CHAPTER 9: BLOOD BANKING ORGANIZATION Flashcards
A place where blood is collected from donors, typed, separated into components, stored, and prepared for transfusion to recipients.
Blood Bank
may be a separate free-standing facility or part of a larger laboratory in a hospital.
Blood Bank
is a key international association of blood banks, including hospital and community blood centers, transfusion and transplantation services and individuals involved in transfusion and transplantation medicine.
American Association of Blood Banks (AABB)
establishes the standards of care for patients and donors in all aspects of blood banking; transfusion medicine; hematopoietic, cellular and gene therapies; and tissue
transplantation.
American Association of Blood Banks (AABB)
In 1975, World Health Organization (WHO) adopted a resolution encouraging countries to promote the development of national blood services based on voluntary non-remunerated blood donation.
Voluntary Blood donation
Also, WHO set a goal for all blood donations to be collected from unpaid volunteer donors by 2020.
Voluntary Blood donation
gives blood, plasma or cellular components of his or her
own free will and receives no payment, either in the form of cash or in kind which could be considered a substitute for money.
voluntary non-remunerated blood donor
Age:
• Between
18 to 65.
In some countries, [?] may donate with appropriate consent and meeting criteria.
16-17-year-olds
Regular donors [?] may be accepted at the discretion of the physician.
over 65
General Appearance:
• Observations for [?].
excessive anxiety, drug/alcohol influence, or nervousness
Weight:
• Minimum [?].
50 kg
• Calculation for volume to collect based on [?].
weight
Pulse:
• Between [?].
50 to 100 bpm
• Athletes with [?] not deferred.
less than 50 bpm
Hemoglobin and Hematocrit:
• Allogeneic donation:
• Autologous donation:
Hb ≥ 12.5g/dL; Hct ≥ 38%.
Hb ≥ 11g/dL; Hct ≥ 33%.
Temperature:
• Not to exceed [?].
37.5°C or 99.5°F
• Donors should avoid [?] before donation.
hot beverages
Blood Pressure:
• Systolic [?]; Diastolic [?].
≤ 180 mm Hg
≤ 100 mm Hg
• Inspect arm for [?]; evidence cause for deferral.
skin lesions
Time Between Donations:
• [?] between various donation types.
Minimum intervals
Health:
• [?] at the time of donation.
Good health
• Deferral for certain [?].
infections, recent procedures, or inadequate hemoglobin levels
Travel:
• Deferral based on travel to areas with [?].
endemic infections
Behaviors:
• Deferral for [?].
“at risk” sexual activity, positive HIV test, or history of recreational drug injection
• Deferral period following [?].
pregnancy and breastfeeding
Assessing Donor Suitability:
• Donors should be in [?].
• [?] for staff involved in donor selection.
• [?] for all donors, considering convenience and efficiency.
good health, free of blood-transmissible infections
Clear guidance
Rigorous and consistent selection process
Key princinles of bloed donor selection are as follows:
• Safeguarding Health and Safety
- Accepting Only Healthy Donors
• Non-Discrimination
• Evaluation of Donor Health
• Providing Information and Consent
• Qualified Staff
• Effective Communication
• Duty of Care
: Prioritizing the well-being of both donors and recipients to ensure a safe donation process.
• Safeguarding Health and Safety
: Ensuring that only Individuals in good health are eligible to donate blood and its components.
Accepting Only Healthy Donors
: Selection criteria should be applied without discrimination based on factors such as gender, race, nationality, or religion.
• Non-Discrimination
: Assessing the health status and medical history of prospective donors on the day of donation before blood collection.
• Evaluation of Donor Health
: Offering appropriate information to donors through a simple questionnaire for health, and risk assessment, and obtaining their informed consent prior to donation.
• Providing Information and Consent
: Ensuring that staff involved in the donor selection process are adequately qualified and trained.
• Qualified Staff
: Establishing clear communication between staff and donors, while maintaining donor confidentiality.
• Effective Communication
: Providing counseling and referral services for deferred donors to ensure their further management and well-being.
• Duty of Care
DONOR SELECTION PROCESS
1.Donor Registration
2.Pre-Donation Information
- Completion of Donor Questionnaire
- Donor Interview and Counselling
- Health and Risk Assessment
- Informed Consent
- Donor Deferral, Records, and Confidentiality
• Prospective donors meeting general criteria are registered, providing essential personal information.
1.Donor Registration
• Each donor is assigned a unique identifier for tracking purposes.
1.Donor Registration
• Donors receive comprehensive information before donation, either orally or through educational materials.
2.Pre-Donation Information
• This information helps donors understand health conditions or behaviors that may impact their eligibility.
2.Pre-Donation Information
• It also assists in self-deferral decisions and encourages Informed participation.
2.Pre-Donation Information
• Donors fill out a detailed questionnaire, providing information on medical history, lifestyle, and risk factors.
- Completion of Donor Questionnaire
• The questionnaire ensures adherence to selection criterla and assists in assessing donor suitability,
- Completion of Donor Questionnaire
• Alternative methods such as electronic questionnaires may be utilized for convenlence.
- Completion of Donor Questionnaire:
• Trained staff conduct Interviews with donors to further evaluate health status and assess risk factors.
- Donor Interview and Counselling
• Counselling sessions provide an opportunity to address any concerns, clarify Information, and ensure donor understanding.
- Donor Interview and Counselling
A thorough evaluation of donor health status, including vital signs, medical history, and recent travel or exposure to infectious diseases.
- Health and Risk Assessment
Risk assessment considers factors such as recent illnesses, medication use, and high-risk behaviors.
- Health and Risk Assessment
Donors voluntarily provide consent for blood donation, testing for transfusion-transmitted Infections (TTIs), and use of donated blood for medical purposes.
- Informed Consent
ensures donor autonomy and understanding of the donation process.
- Informed Consent
• Donors who do not meet selection criteria are deferred on a temporary or permanent basis.
- Donor Deferral, Records, and Confidentiality
• Deferred donors receive clear explanations for deferral and opportunities for counselling and follow-up.
- Donor Deferral, Records, and Confidentiality
• Temporary deferrals are managed with guidance on when donors can return to donate.
- Donor Deferral, Records, and Confidentiality
• Donor records are maintained confidentially, ensuring privacy and respect for donor Information.
- Donor Deferral, Records, and Confidentiality
TYPES OF DEFERRAL
TEMPORARY DEFERRAL
a. Recent Blood Transfusion: Deferral for [?] following a blood transfusion.
12 months
b. Pregnancy: Existing pregnancy or pregnancy within the past 6 weeks mandates a deferral of [?].
6 months
c. Tattoolng or Ear Plercing: Deferral for [?] after undergoing tattooing or ear plercing.
12 months
d. Close Contact with Viral Hepatitis: Deferral for [?] after close contact with an individual with viral hepatitis.
12 months
e. Malaria: Deferral for [?] following travel to an endemic area, or a [?] deferral if diagnosed with malaria or lived in an endemic area for [?].
12 months
3-year
5 consecutive years
f. Leishmania Risk: Travel to Iraq in the last [?] warrants a deferral of [?] from the last departure.
3 years
12 months
g. West Nile Virus (WNV) Risk: Deferral for [?] from symptoms of headache with fever during the defined risk season or [?] from recovery with a clinical diagnosis or suspicion of WNV infections.
120 days
• Smallpox,measles, mumps, yellow fever, or oral poliomyelitis vaccine:
2 weeks
• Rubella vaccine:
4 weeks
• Rabies vaccine:
12 months
• Hepatitis B Immunoglobulin:
12 months
• Proscar, Avodart, Propecia, Accutane, Soriatane, or Tegison: Varies from [?] deferral depending on the medication.
1 month to permanent
• Growth hormone from human pituitary glands:
Permanent deferral.
• Insulin from cows (bovine, or beef, insulin):
Indefinite deferral.
• Hepatitis B immune globulin (HBIG):
12 months.
• Unlicensed vaccine:
1 year unless otherwise Indicated by the medical director.
• Residence in an Endemic Area: For example, living in England for 1 year in 1989.
INDEFINITE DEFERRAL
• History of Chagas’ Disease or Babesiosis
INDEFINITE DEFERRAL
• Received a Dura Mater Graft
INDEFINITE DEFERRAL
• History of Cancer, Leukemia, or Lymphoma
INDEFINITE DEFERRAL
• Use of Insulin from Cows (Bovine or Beef Insulin)
INDEFINITE DEFERRAL
• Hepatitis C: Individuals with hepatitis C are [?] from donating blood due to the risk of transmitting the virus to recipients.
permanently deferred
• High-Risk History of AIDS: Individuals with a high-risk history of AIDS, including men who have had sex with other men since 1977, hemophiliacs, intravenous drug abusers, and those who engaged in sex for money or drugs since 1977, are [?].
permanently deferred
• Symptoms of Viral Hepatitis After Age 15: Individuals who have experienced symptoms of viral hepatitis after age 15 are [?].
permanently deferred
• Positive Tests for Hepatitis C Antibody (HCAb): Individuals with confirmed positive tests for hepatitis C antibody are [?].
permanently deferred
• Confirmed Positive Test for Human T Cell Lymphotropic Virus (HTLV): Individuals with confirmed positive tests for
HTLV are [?].
permanently deferred
• Malignant Solid Tumors and Hematologic Malignancies:
Individuals with malignant solid tumors (except for basal cell carcinoma of the skin and carcinoma in situ of the cervix) or hematologic malignancies are [?].
permanently deferred
• Chemotherapeutic Agents: Individuals who have received chemotherapeutic agents for malignancy are [?].
permanently deferred
• Chronic Cardiopulmonary, Liver, or Renal Disease:
Individuals with chronic cardiopulmonary, liver, or renal disease are [?].
permanently deferred
• Serious Abnormal Bleeding Tendences: Individuals with serious abnormal bleeding tendencies are [?].
permanently deferred
• Use of Etretinate (Tegison) for Psoriasis: Individuals who have used etretinate (Tegison) for the treatment of psoriasis are [?].
permanently deferred
• Use of Growth Hormone from Human Pituitary Glands:
Individuals who have been prescribed growth hormone obtained from human pituitary glands, particularly for children with delayed or impaired growth, are [?] due to the risk of Creutzfeldt-Jakob Disease (CJD).
permanently deferred
• Toxoids or killed or synthetic viral
NO DEFERRAL (Provided that the donor is symptom free and afebrile)
• Cholera bacterial or rickettsial vaccines
NO DEFERRAL (Provided that the donor is symptom free and afebrile)
• Paratyphoid
NO DEFERRAL (Provided that the donor is symptom free and afebrile)
• Diphtheria
NO DEFERRAL (Provided that the donor is symptom free and afebrile)
• Rabies
NO DEFERRAL (Provided that the donor is symptom free and afebrile)
• Hepatitis A and B
NO DEFERRAL (Provided that the donor is symptom free and afebrile)
• Influenza
NO DEFERRAL (Provided that the donor is symptom free and afebrile)
• Rocky mountain spotted fever
NO DEFERRAL (Provided that the donor is symptom free and afebrile)
• Lyme disease
NO DEFERRAL (Provided that the donor is symptom free and afebrile)
• Polio injection (Salk)
NO DEFERRAL (Provided that the donor is symptom free and afebrile)
• Tetanus or typhoid injection
NO DEFERRAL (Provided that the donor is symptom free and afebrile)
• Anthrax
NO DEFERRAL (Provided that the donor is symptom free and afebrile)
• Key records, including dates, times and signatures, to be maintained and retained during the donor selection process include:
o Donor registration information
o Completed donor questionnaires and informed consent
o Outcomes of donor interview and assessment
o Donor deferral records
o Unique donation number for each donation
o Donor counselling and follow-up records
o Adverse donor events and reactions
o Donor deferral registry.
also enable the previous deferral status of donors to be checked and decisions made on the re-entry of temporarily deferred donors.
Donor deferral records
is a confidential list of donors who are positive for a transfusion-transmissible infection and who have been permanently deferred.
donor deferral registry (DDR)
is used to monitor the incidence and prevalence of such infections in the donor population
donor deferral registry (DDR)
may also assist in identifying areas that require strengthening in the donor selection process.
donor deferral registry (DDR)
EQUIPMENTS/MATERIALS FOR BLOOD CONNECTION
: Used to measure the blood pressure of donors before and after donation to ensure they are within acceptable ranges for donation.
• Blood Pressure Monitors
: Used to accurately measure the weight of donors, as weight requirements are necessary for blood donation eligibility.
• Scales
: Comfortable seating arrangements where donors can recline during the donation process.
• Donor Couches or Chairs
: Devices used to monitor the blood flow during donation and ensure proper mixing of anticoagulants with the collected blood to prevent clotting.
• Blood Collection Monitors or Mixers
: Used to seal the tubing connected to the blood collection bag once the donation is complete, ensuring a closed system and preventing contamination.
• Blood Bag Tube Sealers
: Insulated containers designed to safely transport collected blood units from the collection site to the blood bank or processing facility while maintaining appropriate temperature conditions.
• Blood Transportation Boxes
: Specialized refrigerators used for storing blood components at controlled temperatures to maintain their Integrity and viability until they are needed for transfusion.
• Blood Bank Refrigerators
Common blood donation materials and equipment
: Provides comfort and support to donors during the blood collection process, adhering to clinical standards.
• Blood Donation Chair
: Designed for collecting, processing, and storing whole blood and blood components in aseptic conditions.
• Blood Bags
: Ensures proper mixing of anticoagulant and blood, reducing the risk of incomplete or excessive bleeding
• Blood Collection Mixer
: Compact equipment used to seal PVC blood bag tubes for cryopreservation.
• Blood Bag Tube Sealer
: Essential for safe storage of whole blood, blood components, and reagents to maintain freshness and integrity.
• Blood Bank Refrigerator
: Maintains freezing temperatures for safe storage of plasma, red cells, cryoprecipitate, and platelet concentrates.
• Plasma Freezer
: Store platelet concentrates in continuous
motion at specified temperatures to maintain viability.
• Platelet Agitators
: Separates platelets from other blood components and returns the remaining blood to the donor.
• Platelet Extractor
