(M) Donor Selection Flashcards
familiarize the regulating agencies / accreditation
- CFR (code of federal regulations)
- CBER (Center for Biologics Evaluation and Research)
- AABB (American Association of Blood Banks)
- CMS (Centers for medicare and medicaid services)
- CLIA ‘88 (Clinical Laboratory Improvement Amendments of 1988)
- CAP (College of American Pathologists)
Definition of terms
regular donation; collected blood use for transfusion of another patient or individual
allogeneic donation
Definition of terms
The one who donates blood for his or her own use
Autologous Donation
Definition of terms
Same with allogeneic but unit collected is directed towards a specific patient
Directed Donation
Definition of Terms
Desired component of blood collected and centrifuged, and remaining elements subsequently returned to the donor
Apheresis Donation
Steps in blood donation
Step 1 : Donor registration
1. ____ ID
2. Donor fills up the donor ____.
3. Should fully identify the donor & link the donor to existing ____.
- Picture ID
- donor fills up the donor form
- Should fully identify the donor & link the donor to existing records
Donor history questionnaire form
- ____ personal information / data
- Medical ____ questions
- ____ awareness
- Donor’s informed ____
- Confidential Unit ____
- ____ Examination
- This can be ____ or by a trained donor historian
- Donor personal information / data
- Medical history questions
- AIDS awareness
- Donor’s informed consent
- Confidential Unit exclusion
- Physical Examination
- This can be self administered or by a trained donor historian
Step 2: Donor Selection & Screening
(enumerate the two steps)
a. Interview and Physical Examination
b. Pre-donation testing
Step 2: Donor selection and screening
- First Step in ensuring safety of our blood supply?
- What are the two considerations?
- Interview and physical exam
- Safe for the donor and beneficial to the recipient
Step 2: Donor Selection and Screening
Pre-donation counseling
1. ____ history assessment
2. knowledge of ____ and other ____
3. Donation information
4. ____ factor and knowledge
- Risk history assessment
- knowledge of HIV and other TTIs
- Donation information
- Psychosocial factor and knowledge
Step 2: Donor selection and screening
- Age limit for donors?
- Temperature?
- Pulse?
- 16 years and above (no upper age limit)
- ≤ 37.5 C
- 50-100 bpm
Step 2: Donor selection and screening
- Weight
- Hgb
* Women
* Men - Hct
* Women
* Men
1.equal to or more than 50 kg
2.Hgb
* Women : ≥ 12.5 g/dL
* men: ≥13 g/dL
3.Hct
* Women: ≥38%
* Men: ≥39%
Hgb maximum values
- Women : 17.2 g/dL
- Men: 18.5 g/dL
study the computation of the maximum draw for donors weighing less than the ideal weight (50kg)
Gaur
Types of donor deferral
- donor is unable to donate blood for a limited (specified) period of time
- Donor will never be eligible to donate blood
- Donor is unable to donate blood for an unspecified
- Temporary deferral
- Permanent deferral
- Indefinite deferral
Timing of donation or deferral
Antihistamine, Analgesic, Bronchodilators, Contraceptives, Decongestant, Food supplements, NSAID (except for platelet prep), Vitamins, Topical steroids
Anytime
Timing of donation or deferral
Anticonvulsant, betablockers, digitalis, growth hormone, psoriasis treatment, Tegison / etretinate psychosis drugs, insulin
permanent
Timing of donation or deferral
Antibiotic (after end of treatment), Proscar, Propecia, Acutane
one month
Timing of donation or deferral
Dutasteride / avodart (BPH)
6 months
Timing of donation or deferral
Anti-platelet activity
1. Feldene
2. Aspirin
3. Plavix / Ticlid
- 2 days
- 3 days
- 14 days
Timing of donation or deferral
- Soriatane
- Glutathione as prep for liver disorder
- Glutathione for cosmetics use
- Anti-hypertensive drugs
- 3 years
- permanent
- 1 year
- temporary (needs medical clearance)
Timing of donation or deferral
- COVID-19 Vaccine
- Killed toxoids or synthetic viral / bacterial / rickettsial vaccine
- Hepa A (non-exposure)
- Hepa A (w/ close contact)
- 14 days
- No deferral (anytime)
- Anytime
- 6 weeks
Timing of Donation / Deferral
- Tetanus immunoglobulin
- Rabies (post-exposure / bite)
- Hepa B (non-exposure)
- Hepa B (w/ close contact)
- one year from last dose
- one year from last dose
- 1 week after vaccination
- one year
Timing of Donation / Deferral
- Allogeneic whole blood donation (single unit)
- Allogeneic whole blood donation (two units of RBC donation)
- ≥ 8 weeks
- ≥ 16 weeks
timing of Donation / Deferral
Apheresis
1. platelet
2. Plasma (occasional)
3. Plasma (Serial)
4. Granulocyte
5. Double RBC autologous / allogenic
- 48 hrs
- 4 weeks
- 48 hours
- 48 hours
- 16 weeks
Timing of donation / deferral
- Pregnancy (existing / 6 weeks)
- Pregnancy (miscarriage / abortion)
- Malaria (lives in an endemic area)
- Previously diagnosed with malaria (done with treatment, symptom-free)
- History of travel from a malaria endemic area
- Surgery, Blood transfusion, tooth extraction, tattoo, ear piercing, acupuncture, close contact w/ a person w/ hepatitis, incarcerated receipt of clotting factors
- 6 weeks after delivery / 3 weeks after weaning
- accept
- 3 years
- 3 years
- 12 months
- 12 months
Timing of donation / deferral based on HARMENING
- CHD, CVD, RHD
- Confirmed positive for HBsAg, anti-HBc, anti-HCV, HTLV 1/2, HIV
- Cancer, leukemia, lymphoma
- IV drug users
- Blood diseases, hemophilia, SCA, kAPOSIS, Thalassemia, PCV
- deffered ; if without disability may be accepted
2-5. Indefinite
Timing of donation / deferral based on the A-Z guide DOH
- CHD, CVD, RHD
- Confirmed positive for HBsAg, anti-HBc, anti-HCV, HTLV 1/2, HIV
- Cancer, leukemia, lymphoma
- IV drug users
- Blood diseases, hemophilia, SCA, kAPOSIS, Thalassemia, PCV
- PERMANENT
- PERMANENT
- PERMANENT
- INDEFINITE
- PERMANENT
Timing of donation / deferral based on HARMENING
- Sexual contact with anyone with HIV/AIDS positive individuals
- Female who had sex with men who had MSM
- Treated for STD such as syphilis and gonorrhea
- 12 months
- 12 months
- 12 months after completion of therapy
Timing of donation / deferral based on DOH
- Sexual contact with anyone with HIV/AIDS positive individuals
- . Female who had sex with men who had MSM
- Treated for STD such as syphilis and gonorrhea
- indefinite
- indefinite
- permanent
timing of donation / deferral based on HARMENING
- MSM anytime since 1977
- Casual sex, sex with IVD user, sex for money / drugs
- From Central African Republig, Negeria, Chad, Congo, Gabon, Camerron
- Permanent
- Permanent
- Indefinite
Timing of Donation / Deferral based on the A-Z guide (DOH)
- MSM anytime since 1977
- Casual sex, sex with IVD user, sex for money / drugs
- From Central African Republig, Negeria, Chad, Congo, Gabon, Camerron
1-3. Indefinite
Step 2: Donor selection
What are the two tests done during the pre-donation testing
- ABO slide / tube method
- Hemoglobin
Step 2: Donor Selection
What are the two possible methods of hemoglobin testing for the pre-donation testing?
- Copper sulfate
- automated analyzer
Step 3: Donor phlebotomy
- Use ____ technique
* 70 % ____ alcohol
* ____ compound
. Use aseptic technique
* 70 % isopropyl alcohol
* Iodophor compound
Step 3: Bleeding / phlebotomy
- when do you label the blood bag
- Ask donor to open and close hand every ____ seconds
- Mix blood periodically every ____ seconds
- Fill ____ tubes
- during collection
- 10-12 seconds
- 45 seconds
- pilot tubes
Step 3 : bleeding / phlebotomy
- volume of a standard blood bag
- low volume range for a 450 mL bag
- low volume range for a 500 mL bag
- 450 mL
- 300 - 404
- 333 - 449
Step 3: donor phlebotomy
- tool used to mix blood from the segment with AC in the mother bag
- tool used to keep a close system / hermetic seal
- tube stripper
- automatic tube sealer
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What are included in the post donation screening?
- ABO
- Antibody
What are the 5 TTIs
- HIV
- HEPA-B
- HEPA-C
- SYPHILIS
- MALARIA
Mild, severe, or moderate?
- syncope
- decreased pulse
- hyperventilation
- vasovagal syncope
- Twitching / muscle spasm
- mild
- moderate
- moderate
- severe
- mild
Mild, Moderate, Severe?
1. loss of consciousness
2. shock
3. marked hyperventilation
4. Vomitting
5. fall in systolic bp
- mild
- severe
- severe
- mild
- moderate
Matching type
- Weakness, sweating dizziness, pallor, nausea and vomiting
- syncope
- twitching, muscle spasm
a. cold compress on back of neck
b. Remove needle and tourniquet, elevate legs above head, apply cold compress to forhead and back of neck
c. have donor cough
- b
- a
- c
Maching type
- Convulsion
- Hematoma
- Cardiac difficulties
a. apply pressure for 7-10 minutes, apply ice to area for 5 minutes
b. begin cardiopulmonary resuscitation, call for help emergency
c. call for help, prevent donor from falling from donor chair to prevent injury, ensure donor’s airway is adequate
- C
- A
- B
AUTOLOGOUS DONATION
familiarize the 4 collections
- preoperative collection
- acute normovolemic hemodilution
- intraoperative collection
- postoperative collection
Autologous donation
Preoperative collection
1. Hgb =
2. Hct =
3. Last donation must be within ____ hrs before surgery
4.ABO Rh is (required / not required)
5. Distinct label =
6. TTI is only if to be transfused ____ the collecting facility
Preoperative collection
1. Hgb = 11 g/dl
2. Hct = 33%
3. Last donation must be within 72 hrs before surgery
4. ABO Rh is mandatory
5. Distinct label = for autologous use only
6. TTI is only if to be transfused outside the collecting facility
Autologous Donation
Acute normovolemic hemodilution (ANH)
1. WB is removed, replaced with ____ / colloid before surgical blood loss
2. Indication =
3. Label =
4. Storage: ____ hrs RT ; 24 hrs ____C
5. Reinfusion (shed blood) is done on ____ order. last unit with the highest HCT
- WB is removed, replaced with crystalloids / colloid before surgical blood loss
- Indication : surgical blood loss
- Label = For autologous use only
- Storage: 8 hrs RT ; 24 hrs 1-6C
- Reinfusion (shed blood) is done on reverse order. last unit with the highest HCT
Autologous donation
Intraoperative collection
1. collecting and reinfusing blood lost during ____
2. Indication: cardiac, cardiothoracic, vascular major orthopedic surgery
3. Label:
4. Storage : ____ hrs RT; 24 hrs ____C
5. Risk =
- collecting and reinfusing blood lost during surgery
- Indication: cardiac, cardiothoracic, vascular major orthopedic surgery
- Label: for autologous use only
- Storage : 6 hrs RT; 24 hrs 1-6C
- Risk = DIC
Autologous donation
Post operative blood collection
1. blood is collected from a drainage tube at the ____
2. Indication:
3. Storage : ____ hrs RT; 24 hrs ____
4. Reinfused without processing; volume no more than ____
- blood is collected from a drainage tube at the surgical site
- Indication: cardiac and orthopedic surgery
- Storage : 6 hrs RT; 24 hrs 1-6C
- Reinfused without processing; volume no more than 1400 mL
Step 4: post donation processing
What are the four components?
- whole blood / red cell components
- platelet concentrate
- Fresh Frozen plasma
- cryoprecipitate
Arrange the following from the first to the last step
a. Post-donation care
b. Donor selection and screening
c. Donor Phlebotomy
d. Donor Registration
d, b, c, a