1. Collection Staff Training Double Red Cell Donation
This training material is a template which Blood centers can use to help draft their training material.
COL-COPY (AA)

2. Agenda What a double red cell blood donation IS and IS NOT
Why double red cell donation is important to our blood center and the Patients and Donors you serve
Why some types are more important for double red cell blood donation
Donating double red cells
Benefits to Donors
Donor Conversion
Who do you ask
How do you ask
FOR INTERNAL USE ONLY

3. Double Red Cell Donations
Two Units of RBCs collected from one donor (one needle, one arm)
Donors keep their own platelets and plasma and get additional saline compensation to make up for blood volume loss
Millions of these procedures have been performed to date
Safe, effective and efficient
A double red cell donation is actually less total volume blood loss than a whole blood donation.
Double Red Cell donation is a safe, effective way to donate and provides hospitals and patients with what is most needed while allowing the donor to feel better after their donation. When compared to whole blood donation, donors lose less total blood volume and the donation takes place over a longer period of time which allows donor to feel better.
2RBC Donation
Red Cell’s Only
Volume 400ml
Saline Return 500ml
(approximately 12 oz)
Whole Blood Donation
Red Cell’s, Plasma & Platelets
Volume 500ml
Saline Return N/A
(approximately 16 oz)
FOR INTERNAL USE ONLY

4. Double Red Cell Devices
Our Blood Center uses the Haemonetics MCS/8150 automated red cell device to collect double red cells.
Some blood centers refer to double red cell donation as red cell apheresis.
This slide shows the MCS+/8150 that is used by the your blood center to collect red cells.
WBC= White blood Cells
RBC= red Blood cells
Haemonetics – MCS/8150
FOR INTERNAL USE ONLY

5. Principle of Operation 1: Fill Bowl
500 ml of Saline
Bowl or Centrifuge
The Presenter will describe the “double” red cell donation process on the MCS/8150.
Step 1: Blood is collected from the donor into the bowl (pictured in the right hand side of the slide).
Red Cell Storage Bag
Plasma/Platelet Storage Bag

6. Principle of Operation 2: Collect (temporarily hold) Plasma
Bowl or Centrifuge
Step 2: The bowl acts as a centrifuge and separates the whole blood into plasma/platelets and red cells.
Once separated, the device pumps the plasma/platelets into their storage bag.
Plasma/Platelet Storage Bag

7. Principle of Operation 3: Collect Red Cells (Return Plasma)
500 ml of Saline
Bowl or Centrifuge
Red Cell Storage Bag
Step 3: The red cells are pumped into their storage bag and then the plasma/platelets are returned to the donor along with saline.
The cycle repeats itself after the first return is complete and that is how two units of red cells are collected.
Plasma/Platelet Storage Bag

8. Haemonetics double red cell kit
What a Double Red Cell Donation is NOT…
A Less Safe Way to Donate Blood
Double Red Cell blood donation uses a “closed environment” and a donors blood does not come in contact with a previous donors blood or is it exposed to the external environment.
The “kit” is packaged sterile and is disposed of after each donation.
The presenter will discuss how the kit is packaged sterile and disposed of after each use.
Haemonetics double red cell kit
FOR INTERNAL USE ONLY

9. Safety Initiatives for Young Donors
The purpose of this slide is to share with students that studies on the complication rates (including prefaint, vasovagal and post donation) are less for all ages of 2RBC donors in comparison to WB donors.
This specific study was completed by Anne Eder who is an executive medical director for the ARC.

10. Exercise Tolerance After Donation
“No difference has been found in the post-donation exercise tolerance between a 2RBC collection when compared to a whole blood donation.”
Smith et al. Transfusion 1996;36:674-80
This purpose of this slide is to share with students that studies have shown that there is no difference in post-donation exercise tolerance when comparing WB and 2RBC donation.

11. Know The Facts of Automated Collection Donor Safety
2RBC – Total amount of blood removed is less than WB
Automated RBC and WB are both safe for first time donors
The presenter can review the facts on donor safety and ask if there are any questions from the student(s).

12. What a Double Red Cell Donation is NOT…
Double the Amount of Blood
A double red cell donation is actually less total volume blood loss than a whole blood donation.
The donor donates two transfusable units of red cells (≈200ml each) instead of donating a unit of whole blood (500ml) which is made up of red cells, platelets and plasma.
The presenter will review the difference between the total volume blood loss between a whole blood donation and a “double” red cell donation emphasizing that the “double” red cell donation is less total volume blood loss and that the donor receives 500ml of saline which may allow donors to “feel better”.
2RBC Donation
Red Cell’s Only
Volume <400ml
Saline Return 500ml
Whole Blood Donation
Red Cell’s, Plasma & Platelets
Volume 500ml
Saline Return N/A

13. Why “Double” Red Cells are important to our patients…
Hospitals transfuse red cells more than any other blood component:
About 65% of all transfusions are red cell transfusions.
Red Cells uses?
Trauma and Surgery
Our blood center only collects the following types of blood for “Double” Red Cell Donation: O+, O-, A- and B-
The presenter will emphasize that most (approximately 65%) of all hospital transfusion are red cell transfusion and that is why it is so important to collect just red cells from certain blood types.
The presenter could also include the following:
“O” means absence of “A” or “:B”- that’s why “O” is the ‘universal donor’. Also, a negative (-) can go to a positive (+), but a positive cannot go to a negative. This is why we are targeting all “Os” and negative blood types.
AB donors are not targeted because so few people can receive their red cells, but they are the universal plasma donor and should be advised and encouraged to continue to donate whole blood or plasma apheresis donation so their plasma can be used.
FOR INTERNAL USE ONLY

14. Percent of Population by ABO type
Blood Types
“Special” Blood Types for “Double” Red Cell’s (O+, O-, A- & B-)
Your Blood Type
You Can Give To
% Able to Receive. O+
O+, A+, B+ & AB+
84% O-
All Types
100% B+
B+ and AB+
12% B-
B+, B-, AB+ & AB-
15% A+
A+ & AB+
37% A-
A-, A+, AB- & AB+
44%
AB+ 3%
AB-
AB- & AB+ 4%
Presenter will explain to group why the blood center collects specific ABO types and not others.
If you look at the ABO types that are considered “right types” for double red cell donation, you will notice that each type can donate to a higher percentage of the population when compared to the donors ABO type.
O+ is 38% of the population, but can donate to 84% of the population.
A- is 6% of the population, but can donate to 44% of the population.
B- is 2% of the population, but can donate to 15% of the population.
O- is 7% of the population, but can donate to 100% of the population.
Alternatively, A+ is 34% of the population, but only 37% of the population can receive A+ blood.
Percent of Population by ABO type

15. Blood Donor Math Why is it so important to convert type O- donors?
If a city has a population of 100,000 people
5% of the population will donate blood
Resulting in 5,000 Donors
Of the 5,000 donors 7% have type O- blood
Therefore, 350 type O- donors are meeting the emergency, universal type transfusion needs of 100,000 people
We need to make the most of each donor visit!
This slide shows how important O- donors are to the “double” red cell program. If donors become educated on how important it is for them to make the most of their donation, it will help to improve the blood supply for our hospitals and patents.

16. Double Red Donation – Blood Donor Benefits
Life saving impact with their donation
Smaller Needle
Convenience (Donate every 112 days instead of 56)
Less telerecruitment calls
Less Total Volume
This slide goes over several benefits:
Greatest life saving impact with their donation
Donors want to do what is right for hospitals and patients. If we educate them on what is needed most and why it will help to motivate them to donate what your blood center is asking for.
Smaller Needle
If a donor is afraid of needles, a smaller needle is used for double red cell donation.
Convenience
(Donate every 112 days instead of 56)
If a donor is really “busy” they would only have to donate half as often and provide hospitals and patients with what is needed most.
Fewer TR calls.
Less Total Volume
You actually leave more hydrated than when you came in!
Fewer Donor Reactions / Feel Better After Donating
Studies have shown that there are fewer donor complications post donation when compared to WB donation. Not a surprise since you gain fluid volume during the donation process.

17. Donor Conversion Who should you ask and how should you ask?
Starting the drive off right…
It is important to convert donors at the beginning of the drive if there are none scheduled
The presenter should emphasize how important it is to convert donors for the first appointment slot of the drive if one isn’t scheduled:
It sets the drive up for maximum success with respect to filling all of the available appointment slots.
It helps recruit other donors when they see a donor already donating double red cells. If a donor sees someone donating double red cells, they are more likely to say yes.

18. Selecting Donors People who have done it before are easiest
Ask each donor if they know their blood type, if they are the “right blood type” (O+, O-, A-, B-), ask them if they are signed up for to donate red cells.
Men who have the right blood type (O+/-, A- and B-)
You can just say something like:
“Your special blood type makes you an important candidate for a red cell donation.” Or
“At this time, the largest need that hospitals have for your blood type is your red cells, will you please help us out and donate red cells today?”
Because women have to weigh more and be taller, you will need to approach them with the requirements
“The criteria for women is: 5’3”* and 150lbs. If you meet those 2 criteria, we would love to have you for a red cell donation”
*according to L.1 Software MCS+ 8150
The presenter should emphasize asking donors if the following questions when they approach them:
Do you know your blood type?
Have you ever donated just your red cells (or “double” red cells) before?
If speaking to a woman, the criteria for women is 5’5” and 150#, if you meet those criteria… (if in health history, collection staff will see this on the donors information).

19. If you recruit first time donors, make a list of things you might say…
Your blood type may be important to the patients we serve for a donation of red blood cells
Instead of collecting 500ml of whole blood (all 3 components) we collect <400 ml of just your red blood cells
Millions of these donations have been made
You get credit for 2 donations and donate ½ as often
Use this slide if your blood center recruits first time donors for “double” red cell donation.

20. If using Anti- A screening, be prepared to discuss the results with the donor?
This screen shows that you have type A blood
Today we would like to ask you to donate whole blood but your blood will be tested in our lab to see if it is a negative type. If it is A-, we will ask you to donate red cells next time.
We do not see if it is a positive or negative type
We transfuse more type O, B- and A- red cells and use this donation type to increase our inventory of those types.
We also need an ample supply of plasma and platelets which we will get from whole blood donations
Use this slide if your blood center recruits first time donors for “double” red cell donation and uses an Anti “A” test.

21. Donor Conversion Educate & Motivate the Donor, then ASK…
A Two-Unit Red Cell Donation is less blood than a regular whole blood donation and a smaller needle is used. So how would you like to try it?
Our hospitals greatest need for their patients is red cells and because you have one of the blood types most needed, you can make the greatest impact by donating just your red cells. So can you help us today?
These types of true statements can demonstrate the importance of red cell donations, making the donor more likely to agree when you ask!
The presenter will emphasize that is the students job to educate the donors and then motivate them to want to donate whatever they are being asked to donate on that particular day based on the needs of the hospitals and patients your blood center serves.
The presenter will also emphasize that it is important to actually ask the donor if they will donate “double” red cells.
These are all true statements that you can use.

22. Why Do People Say No to Double Red Cell Donation?
Don’t want to get anything back – “It’s not safe”
Take twice as much blood out of me
Time
If we educate our donors, time will become less of an issue
The presented will review the two objections previously discussed and then talk about how to address the issue of “not enough time” or “too busy” to donated “double” reds.
Now is also a good time for the presenter to pause and ask if anyone has questions.
You need to think about what to say when people have concerns.

23. Offset the TIME Issue Donor: “I don’t think I have enough time.”
Collection Staff: “How much time were you planning on spending while donating blood today?”
This allows you to help the donor decide if they do or do not have the time to donate double red cells.
If there is no one on the double red cell bed and the donor told us they were planning on an hour donating, do they have enough time?
The presenter will emphasize that a “double” red cell donation will take varying amounts of time and that they should ask the donor how much time they were planning on spending donating today so they can assess if they can process the donor in the amount of time he/she has communicated.

24. Offset the TIME Issue What our hospitals and patients need
Fast-track them to the front of the Health
History line (if your blood center allows you to)
Potentially less time in the canteen
Fewer visits to donate blood
Fewer telemarketing calls
Point out the convenience of donating at work (mobile drives)
Turn beds quickly and efficiently (team work)
Donor Conversion means making sure donors are educated
The presenter will review the bullets points and how each of them impacts the donor or the amount of time it takes to process a “double” red cell donor.
If your blood center allows collections staff to “fast track” donors (allows them to cut to the front of the health history line), the presenter will want to emphasize how to address donors that might complain if they see someone “skip the line”.

25. Just ASK… The ASK is important. Don’t assume they don’t have time.
According to a recent study, participants indicated that “being asked” was a major motivator for selecting automation.
Two thirds of the respondents who had been asked to donate on an automated system had done so.
The presenter will emphasize that it might be difficult at first for new collections staff to provide all of the information to the donor, but eventually they will feel more comfortable and the must ask each and every donor that is the right type for “double” red cell donation .

26. Review of Specific Ways to Ask…
Your blood type is special to us for collection of red blood cells. We offer a donation option that allows you to donate only red cells instead of whole blood. May I ask you a couple of questions to see if you are eligible?
I’d like to offer you another donation option based on your special blood type. Do you mind if we talk about eligibility requirements?
Would you be interested in a more convenient way to optimize your donation by donating red cells instead of whole blood? Can we talk about eligibility?
The presenter can either go over each of these bullet points or ask students to read them aloud.

27. Conclusion
There are several misconceptions that donors have about double red cell donation, it is our job to educate them.
Having someone donate double red cells as soon as the drive begins, “jump starts” collections for the rest of the day.
The majority of people who donate want to help. Most of them will say yes to “double” red cell donation if asked.
To have a successful “double red cell” program you need to ask people to participate and the way you ask is very important.
It takes longer for a “double” red cell donation so it is important to prepare the donor for that extra time.
FOR INTERNAL USE ONLY

28. Donor Conversion Scenarios
B- Donor – Bad experience last time they donated, “felt queasy”.
O+ Donor/Male – Never donated 2RBC’s before.
A- Donor – “Doesn’t think they have enough time”, remembers someone saying it takes longer, but that’s it.
O- Donor – doesn’t want to donate 2 units of blood, “I don’t think I have enough to donate two units”.
O+ Donor – Doesn’t want anything back, “You can take my blood, but I don’t want anything back, especially if it goes through some machine”.
A+ Donor – Donated double reds before and liked it. Signed up for a 2RBC appointment.
It is important that the that the presenter complete these scenarios with the class by asking the student(s) to write down responses to each scenario and then practice them through individual or group role play.
Adult learners learn through participation and this exercise will be instrumental in the students retaining what they have just learned.

29. What is Double Red Cell Donation
Double Red Cell Guide
Blood Center Logo Here
An automated blood donation where two patient doses of red cells are collected in a single donation (one needle, one arm)
Donors keep their own platelets and plasma and get additional saline compensation to make up for blood volume loss
What is Double Red Cell Donation
Total Volume Blood Loss
Whole Blood Donation “Double” Red Cell Donation Approximately 500ml Approximately 400ml
Saline Received 500ml
A “double” red cell donation is actually less total volume blood loss than a whole blood donation
Why is Double Red Cell Donation Important
Hospitals transfuse red cells more than any other blood component, about 65% of all transfusions are red cell transfusion.
Red Cells are used for patients in need of life saving blood.
Percent of population by ABO blood types…
Height/Weight Requirements
Haemonetics (MCS / 8150)
Men - 5’ 1” and 130 lbs.
Women - 5’ 3”* and 150 lbs.
Days Between Donations
Double Red Cell days
Whole Blood days
Double Red Cell donation is a safe alternative to donating whole blood. A single use sterile collection set is used for each donor and the donors blood never comes in contact with a previous donors blood or the machine,
Millions of double red cell donations given since the early 1990’s
*according to L.1 Software standards of the MCS+ 8150
Is Double Red Cell Donation Safe
If your regions marketing department allows the presenter to share this slide with students, it can be printed out as a reference sheet or used as for reference during the role play exercise.
Highlighted types are currently being recruited for “Double” Red Cell donation

30. Component Therapy
Blood Center Logo Here
Whole Blood is not normally what is transfused to patients.
The whole blood you donate is separated into its different components – primarily Red Blood Cells, Plasma and Platelets
Plasma & Platelets
The presenter can share this slide if they want to show what a unit of whole blood looks like after being centrifuged. The presenter can then identify the individual components.
Red Blood

31. Component Therapy - Transfusions of specific blood components are given to patients to deal with a specific medical problem
Red Cells transport oxygen from the lungs to cells of the body and helps transport carbon dioxide from the body cells to the lungs
Platelets are essential in maintaining hemostasis – they prevent the loss of blood from the body by patching damage
Plasma carries antibodies that assists in immunity
Plasma also plays a role in clotting as it is rich in important clotting factors
The presenter can use this slide to educate students on what the different blood components are used for by the hospitals that we serve and the role of each blood component.

32. Different ways to ask… SEE THE DIFFERENCE? COMMON APPROACH
Want to Give Doubles?
You don’t have time to do doubles today, do you?
BETTER APPROACH
Hospitals/Patients have a real need for your type of blood.
Can you help out our Hospitals and Patients by donating red cells today?
I’d like to offer you another option for your donation based on your special blood type.
Would you be interested in making the most of your blood donation?
The presenter can use this slide if they want to emphasize the importance of properly educating, motivating and asking a donor to donate “double” red cells.
SEE THE DIFFERENCE?
FOR INTERNAL USE ONLY