Blood Banking 1 Flashcards
1
Q
Order
A
- Blood Donor Selection
- Blood Collection
- Unit processing and component preparation
- Compatibility testing
- Blood transfusion
- ***Transfusion reactions
2
Q
Includes the medical history
, physical examination, and
serologic testing on the donor blood
A
Donor Screening
3
Q
is very important in blood donation to
make sure the donor is well fit for donation, and to make sure the blood is safe and beneficial to the recipient of the blood
A
Medical history
4
Q
Medical History Questionnaire
A
Consist of question answerable of “Yes” or “No”
Answered on the same day as the donation
5
Q
Physical Examination
A
Weight
Temperature
Pulse
Blood Pressure
Hemoglobin
Hematocrit
Age
6
Q
Weight
A
110 lbs/ 50 kg (Standard)
7
Q
Temperature
A
Donor temperature should be less
than or equal to 37.5C (99.5F)
8
Q
Pulse
A
50-100 bpm
9
Q
Blood Pressure
A
-Systolic: 90-160 mmHg (Systolic should not
exceed 180 mmHg)
-Diastolic: 60-100 mmHg (Diastolic should not exceed 100 mmHg)
10
Q
Hemoglobin
Autologous?
A
greater than or equal to 12.5 g/dL (125 g/L)
> 11 g/dL
11
Q
Hematocrit
Autologous?
A
greater than or equal to 38%
>33%
12
Q
Age
A
18-65 years old
-17 years old can donate but should need a
parent’s consent
-Donors above 65 years old needs a physician’s consent
13
Q
donors should be informed of the procedure for donating blood and its potential risks.
Donors must sign a statement documenting that they have given consent to the donation
A
Consent to donate
14
Q
If the blood donor weighs less than 110 lbs
A
Decrease the volume of blood collected
–Donor weight / Ideal weight X 450 mL = Volume of blood to draw (mL)
Anticoagulant adjustment - Amount needed
–Volume of blood to draw / 100 X 14 = Volume of anticoagulant needed (mL)
Anticoagulant adjustment - Anticoagulant
removed
–63 mL - AC needed = AC to remove (mL)
15
Q
Can be done via CBC
A
Hemoglobin Testing
16
Q
In hemoglobin Testing, if mass donation ____method can be used
A
CuSO4
17
Q
CuSO4method
CuSO4 is placed in a _____
Up to ______ can be done in ______
Acceptable result:
Hemoglobin:
A
-30 mL container
-30 tests; one container
-The drop of blood sinks in the solution within 15 seconds.
->/= 12.5 g
18
Q
-A donor who donates blood for his or her own use. (“Donor patient”).
-Most commonly used in patients with upcoming surgery
A
Autologous Donors
19
Q
Autologous Donors Advantages
A
Decreased risk of disease transmission
o Decreased risk to transfusion reactions
Decreased risk to transfusion alloimmunization
Blood for person with rare blood groups
20
Q
Autologous Donors Disadvantages
A
Bacterial contamination
Circulatory overload
Cytokine-mediated reactions
Misidentification
Higher cost
21
Q
AAB stand for
A
American Association Blood Bank
22
Q
Not feeling well
A
- deferred temporarily
23
Q
Drunk
A
deferred for 12 hours
24
Q
Skin lesions at venipuncture site
A
deferred until fully recovered
25
Aspirin-containing medications
3-Days Deferral
26
2 Weeks Deferral
Measles vaccine
Mumps vaccine
Polio vaccine
Yellow fever vaccine
Acute Febrile Illness (2-3 weeks/until fully recovered)
27
12 Months Deferral
Syphilis
Gonorrhea
Animal bite
Hepatitis vaccine
Tattoo
Skin penetration with sharp contaminated with blood Ear piercing
Imprisoned
Tooth extraction
Household or sexual contact with individual w/ hepatitis, HIV
Traveled to area endemic for malaria
28
3 Years Deferral
From an area (Citizen) endemic for malaria
29
Permanent Deferral
Parenteral drug use
Family history of Creutzfeldt Jakob disease
Treated with growth hormone
Viral hepatitis after 11thbirthday
Repeatedly reactive anti-HBc, anti-HCV, or anti-HIV
Babesiosis
Chaga’s disease
Cancer patient
Patients with bleeding disorders
Anemic
30
A numeric and Alphanumeric system is used to identify donor.
Carefully monitored to avoid
duplication or wrong identification.
Donor Blood Collection
31
The Phlebotomist must identify the donor and make sure the donor name and the identification number match.
Donor Blood Collection
32
The donor states
Donation should
Donor bleeding:
Donation Intervals:
his/her name
not exceed 10% of donor’s
7-10 minutes (Philippine standard = < 15 minutes
3-4 months
33
Blood Collection Sets
Must be approved by the
The set must be
Key properties for containers
Should be
Should allow adequate
-Food and Drug Administration (or any governing body)
-sterile, uncolored, transparent, and hermetically sealed
-Flexibility, Pliability, Toughness
-kink and scratch resistant
- gas exchange of O2 and CO2 but prevent evaporation of the liquid
34
Blood Collection Sets
The whole blood collection set is a _____ with a ______ and one or more _____
Close system collection maintains
During component preparation, ______ is introduced into the system; instead an ______ or _______ allows the transfer of components from bag to bag
-closed system; primary bag; satellite containers
-sterility of the blood.
-no external air ;internal access port or cannula
35
Blood Collection Sets
The collection set may contain a ________integrally incorporated into the set to filter WBCs.
If the seal is broken or compromised, the expiration date and time must be changed and the set is now considered as _______
-leukoreduction filter
- “Open system.”
36
Collection Proper
1. Inspect the blood bags for any
2. Using a________, select a good site for venipuncture
3. Follow aseptic technique
Disinfect using
Scrubbed the selected area at least
Donors who are sensitive to iodine can use
4. Insert the needle and position it properly.
Tape the tubing to the donor’s arm to hold the needle in place
5. Ask the donor to open and close the hand every 10-12 seconds during the collection proper
-defects, cuts, or discoloration
-tourniquet or blood pressure cuff
-Povidone-Iodine or Polymer iodine complex
-4 cm in all directions (minimum of 30 seconds)
-chlorhexidine gluconate or isopropyl alcohol
- needle; tubing
-open and close; 10-12 seconds
37
6._____the donor. Never leave the donor _____
7. ___the blood bag every _____ to mix the blood and the anticoagulant
8. After collection, ______ the needle and ____. ____ the segment of the blood bag.
9. ______ the donor and let him/her remain seated for _____
10. Give snacks to the donor _____
11. Heat seal the tubing into _____. Cut ______for post collection testing (serological etc.).
-Monitor ; unattended
-Swirl; 45 seconds
-remove ; recap (fish-out method); Lock
-Reassure; 10-30 minutes.
-(water)
-segments; one segment
38
Fainting (anxiety or hypoglycemia)
Stop the donation
Administer glucose solution if necessary
Position the donor that protects him/her from a possible fall
39
Convulsions (Anxiety or underlying disease)
Stop the donation o Maintain airway
Restrain gently to prevent injury
Warn possible involuntary loss of control of urine and stool
40
Cardiopulmonary disease (underlying heart
disease)
Stop the donation
Apply ventilation, Cardiopulmonary resuscitation (if necessary)
Donor is taken to the ER
41
due to fragile veins, unskilled
phlebotomist, uncooperative donor
Hematoma
42
Hematoma
Stop donation if the hematoma is large
Apply pressure to the site (5 minutes)
Apply cold packs
Reassure donor
43
inadvertent puncture of artery
Jet-like bleeding with bright red blood -
44
Jet-like bleeding with bright red blood
Stop ASAP
Apply dressing on site o Follow up donor for additional care
45
due to anxiety, hypoglycemia
Lightheadedness, Weakness, Tingling sensation, Palpitations
46
Lightheadedness, Weakness, Tingling sensation, Palpitations
Reassuring conversations
Elevate donor’s feet at 45 deg for few minutes then lower to 20 deg to increase venous return
Apply cold, wet towels to the neck and
forehead
Have the donor breath into a paper bag
Provide juice even before donation
Last resort: STOP DONATION
47
All units are processed before compatibility test and transfusion
Donor Unit Processing
48
Unit processing includes:
ABO and Rh typing
Antibody screening
Serologic testing: Syphilis, Hepatitis B, Anti-HCV, Anti-HIV, Malaria
Component preparation
Unit storage: ASAP after processing at 1-6C.
49
confirm the ABO blood type of the donor blood
ABO
50
ABO
Must include:
Donor serum should also be collected for the:
forward and reverse typing
reverse typing
51
-Rh type should be tested with:
-In every negative typing, always test for:
-anti-D reagent
-weak-D
52
A single blood unit can provide transfusion therapy to multiple patients in the form of RBCs, platelets, fresh frozen plasma, and cryoprecipitate.
BLOOD COMPONENTS PREPARATION
53
Approved Preservatives
Sodium Citrate
Phosphate
Dextrose
Adenine
54
Binds Calcium in exchange for sodium salt
Sodium Citrate
55
supports metabolism of RBCs
Phosphate
56
maintain RBC membrane o Substrate for ATP
production
Dextrose
57
provides energy for the RBCs
Increases ADP levels
Adenine
58
Provided by the manufacturer in the whole blood collection set and mixed with the donor blood during the collection process
Anticoagulants
59
ACD stands for
CPD stands for
CPDA-1 stands for
CP2D stands for
and state its days
Acid-Citrate-Dextrose -21 days
Citrate-Phosphate-Dextrose-21 days
Citrate-Phosphate-Dextrose-Adenine - 35 days
Citrate-Phosphate-Double Dextrose - 21 days
60
developed to further extend the
shelf-life of RBCs
Additive Solutions
61
Additive Solutions contains:
and state its purpose
saline, adenine, and dextrose
1. To suspend the solutes
2. For increasing survival of RBCs
3. To provide energy for RBCs
4. RBC membrane stabilizing agent
62
Blood component preparation
Fresh Whole Blood (450-500cc)
Platelet Rich Plasma (200-250cc)--PRBC (200-250cc)
Platelet Poor Plasma (200cc)--Platelet Concentrate (50-70cc)
FFP(200cc)
Cryosupernate (180-200cc)--Cryoprecipitate(15-20cc)
63
Contains all cellular and liquid elements +anticoagulant and/or preservatives
Whole BLood
64
Whole BLood
Intended to replace ______, _______on bleeding patients
-Volume:
-PCV:
Stored at
One unit can increase
Not used for __________replacements since it does not survive on stored whole blood.
-RBC (provide oxygen carrying capacity); Plasma (Volume expansion)
-450ml, 38%
-1-6C
-3-5% PCV, and1 -1.5g/dL Hemoglobin
-Platelet, WBCs, and clotting factor
65
Prepared from Whole Blood via centrifugation or sedimentation after donation
Packed RBC
66
Packed RBC
-Volume of RBCs =
- Plasma =
-Hematocrit =
Volume removed should be_____ of the total
plasma.
-200 ml
-100 ml
-70%
-80%
67
Intended for patients that needs to increase its RBC mass and oxygen-carrying capacity without increasing the circulatory volume.
Packed RBC
68
Decreased RBC mass may be caused by:
Decreased production,
Decreased RBC survival, Trauma or surgical
bleeding
Critical levels that indicates transfusion is <6 g/dL
Contraindicated in patients with well
compensated anemia
69
Packed RBC
One unit can increase hemoglobin level to _____ and the hematocrit level to ____ in a typical ____ human (adjustment is quick compared to Whole blood)
1- 1.5 g/dL; 3-5%; 154 lbs
70
Used for neonatal patients or infants under 4
months
RBC Aliquots
71
Neonatal transfusion may require only ____
One aliquot can increase the hemoglobin of
infants at about ____ and hematocrit at _____
-10- 25mL
-2-3 g/dL, 6-9%
72
RBC units with irradiated T-cells to prevent graft- versus-host disease
Intended for:
-Irradicated RBCs
-immunocompromised patients, bone
marrow transplant patients, fetus undergoing
intrauterine transfusion
73
Recommended minimum dose of gamma
irradiation:
Done with?
25 Gy
Cesium-137 or Cobalt-60
74
is used to confirm irradiation (darkening of the film)
Expiration date?
A radiochromic film label
28 days from the time of irradiation
75
RBC unit with a WBC count reduced to <5 x 10° and with at least 85% of the original RBC mass. (original unit may contain about 2 x 10")
-- Reduced to 1 x 10
Leukoreduced RBCs
76
RBC unit with a WBC count reduced to _____ and with at least ____ of the original RBC mass. (original unit may contain about _____)
Reduced to ___
-<5 x 10°; 85%
- 2 x 10"
-1 x 10
77
Donor WBCS can cause
-febrile non- hemolytic transfusion reactions
, transfusion- associated graft- versus-host disease
, transfusion-related immune suppression
, HLA alloimmunization
, and maynintroduce Cytomegalovirus
78
Leukoreduced RBCs
Shelf-life:
24hours
79
-Facilitates removal of 99.9% leukocytes via multiple layers of polyester or cellulose acetate non woven fibers
Retains 85%of the original RBC mass.
Prestorage Leukoreduction
80
Prestorage Leukoreduction
Methods
In-line method
Plasma removal
Sterile docking device
81
In-line filter attached to the whole blood unit and filtered via gravity
In-Line Method
82
Plasma initially removed; remaining cells pass through an in-line filter.
Plasma Removal
83
used to attach a leukocyte
reduction filter to a unit of RBCs, which is allowed to flow via gravity
Sterile Docking Device
84
WBCs are removed in the blood bank prior to issuing blood or at the bedside before transfusion.
______reduce leukocytes to____ or lower
Post-Storage leukoreduction
Third-generation filters; 5 X 10⁶
85
Frozen RBCs that can be then stored up to ?
for patients with ?
-10 years
-rare phenotypes, for backup blood supply, and for autologous use
86
Cryoprotective agents
Penetrating
Nonpenetrating
87
involves small molecules that cross the cell
membrane into the cytoplasm o The osmotic force of the agent prevents water from migrating outward as extracellular ice is formed, preventing cellular dehydration
give its example
Cryoprotective agents Penetrating
Glycerol
88
comprises large molecules that do not enter the cell but instead form a shell around it, preventing loss of water and subsequent dehydration
give its example
Cryoprotective agents Nonpenetrating
Hydroxyethyl starch (HES)
89
- common
Increases the cryoprotective power of glycerol
The freezer provides an initial temperature of -80C
RBCs are frozen within _____of collection (if
______ is used)
Freezing temperatures: _____
RBCs must be placed in the freezer within _____
Also freeze a _____of the donor for additional testing in the future
High Glycerol (40% Weight per volume)
-6 days; CPD or CPDA-1 is used
- 65 C
-4hours of opening the system.
-serum
90
Takes about 30 minutes o Units are placed in a 37 C water bath, and washed with solutions of decreasing osmolarity
Expiration:
Stored:
Thawing process
-24 hours
-1-6C
91
Minimal glycerol cryoprotection
Rapid and more controlled freezing procedure
It requires?
-Initial freezing temperature:
Frozen units are stored at:
-Low Glycerol (20% Weight per Volume)
-Requires Liquid Nitrogen for the freezing process
-196 C
-120C
92
Washed RBC
Intended for patients with?
For anemic patients with history of:
Shelf-life after washing:
RBC loss:
-rare IgA deficiency or anti-IgA antibodies.
-febrile reactions
-24 hours
-10-20%
93
Eliminates plasma proteins to prevent allergic reactions.
Washed RBC
94
Acquired from Whole Blood processing (random- donor)
Platelet Concentrate
95
Platelet Concentrate
Platelets must be separated from the whole
blood within ____of collection
Intended for
May be contaminated with _______ so follow transfusion rules
-8 hours
-bleeding patients
(thrombocytopenic),
Cancer patients,
and thrombocytopenic preoperative patients
-RBCs or WBCs
96
facilitates oxygen transfer into the
platelet bag and oxygen consumption of
platelets
Agitation
97
Random-donor platelet concentrates contains about__________platelets
Stored in a _______ environment with agitation, and should contain adequate plasma of _____________
- 5.5 x 10¹º platelets
-20-24C ; 50-70mL, and a pH of 6
98
Platelet Concentrate
One unit should increase platelet count to ____________
Transport at________: platelets
survive without agitation for a maximum of _____
Shelf-life:
If opened:
-5000- 10000/ul in a 70 Kg person
-Room temperature; 24 hours
- 5 days
-6 hours
99
***Single-donor platelets
Contains at least _______ platelets
Stored at _________environment with agitation, and contains about ________
Shelf-life: ____
-3 x 10¹¹ platelets
-2-24C environment; 300 ml plasma
-5 days
100
Preparation
1. Whole blood is
centrifuge at _______
Light spin _____
2. Platelet Rich Plasma
Centrifuge at ________
Heavy spin __________
3. Platelets_________
- stand for _________
Store at ___________
Avoid _________
4. Determine the _______ of the plasma bag and the______
-22C; 3200 RPM in 2-3 minutes
-22C; (3600 RPM in 5 minutes
- 50-70 mL;1-2 hours at 20-24C with constant agitation
-bacterial contamination
-weight and volume
101
Note
6-8 units can be pooled in 1 bag (shelf-life is reduced to 4 hours)
102
-Platelets can be leukoreduced to help prevent febrile non-hemolytic reactions
-Done via ________ designed for
platelets
-Leukoreduced Platelets
- leukoreduction filter
103
Note
Why do we need to reduced WBCs? Because remember that our platelet concentrate is around 50-70 ml, there is still plasma ,now the plasma may contain WBCs that can cause febrile reactions
104
Despite the chemicals in the anticoagulant, the environment within the blood bag is different from the environment in the body. The impact of this altered environment on the blood product is referred as
“Storage Lesions.”
105
EFFECTS OF STORED BLOOD (WHOLE BLOOD)
Decrease pH
Increase potassium
Decrease 2, 3 DPG in RBCs
Decrease glucose consumption
Decrease ATP and Plasma sodium
50% decrease of factor VIII in 24 hours
50% decrease of factor V in 10-14 days
Platelets and WBCs loss of function after few hours
Building of lactic acid
Increase in plasma hemoglobin
106
POTENTIAL BENEFITS OF ARTIFICIAL OXYGEN CARRIERS
Abundant supply
Readily available for use in prehospital settings, battlefields, and remote locations
Can be stockpiled for emergencies and warfare
No need for typing and crossmatching
Available for immediate infusion
Extended shelf-life
Can be stored at room temperature
Free of blood-borne pathogens
At full oxygen capacity immediately
Do not prime circulating neutrophils, reducing the incidence of multiorgan failure
Can deliver oxygen to tissue that is inaccessible to RBCs
Have been accepted by Jehovah’s witnesses
Could eventually cost less than units of blood
106
The following information is required on the label
Proper name of the blood component (with included indication of any qualification or modification such as irradiation)
Method of collection
Expiration date (and time if applicable)
Donor category
Volume of the blood component
The anticoagulant used in the preparation of the component
Screening test results
Storage temperature requirements of the blood component
Special handling instructions
107
is the liquid portion of whole blood
Plasma
108
Can be prepared from whole blood via ____________
Contains all coagulation factors
-Used to treat
patients with __________________________
-centrifugation and sedimentation.
-liver failure, DIC, Vitamin K deficiency, warfarin overdose, singlef actor deficiencies, massive transfusion
109
Plasma frozen shortly after separation from whole blood or within 8 hours of collection.
Fresh Frozen Plasma
110
FFP
-preserved with ACD, it should be frozen within?
-Used for patients with ?
-Can be stored for up to?
-One unit contains?
-Thaw at ______if using a water bath, cover the unit to prevent water contamination.
-Thawed shelf-life:
-W/less factor V, Factor VII, Factor VIII, and Factor X compared to fresh plasma.
-6 hours
-active bleeding and multiple clotting factor deficiencies.
-1 year at -18°C or lower, or at -65°C for up to 7 years.
-150-250 mL of plasma
-30-37°C;
-24 hours; store at 1-6°C.
-Factor V, Factor VII, Factor VIII, and Factor X compared to fresh plasma.
111
primarily used for fibrinogen replacement, Factor XIII deficiency, treating hemophilia A, and Von Willebrand disease
Cryoprecipitate
112
Cryoprecipitate
-Prepared from?
-Cold-insoluble proteins precipitate out of plasma when thawed at _____ collected by centrifugation at ____
-______is removed via internal access port, retaining ______of plasma on the cryoprecipitate.
-Must be refrozen within _____ of removal from the cold environment and stored at ____or lower for up to 1 year.
-Thawed shelf-life:
- Contains??
- Fresh Frozen Plasma.
-4°C; 1-6°C.
-Cryo-poor plasma (supernatant);5-15 ml
-1 hour; -18°C
-6 hours, or 4 hours (if pooled).
-Contains: Factor VIII, Factor XIII, Fibrinogen, Von Willebrand Factor, and Fibronectin
113
-AABB requires at least :
-150 mg of fibrinogen per unit.
114
T or F
Once thawed, store at room temperature and transfuse as soon as possible, as Factor VII levels decline 2 hours post-thawing
F; Factor VIII
115
T or F
Fibrinogen replacement is crucial in patients with liver failure, DIC, and Congenital Fibrinogen deficiency.
T
116
-is refrozen within 24 hours and
stored at -18C or colder for 1 year
-The product still contains?
-Cryo-poor plasma
-Albumin, Factor II, Factor
V, Factor VII, Factor IX, Factor X, Factor XI
117
From plasmapheresis of donors
Acquired via fractionation and lyophilisation of pooled plasma
Factor VIII
118
Intended for Factor VIII deficiency patients
Hemophilia A
119
Other Plasma Derivatives
Factor IX concentrate (Prothrombin complex)
Immune Serum Globulin
Normal Serum Albumin
120
Factor IX concentrate (Prothrombin complex)
Shelf-life:
Storage temperature:
Indication:
-varies on expiration date on the vial
- 1-6C
-Hemophilia B
121
Immune Serum Globulin
Shelf-life:
Indications:
- Intramuscular administration = 3 years, Intravenous administration = 1 year.
-Prophylactic treatment for patients exposed to hepatitis, measles, or chickenpox; treatment of congenital hypogammaglobulinemia.
122
Normal Serum Albumin
Shelf-life:
Contents:
Indications:
-3 years at 20-24°C, 5 years at 1-6°C.
-96% Albumin, 4% Globulin.
-Used for plasma volume expansion in conditions such as surgery, trauma, and burns.
123
REJUVINATION
-Regeneration of?
-RBCs should be?
- Incubate for _____ at _____ with ______
-ATP and 2, 3 DPG
- < 3 days after expiration
-1-4 hours at 37 C with Rejuvesol
(Phosphate, Inosine, Pyruvate, Adenine)
124
only FDA approved rejuvenation
solution in US.
Rejuvesol
