Presentation on theme: "Unit 1 Part 1 Blood Collection"— Presentation transcript:
1 Unit 1 Part 1 Blood Collection Terry Kotrla, MS, MT(ASCP)MLAB 2431 Immunohematology
2 Introductory Comments An overview of the process involved in collecting donor blood
3 Donor Screening All blood comes from VOLUNTEER donors. Screening performed to ensure donor is healthy.Starts with the donor and first impressions are criticalClean, well lit donation facility from waiting room to collection areaPleasant, professional staff who can ask the appropriate questions, observe and interpret the responses, and ensure that the collection process is as pleasant as possible
4 Blood Bank versus Blood Center Confusion exists and terms are sometimes used inappropriatelyBlood bank in a hospital is also known as the transfusion service, performs compatibility testing and prepares components for transfusionBlood Center is the donation center, screens donors, draws donors, performs testing on the donor blood, and delivers appropriate components to the hospital blood bank
5 Standards, Regulations, Governing Bodies Strict guidelines exist and inspections are performed in both blood centers and blood banks to ensure the safety of the donors and patientsSome or all of the following agencies may be involved:FDA – Food and Drug Administration – CBER and CFRAABBCAP – College of the American PathologistsJoint Commission – inspects hospitals, lab includedCLSI – Clinical Laboratory Standards Institute
6 Donor Screening Two goals or purposes for screening Four outcomes Protect the health of the potential donorProtect the health of the potential recipientFour outcomesAcceptanceTemporary deferralIndefinite deferralPermanent deferralThree components of screeningRegistrationHealth history interviewLimited physical examination.
7 Donor Registration Donor signs in Written materials are given to the donor which explains high risk activities which may make the donor ineligibleDonor must be informed and give consent that blood will be used for others unless they are in a special donor categoryFirst time donors must provide proof of identification such as SS#, DL#, DOB, address and any other unique information.Repeat donors may be required to show DL or some other photo ID.
8 Donor Registration Additional useful information Name of patient or group to creditRaceUnique donor characteristicsDonor must be provided withHIV high risk activitiesWarnings about donor reactionsTests that will be performed and notificationPost phlebotomy care instructions
9 Medical History Frequency of donation Whole blood or red blood cells 8 weeksTwo unit red cell unit 16 weeksPlateletpheresis – up to 24 times/yearPlasmapheresis– once every 4 weeks, can be done twice a week
10 Medical History A thorough history is obtained each time Standardized universal questionnaire is usedQuestions are asked that are very intimate in nature but are critical in assessing HIV or HBV risksHas donor ever been deferred, if “yes”, why.Medications the donor is taking are present in plasma, may cause deferralInfections the donor has may be passed to recipient, may be cause for deferral
11 Permanent DeferralsMales who had sex with males OR engaged in sex for drugs or money sinceUsed IV drugs even ONCE in lifetime.Taking clotting factors.Hepatitis after age 11.Cancer deferrals vary, some accept after period of being disease free others do not accept.Lived in a country where Creutzfeld-Jacob disease is prevalent or family member with CJD.Protozoan diseases such as Chagas disease or BabesiosisReceived human pituitary growth hormone.Positive test for: HBsAg, Hepatitis C, HTLV I/II or HIV.Donated only unit of blood in which a recipient contracted HIV or HBVWas the only common donor in 2 cases of post-transfusion HIV or HBV in recipient
12 12 Month DeferralRecipient of blood, components or blood products such as coagulation factorsSexually transmitted disease-if acquired indicates safe sex not practiced and donor at risk for HIV and HBVReceived HBIG.Accupuncture, tattoo, ear piercingNeedle stickRabies vaccineAny intimate sexual relations with HIV or HBV positive, hemophiliacs, drug users or individuals receiving drugs/money for sex.
13 Temporary Deferrals Certain immunizations 2 weeks -MMR, yellow fever, oral polio, typhoid4 weeks -Rubella, Chicken Pox2 months – small poxPregnancy – 6 weeks upon conclusionCertain medicationsProscar/Propecia, Accutane – 1 monthAvodart – 6 monthsSoriatane – 3 yearsTegison – permanentFeldene – no platelet donation for 2 days.Plavix and Ticlid – no platelet donation for 14 daysMalaria 3 yearsWest Nile virus 28 days
14 Helpful HintPermanent deferral – any member of high risk group such as: HIV/HBV/HCV pos, drugs/sex for money, cancer, serious illness or disease, CJD, Chagas disease, Babesiosis12 month deferral – sex with any high risk group, any blood exposure, recipient of blood/blood products, STD, jail/prison, rabies vaccine after exposure, HBIG, malariaHave to memorize: medications and vaccinations
15 Physical Examination Evaluate general appearance Weight – 110 1bs national, 123 lbs. Austin – eff. Jan 2010Temperature 37.5 C OR 99.5FBlood pressureSystolic </= to 180 mm HgDiastolic </= 100 mm HgHemoglobin and HematocritAllogenic 12.5 g/dL or 38%Autologous 11.0 g/dL or 33%
16 Self-ExclusionRescinded by FDA in 1992 but some blood centers may still use.Two stickers“Yes, use my blood”“No, do not use my blood”After interview the donor will place the appropriate bar coded label on the donation recordIf “no” selected the unit is collected, fully tested, but not used for transfusionAllows donors who know they are at risk to “save face” if pressured to donate by friends and family
17 Donor Categories“Allogeneic”, “homologous” and “random donor” terms used for blood donated by individuals for anyone’s useAutologous – donate blood for your own use onlyRecipient Specific Directed donation – donor called in because blood/blood product is needed for a specific patientDirected Donor – patient selects their own donorsTherapeutic bleeding – blood removed for medical purposes such as in polycythemia vera. NOT used for transfusion.
19 Donor Categories Apheresis – removal of 1 component, return the rest LeukapheresisPlateletpheresisPlasmapheresisStem cellsBone marrowApheresis
20 Donor CategoriesSafest is autologous, blood is your own, no risk of disease acquisitionMost dangerous is Directed Donor, you select a donor who may, unknown to you, be in a high risk category but feels obligated to follow through and donate