Donor Eligibility Flashcards
Which of the blood donors listed below is acceptable to donate allogeneic whole blood?
a. 15 year old male, Weight 110 lbs, HCT 36%, Oral Temp 38C
b. 45 year old female, pregnancy 12 months prior, HCT 38%, Oral Temp 37.2C
c. 60 year old male, weight 185 lbs, HCT 32%, Oral Temp 37C
d. 25 year old female, last WB Wb donation 6 weeks ago, HCT 39%, Oral Temp 37C
Correct Response is : B 45 year old female, pregnancy 12 months prior, HCT 38%, Oral Temp 37.2C
Donor 1 is deferred because he is too young
Donor 3 has a HCT below the minimum range of 38%
Donor 4 has not waited long enough before donating. Whole Blood donations should be at least 8 weeks apart.
Age, vital signs, HCT, pregnancy history are all quesions designed to protect the DONOR
What is the deferral period for a potential blood donor who received the Rubella vaccine?
a. 48 hours
b. 2 weeks
c. 4 weeks
d. 1 year
The correct answer is 4 weeks.
There can be some confusion between Rubella and Rubeola vaccines. Rubeola is the “ordinary measles” and the deferral period is only 2 weeks.
For Rubella (German Measles), the deferral period is 4 weeks because the vaccine incorporations an attenuated live virus (attenuated means a chemically weakend form of the virus).
Many donors will not know the difference, so if there is a question, just go with the 4 week deferral. In addition, it is more common to vaccinate using the MMR vaccine (measles, mumps, rubella) which is a 4 week deferral.
On the SBB exam, be sure to know the difference between Rubeola and Rubella.
Rubella vs Rubeola
Rubella = German Measles
- Four week deferral after vaccination
Rubeola = Measles
- Two week deferral after vaccination
What is the defferal period for a potential donor who obtained a tattoo?
a. 48 hours
b. 2 weeks
c. 4 weeks
d. 12 months
The corrrect answer is 12 months. The reason for the deferral is that there is a risk of contracting and transmitting Hepatitis from receiving tattoos.Waiting 12 affords us the opportunity to detect viral markers for Hepatitis, if the individual contracted it during the tattoo procedure. . See the chart below for timelines of viral marker emergence. We will study Hepatitis more in the viral marker session, but I include this just for more complete picture of what is happening.
A potential donor states that he had malaria, and now has been asymptomatic for 2 years. Is this an acceptable donor?
a. Yes
b. No-deferred for 3 years after he is asymptomatic
c. No-deferred for 5 years after he is asymptomatic
d. No-permanently deferred
Correct answer: Deferred for 3 years.
Donors who have had Malaria are deferred for 3 years AFTER they become asymptomatic. This is not the same as 3 years after being diagnosed.
A 35-year-old female is being interviewed for suitability as a whole blood donor, and states that she ingested aspirin 4 days ago. What should the phlebotomist do?
a. Defer the donor
b. Accept the donor, but tell the component production lab NOT to make platelets from this donation.
c. Accept the donor, but tell the component production lab to label the platelets as “not for single use”
d. Accept the donor and make components as usual. No special labeling is required
Correct answer is to accept the donor and make components as usual.
The rational here is that aspirin and aspirin containing compounds can have an adverse effect on platelet function, by preventing the release of pro-coagulant compounds. It does not totally incapacitate the platelets, but we don’t want to use the platelets as a single unit transfusion. It would be fine to use affected platelets in a pool of platelets, or if multiple units are being transfused simultaneously, but not as a “sole source” of platelets.
So for whole blood donors, individuals who have ingested aspirin or aspirin containing compounds within the past 48 hours are acceptable to donate, but if platelets are prepared, the unit must be labeled “Not For Single Use Transfusion” or similar verbiage.
Some facilities may opt not to make platelets at all from these donors to reduce the chance of labeling and transfusion errors.
Platelets Pheresis donors would of course be deferred if the ingestion was in the past 48 hours.
Females who have had recent pregnancy are deferred for:
a. 4 weeks from the end of the pregnancy
b. 6 weeks from the end of the pregnancy
c. 8 weeks from the end of the pregnancy
d. 6 months from the end of the pregnancy
Female donors are deferred for 6 weeks after the pregnancy ends. This is for the protection of the donor.
45-year-old male attempts to donate as an allogeneic donor and states that he donated a unit of double red cells by apheresis 8 weeks ago. What should the phlebotomist do?
a. Accept the donor.
b. Defer the donor for 2 more weeks
c. Defer the donor for 8 more weeks
d. Defer the donor for 11 more months
Correct: Defer the donor for 8 more weeks
Blood donors who give WB, plateletspheresis or plasmapheresis are deferred for 8 weeks. Donors who give a double red cell via aphersis are deferred for 16 weeks. This is to protect the donor against excessive blood loss. The rationale is that giving one unit of blood would defer the person for 8 weeks, so giving two units of blood would defer the person for 16 weeks. The “8 week” guideline was chosen because the average adult human replenishes the pint lost in donation in an 8 week period.
You are a phlebotomist and notice that during the whole blood donation, your whole blood donor is pale, sweating, and appears nervous. According to the AABB, which of the following is the most appropriate action to take?
a. Stop the donation
b. Begin talking to the donor to engage him in conversation.
c. Have him begin taking TUMS orally for calcium replenishment
d. Have him inhale smelling salts.
Correct: STOP THE DONATION
The AABB Technical Manual states “In the case of a vasovagal reaction, phlebotomy should be stopped….”
Some facilities may opt to continue in the case of an autologous donor. These are the signs of a mild donor reaction. Most of the donor reactions we observe are mild in nature, and are caused by anxiety over the blood donation process. Engaging the donor in conversation, and lying him back and elevating his feet are typically enough to calm the donor and allow the donation to proceed. If you see that your donor is anxious even before the donation begins, make it a point to pay special attention to him and talk to him to keep him calm. If you opt to do this, be sure to have an SOP and a medical director approval for the donation.
A blood donor states that he is recently divorced because he found out that his wife was working as a prostitute. You should:
a. Defer the donor permanently
b. Defer the donor for 12 months from the date of his last sexual contact with his ex-wife
c. Accept the donor-he is no longer married
d. Defer the donor for 3 years
Defer the donor for 12 months from the date of his last sexual contact with his ex-wife
High risk behaviors put the donor at risk for transmitting viral diseases. The current recommendations are that the donor is deferred for 12 months from the last date of sexual contact with the high risk individual. The rational is that by the 12 month time, viral markers will be detectable in the serum of infected individuals.
Review the donor criteria below. Select the question that is asked in order to protect the donor from being harmed by the donation process.
a. Has the donor received Hepatitis B Immune Globulin?
b. Has the donor had any chest pains or shortness of breath?
c. Has the donor traveled out of the country?
d. Has the donor lived in Africa?
Correct: Has the donor had any chest pains or shortness of breath?
The other questions are designed to protect the RECIPIENT. HBIg suggests that a blood exposure occurred and should be evaluated to determine the deferral period. Travelling out of the county may involve visits to areas where Malaria or other infectious diseases are present. Living in or visiting Africa may put the donor at risk for HIV O
With the addition of pilot tubes, donors who weigh 110 lbs (50kg) may donate the following maximum amount of whole blood
With the addition of pilot tubes, donors who weigh 110 lbs (50kg) may donate the following maximum amount of whole blood
a. 400ml
b. 450ml
c. 500ml
d. 525ml
Correct: 525ml.
Blood Collection volume is determine by what is safe for the donor to give, the ratio of blood to antiboagulant, and the size of the collection bag
standard 5.4.1A permits collection of 10.5 mL of blood/kg of the donor’s weight for each donation including the blood unit and all samples for testing.
Thus, a donor weight 110lbs (the minimum weight requirement) would be calculated below…
1kg= 2.2lbs
110lb x 1kg/2.2lbs = 50 kg x 10.5 mL/kg= 525mL the max allowable volume to be collected from a whole blood donor
A donor is giving whole blood and loses consciousness. Which of the actions below should be taken in this event? a. Stop the donation b. Elevate the donor's feet c Document the reaction d. All of the above
Correct: All of the above
This is considered a severe reaction to donation, and the process must be immediately stopped and the donor cared for. If you can’t revive the donor, then emergency medical help must be obtained. The donor reaction must be documented on the donor record. If the blood collection was adequate (either a minimum of 405ml or 450ml, depending on the blood bag used, then the unit may be used). The alternative name for this type of reaction is VASOVAGAL.
To ensure trackability and traceability of a collected unit, a unique identifying number should be applied to: a. donor history record b. primary collection bag c. all pilot tubes d all of the above
Correct: ALL OF THE ABOVE
Blood Units must be labeled in a way so that every step of the production is identified. The purpose of labeling all these items is to provide both trackability and traceablily. Trackability means that you can follow the path of production. In this case, the path of production would be the donor, the interview, the collection, the component production, the testing, the labeling and the storage. Traceability means that you can identify all the materials and reagents used to produce the blood components.
For example,I acheive trackability when I label the tubes for the samples for testing with the blood donor ID number. This affords me the ability to see which tests were done and link those tests to the donor record and ultimately to the components produced. I achieve traceability when I am able to identify which instruments were used for testing, the lot numbers of reagents used, the date the testing was done, the QC of the testing batch, etc.
A 35-year-old nurse received Hepatitis B Immune Globulin, one week ago after a needlestick. He is eligible to donate blood;
a. today
b. in three more weeks
c. 6 months from date of injection
d. 12 months from date of injection
12 months from date of injection
HBIG is associated with risk of viral marker transmission. Waiting 12 months will allow any viral markers present to rise to detectable levels
A donor states that he had jaundice when he was a baby. What is the correct deferral period for this donor?
a. 12 months
b. indefinite deferral
c. 10 years from date of last positive Hepatitis test
d. none-the donor is acceptable
none-the donor is acceptable
Neonatal jaundice is not cause for deferral. If you ask the donor if they have ever had Hepatitis, and they have had it after their 11th birthday, then they are deferred.
Which statement below reflects the AABB requirement for informed consent for blood donation?
a. informed consent is recommended, not required
b. informed consent may be given orally
c. Written informed consent may be obtained after the donation is completed
d. Written informed consent is obtained prior to phlebotomy
Correct: Written informed consent is obtained prior to phlebotomy
Like any other medical procedure, informed consent must be documented BEFORE the donation takes place.
A 25 year old woman is admitted to the hospital for a procedure and she recruited directed donors to provide blood for her. Of the statements below, which one is true concerning directed donors?
a. Directed donors screening is abbreviated compared to routine allogeneic donor interviews and testing, but the labeling is the same.
b. Directed donors screening is the same as that of Autologous donors.
c. For this particular patient, the BEST donor would be her husband.
d. Directed donors are screened and tested in the same fashion as routine allogeneic donors.
Correct: Directed donors are screened and tested in the same fashion as routine allogeneic donors.
Directed donors must be screened, questioned and tested according to all of the requirements and procedures that apply to routine volunteer allogeneic donors. This is because the units may be released and used for other patients if the intended recipient does not need them.
The FDA has established absolute minimum and maximum requirements for blood donors to qualify for donation. Match the appropriate value to each category which apply to ALLOGENEIC donation only.
Minimum donor weight (lbs): Minimum blood pressure (systolic): Maximum blood pressure (diastolic): Maximum temperature (degrees Celcius): Minimum hematocrit (%) -female
min weight-110
min systolic bp-90
max diastolic bp-100
max temp (C)-37.5
min hct-38
A person who takes a week-long vacation to a country where malaria is present is deferred from donating blood for how long?
a. 1 year if the person took anti-malaria prophylaxis
b. 1 year if the person had symptoms of malaria
c. 1 year regardless of symptoms or prophylaxis
d. 3 years if the person is bitten by mosquitos
e. no defferal unless in a high risk area for more than 24 hours
no defferal unless in a high risk area for more than 24 hours
This is the correct answer! Being in a country where malaria is present is not enough to cause a deferral, unless the person is actually in the area of the country where the CDC defines a high risk for malaria for more than 24 hours.
According to Dr. Mary Townsend in this week’s podcast, higher concern with attenuated vaccines are primarily because:
a. these types of vaccines are living organisms which have lost potency
b. these types of vaccines pose a CJD risk
c. these types of vaccines are not FDA approved
answer: these types of vaccines are living organisms which have lost potency
the attenuated vaccines in general do not pose a risk of CJD and are most often FDA approved. THe main concern is that the organism is living.
Females who have had recent pregnancy are deferred for:
a. 4 weeks from the end of pregnancy
b. 6 weeks from the end of pregnancy
c. 8 weeks from the end of pregnancy
d. 6 months weeks from the end of pregnancy
6 weeks from the end of pregnancy
A donor reveals during the private interview that they have a history of Psoriasis and use Soriatane as a treatment. How long would this donor be deferred from donating blood products?
3 years
A new college student presents to donate blood and annotates they received vaccinations recently. upon investigation during the private interview process, it was discovered that the donor received the varicella-zoster vaccination on August 3rd. Today is September 11th. How long is the donor deferred?
No deferral
