for blood.
Someone has to give blood
in order for someone to receive blood.
One day I
will be as
big as you
and
donate my
Blood
Fact -1
 Hospitals predict that the need for blood will
increase 5% each year.
 Approximately only 2% of the eligible
population in Gaza donates blood.
 75% of donors donate only ONCE per year.
If they donated just two times per year there would
never be any shortages.
Someone
saved my
life ………
was it you
?
Give her a tomorrow …….
Give Blood today
I have
Your
Blood
Running
in my
veins
Fact -2
 A person has 5 - 6 litres of blood in their
body.
 A person can donate blood every 90 days
(3 months).
 Body recovers the Blood very quickly:
 Blood plasma volume– within 24 - 48 hours
 Red Blood Cells – in about 3 weeks
 Platelets & White Blood Cells – within minutes
Some Reasons to Donate Blood
Blood is always needed for,
 accident
victims
 cancer patients
 blood disorder patients
 surgery patients
 Pre-mature, pre term babies
 and many others…….
 1 of out 10 hospital patients needs a
blood transfusion
We are healthy…….
lets pledge to give
blood
We
Received
the gift of
life ….
Thanks for
your blood
donation
You saved our lives …….thank
you
What can YOU do?
• Make Blood Donation a HABIT
• Donate regularly – every 3 months
to commemorate special days like
birthdays, anniversaries ….
• Motivate others to donate
• Refer your friends and relatives
I too will
donate my
blood
one day
Your gift
of blood
saved her
life
……….
Thank you
I need blood
………..
Will you
please
donate some
For me ?
Your
precious
blood is
running in
my veins
………
Thank you
Benefits to Donor of blood donation
Health benefits:
Regular donation (2-3 times a year….)
– Lowers cholesterol
– Lowers lipid levels
– Decreases incidence of heart attacks, strokes
Donor is also eligible to receive one FREE unit
of blood if needed for
– Self
– Spouse/ Child/ Parents, and
– Even friends