Donor Screening Flashcards by Kyra Catedral

sets detailed standards that go beyond the FDA’s minimum requirements.

These standards cover all aspects of blood banking, including donor eligibility, collection procedures, testing, blood processing, quality control, and record-keeping.

The American Association of Blood Banks

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sets standards for donor screening, blood testing, processing procedures, storage, and transportation.

Facilities must also meet Current Good Manufacturing Practices (CGMP) to be licensed by the FDA.

The United States Food and Drug
Administration

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CAP -
JCAHO -
NCLS -

College of the American Pathologists

Joint Commission on the Accreditation of Hospital
Organizations

National Committee for Clinical Laboratory Standards

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Two goals of screening

• Protect the health of the potential donor
• Protect the health of the potential recipient

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Donor screening

Registration

Health History Interview

Physical Examination

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• Documenting information for donor’s identity
• Prevent collection from an unqualified donor
• Contact information for test results or other relevant info

Registration

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Donation records include the fallowing:

• Donor’s fullname
• Permanent address/contact infa
• Date of Birth
• Gender
• Date of last donation

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donor must be atleast_____ years old:
if the state considers it as minor; parental consent is needed

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Date of last donation
•______ must elapse between whole blood danations
•_____ must elapse after 2-unit red cell collection
•______ must elapse after infrequent plasmapheresis
•______ must elapse after plasmapheresis, plateletpheresis and leukapheresis

8 weeks

16 weeks

4 weeks

2 days or more

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All prospective donors must be given _____describing the donation process and donor eligibility

Information about risks of_____

______must be available for donors not fluent in English or have hearing/vision impaired

educational materials

infectious diseases transmitted by blood transfusion

Communication material

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2 Categories:
1.) Questions intended to protect the DONOR
2.) Questions intended to protect the PATIENT/RECIPIENT

Could determine the DEFERRAL STATUS of the donor depending on their answers

Health History Interview

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Due to current regulatory requirements that may change in the future

INDEFINITE DEFERRAL

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Based on High Risk Behavior or a Positive Test Result
Ex. Hepatitis C

PERMANENT DEFERRAL

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No Waiting Time for Temporary Deferral

• Cholera
• Dipthteria
• Hepatitis B (Heptavax)
• Influenza
• Paratyphoid
• Plague
• Polio
• Rabies(Prophylaxis)
• RM spotted fever
• Tetanus
• Typhaid
• Typhus

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2 WEEKS - Temporary Deferral

Measles (RUBEOLA) vaccine
Mumps vaccine
Polio (oral vaccine
Typhoid (oral vaccine)
Yellow fever vaccine

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4 WEEKS - Temporary Deferral

German measles (RUBELLA) vaccine
Varicella Zoster (Chicken pox) Vaccine
West Nile Virus

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6 WEEKS - Temporary Deferral

Conclusion of pregnancy

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8 WEEKS - Temporary Deferral

Smallpox immunization

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Hepatitis BIG Vaccine, Rabies vaccine

Tattoos or permanent makeup (unless applied by state-regulated facility with sterile needles and ink that is not reused)

Mucous membrane or skin penetration exposure to blood

Sexual contact with an individual at high risk for HIV

Incarceration in a correctional institution for >72 hours

Completion of therapy for syphilis/gonorrhea

Transfusion of blood, components, human tissue, plasma-derived clotting factor concentrates

Human diploid cell-rabies vaccine after animal bite

12 MONTHS - Temporary Deferral

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Donors who have had sexual contact with anyone who:

Has used needles to take drugs NOT prescribed by a physician
Has taken clotting factor concentrates for a bleeding problem
Has HIV/AIDS or has had a positive test for HIV
Women who had sex with man has had sex with other men

12 MONTHS - Temporary Deferral

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• History of viral Hepatitis after the eleventh birthday

Indefinite/ permanent

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• Confirmed pastive test for hepatitis B surface antigen
• Reactive test to antibodies to hepatitis B core an more then one occasion
• Present ar past clinical or lab evidence of infection with Hep C virus, HTLV or HIV

Indefinite/ permanent

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• History of Babesiosis or Chagas Disease
• Family history of CJD
• Recipient of dura mater or human PGH
• Risk af vCJD

Indefinite/ permanent

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• Use of needle to administer nonprescription drugs

Indefinite/ permanent

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• *MSM since 1977 are… • Severe heart or liver disease

PERMANENTLY DEFERED

Recommended if donor would be eligible at a specific time in the future

TEMPORARY DEFERRAL

West Nile Virus

28 days

Malaria (Plasmodium spp.) • History of malaria:______ • Lived in endemic country for 5 consecutive years:_____ • Travel to endemic area: defer for _____from departure

3 years 3 years from departure 1 year

History of Babesiosis:

Indefinite deferral

History of Chagas disease:

Indefinite deferral

Leishmaniasis Travel to Iraq: defer for

1 year from departure

Variant Creutzfeldt-Jakob Disease

Indefinite deferral by geographic regions: • Lived >3 months in UK from 1980-1996 • Lived >5 years in Europe from 1980 to present

Creutzfeldt-Jakob Diease months in UK from 1980-1996 • Lived >5 years in Europe from 1980 to present Family history of Creutzfeldt-Jakob Disease, dura mater transplant, human pituitary derived Growth Hormone

indefinite deferral

Tegison Poses problems and complications on neonates

PERMANENT DEFFERAL

Soriatane : Treatment for severe psoriasis

3 YEARS DEFERRAL

Proscar Accutane

1 MONTH DEFERRAL

Avodart : Treatment for Benign Prostatic Carcinoma

6 MONTHS DEFERRAL

ASPIRIN- deferred for…

three days

Temperature Should not exceed_____ Blood Pressure Systolic and Diastolic BP should be____ Pulse - WB: no specifications Plasma:_____bpm Weight ______ ml per kilogram of the dr's weight _____lb (_____kg)

37.5 degrees Celsius within normal limits 50-100 Beats/ minute 10.5 mL 110 lb (50 kg)

HEMOGLOBIN LEVEL • allogeneic (regular) donors_____ • autologous donors_____

12.5 g/dL 11.0 g/dL

HEMATOCRIT • allogeneic (regular) donor • autologous danor

38% 33%

• ______ terms used for blood donated by individuals for anyone's use •_____ - donate blood for your own use only

“Allogeneic", "homologous" and "random donor" Autologaus

•_______- donor called in because blood/blood product is needed for a specific patient •______ - blood removed for medical purposes such as in polycythemia vera. NOT used for transfusion.

Recipient Specific Directed donation Therapeutic bleeding

If drop of blood floats,_______estimated Hgb → DEFFER DONOR

<12.5 g/dL

Bag Labelling

Primary Bag Satellite Bags Sample tubes Donor registration form

MOST IMPORTANT IN THE ACTUAL PROCESS OF BLOOD COLLECTION Make antecubital fossa as sterile as possible Normal skin flora may contaminate and can easily proliferate in blood inside the blood bag

Arm Prep and Venipuncture

Solutions for disinfecting venipuncture site

lodophor and 10% povidone-iodine • Disinfect with the use of both

Needle gauge

16-17 The higher the gauge, the smaller the bore Wide diameter (inversely proportional)

Usual donation time

8-12 minutes

DONATION TIME >15 minutes: not suitable for the preparation of

platelets, fresh frozen plasma, or cryoprecipitate

• Frequent mixing of blood is needed • Volume of blood withdrawn is monitored • ____ tubes are filled with blood samples before or after the procedure • Use of___in units which will be processed for component prep (Platelets)

2-4 tubes DIVERSION POUCH

Weakness, sweating, dizziness, pallor, nausea, vomiting

Remove needle and tourniquet; elevate legs above head; apply cold compress from back to the neck

Syncope

Cold compresses on back of neck

Twitching, muscle spasms

Have donor cough

Hematoma

Apply pressure 7-10 minutes; apply ice for 5 minutes

Convulsions

Call for help; ensure donor's airways are free

Cardiac difficulties

Call for emergency help

Post-Donation Avoid smoking for_____ avoid alcohol until_____ Drink more fluids for the next_____ If dizziness or fainting occurs,_____ Inform the blood center if any symptoms persist

30 mins; something has been eaten 4 hours lie down or sit with the head between the knees

Pre operative Collection _____should be obtained from patient (donor) ____age restriction Amount of blood determined by the_____ and ____ of the patient Hemoglobin:_____ Hematocrit:____

Informed consent No weight and size 11 g/dL 33%

Preoperative Collection Blood collection should be completed_____ before the surgery _____should be followed ______ and ____typing should be performed The units cant be crossed over to the general inventory

72 hours Proper labelling ABO and D

***Normovolemic Hemodilution*** Removing at least_____ units of blood at the beginning of the surgery Blood is removed and replaced with a _____ or ____solutions to restore fluid volume ***Blood is stored for reinfusion during or at the end of the surgery***

1 or more crystalloid or colloid

• Collection and reinfusion of shed blood

Blood Recovery

Whole blood is removed from the donor, component is separated by mechanical means and remainder of blood is returned to the donor

Apheresis

White blood cells are removed ***Requires drug or sedimenting materials*** to be given to the donor before collection

Leukapheresis

• Platelets are removed • 48 hours must elapse between donations • Donors should not undergo more than twice a week or more than 24 times a year • Platelet count: >150,000 uL

Plateletpheresis

Plasma is removed Donate ***once every 4 weeks***

Plasmapheresis

• 2 units of RBCs are removed • Performed using cell operator machine (closed system) • FDA requirement: donors are larger and have HIGHER HEMATOCRIT levels

Red Cell Apheresis

Plateletpheresis •____ are removed •____ hours must elapse between donations • Donors should not undergo more than____ a week or more than____ times a year • Platelet count:_____

Platelets 48 twice; 24 >150,000 uL

Red Cell Apheresis Males:_____ (130 lbs), 5"1' Females:____ (150 lbs), 5"5' HEMATOCRIT:_____ and above Donors deferred for______ after 2 units RBC donation

59 kg 68 kg 40% 16 weeks

Withdraw of blood from a patient for medical reasons

Therapeutic phlebotomy

Blood is removed from the patient Portion that might be contributing to a pathologic condition is retained The remainder is reinfused with a replacement fluid such a ____-

THERAPEUTIC APHERESIS colloid or Fresh frozen plasma

Immunohematologic Testings (2) Infectious Disease Screening (3)

ABO and D typing Antibody screen Syphilis Hepatitis virus HIV and others

ABO and D Typing Methods: (3) Any ABO and D typing discrepancies should be resolved before labelling the donor unit

Microplate Solid Phase Adherence Gel Test

Detects unexpected antibodies in the donor's plasma Most important antibodies detected are those produced after transfusion or pregnancy If clinically significant antibodies are present

Antibody Screen

Antibody Screen If clinically significant antibodies are present… _____ and______are not used for transfusion If used, antibody interpretation is required on the label of the component

PLASMA AND PLATELETS

Serologic Test for Syphilis Methods: (2) Confirmatory test: (1)

• Rapid plasma reagin • Hemagglutination test • Fluorescent treponemal antibody-absorption

Viral Hepatitis • Four current Hepatitis tests (4) • Confirmatory test: (1)

HBsAg, Anti-HBc, Anti-HCV, NAT (Nucleic Acid Amplification Test) Western Blot

Additional Tests (6)

West nile virus Cytomegalovirus Chagas Disease Malaria Babesiosis Prion Disease

Bacterial Contamination Most blood units at risk:______ (Normal skin flora) Most common reactions: (3)

PLATELETS Fever, shock, DIC

Transfusion Service Testing The only repeat testing required is (2)

• ABO on red cell products • D typing (IS) on D negative red cell products

Transfusion Service Testing do not require any testing (3)

Plasma products (Fresh frozen plasma) Cryoprecipitate Platelets

Transfusion Service Testing Donor samples must be stored at _______C at least _____ days after transfusion _____unit transfused today must save sprig for one week Many facilities will pull a sprig from each donor during processing and save all sprigs for____ days, regardless of expiration of unit

1-6 degrees Celsius at least 7 days ADSOL 49 days

Quarantine of prior collections from the donor Notification of facilities (eg hospitals) that receive products to quarantine prior collections Further testing of the donor Notification of recipients

Quarantine and Recipient Tracing (Look-Back)