3. Blood Donation, Blood Collection & Transfusion

4. Introduction: - In order to protect the donor as well as the recipient, each blood donor must be screened by: Medical history. Limited medical examination. - Early attempts to transfuse blood were sometimes successful, but sometimes the patient died

5. BLOOD DONATIONS The Red Cross Blood Service says that anyone can become a blood donor, as long as they are: In good health; Able to meet the Blood Service’s medical guidelines:

6. Aged between 16 and 70 years of age. At least 50 kg in weight. donors who are not pregnant Temperature:37οC or 99ο F Pulse: 50-100 beats/ min/ regular. Hemoglobin: Male: not less than 13.5 g/dl Female : not less than 12.5 g/dl

7. Hematocrit: ==Not less than 41% in male. ==Not less than 38% in female. Specific gravity: > 1.055 = male and >1.o53 = female Blood pressure: ==Systolic = 90 -180 mmHg. ==Diastolic = 50 – 100 mmHg

8. Deferral (not allowed for blood donation)

9. Permanent: HIV patients. Viral hepatitis. Jaundice of unknown cause. Malignant tumors. Leukemia. Fainting Abnormal bleeding tendency. Known HBsAg tests. Serious cardiopulmonary disease.

10. Temporary: (conditions required rest or medications) Cold. Flu. Diabetes. T.B. Syphilis. Others:

11. 3 years: Malaria. Anti-malaria. 1 year: sever illness. 6 months: Major surgery. Injection of blood or components. 2 months: rubella vaccine. 8 weeks: previous blood donation.

12. 6 weeks: after termination of pregnancy. 2 weeks: Small box. Measles. Mumps Yellow fever vaccine. Oral polio vaccine.

13. 72 hours: Oral dental. Minor surgery. 48 hours: Aspirin consumption by donor who to be only the source for platelet.

14. Identifications: Name Address Tel No Age Sex I.D No.

15. What does it involve? Donating blood is safe and easy. It takes about an hour of your time altogether. When you go to donate you will first need to complete a detailed health history questionnaire about: Name: Age: Weight: Questions about health (if there are any current diseases, e.g. malaria, diabetes…etc). Previous and current medical conditions.

16. - After this, a nurse will go through the questionnaire with you and you will be asked to sign a declaration stating that you meet the medical guidelines designed to protect the health of both donors and recipients.

17. - The next step is a brief physical examination that includes: - Checking your blood pressure. - Pulse. - Haemoglobin (red blood cell) levels. If you pass the screening tests, the actual donation process — which takes between 7 and 10 minutes — begins.

18. Phlebotomy - Phlebotomy should be well-trained in a septic technique. - Material should be sterile. - The donor blood bags, sample tubes and donor record should be properly identified and labeled before drawing blood. - The venipuncture site should be free of skin lesions. - Plastic blood bags should be used, with additional outpost bags should be selected according to need.

19. Phlebotomy - Each bags should examined for defect of bags and anticoagulants inside it. - Also inspected for needle marks. - For donor over 50 kg, amount of blood drawn should be 450ml. - A maximum of 30ml blood sample is allowed for additional tests.

20. Y ou’ll be asked to sit in a reclining chair while a new, sterile needle connected to a plastic tubing and blood bag is inserted into your arm vein. One unit of blood (usually 470 mL) is collected and sent to the laboratory for testing and processing. After you have donated, you can sit back and relax with some light refreshments.

21. You don’t have to worry about ‘losing too much blood’ as you will have donated only about 8 per cent of your total blood volume. Your body typically replenishes the fluid lost in about 24-72 hours while the red blood cells lost are generally replaced in a few weeks.

22. Plasma donation Plasma donation is an automated process where the donor's blood is collected, the red cells and plasma are separated, and then the red cells are returned to the donor. If you donate plasma, you can donate more frequently because you are not giving your red cells. Donors can also donate platelets.

23. H ow often can I donate? - You can usually give whole blood every 12 weeks and plasma every 2 weeks. - The donor's body usually replaces the liquid part of blood (plasma) within 72 hours after giving blood. - It generally takes about 4–8 weeks to regenerate the red blood cells lost during a blood donation. An iron-fortified diet plus daily iron tablets can help rebuild a donor's red blood supply.

24. Dangerous of blood donation: Fainting of donor, occurs in 2% - 5% of donors in young, 1st time donation. Damage to vein-spasm, causing bruising of the vein. Donations more than three times in one year will lead to Iron Deficiency Anaemia.

25. When you start collection: Aseptic condition to avoid infection, wash hands, clean the place with alcohol, use one needle for one donor. Be careful in going in an artery.

26. Blood Transfusion: Blood transfusions, routine, fairly safe and sometimes taken-for-granted lifesaving procedures, were not medical options until the early 20th century when the major blood groups were discovered and carefully studied. Who needs blood transfusions? Blood from transfusions is used to stabilize a condition or to save the lives of people who have been in accidents or need surgery for other reasons. It is also used for people with cancer, haemophilia, leukaemia or other bleeding disorders.

27. How is blood used? Nowadays, whole blood is rarely used except in cases of sudden and severe blood loss. Instead, it is nearly always separated into its individual components and used for different purposes. Whole blood transfusion: 1.In the blood loss Extensive or acute, like in operations and accidents. 2.In Aplastic anaemia. 3.Correct anaemia. 4.Kidney dialysis.

28. 2- Washed Red blood cells after removal of WBC, are used for: Treating chronic haemolytic anaemia that can’t be helped by other medical treatments. For giving ‘top-ups’ to people after surgery or childbirth. 3- Platelets: The component of blood that helps control bleeding, are given to people with thrombocytopenia due to: Acute leukemia Lymphoma. ITP. Bone marrow transplant.

29. 4- Plasma or fresh frozen plasma (FFP), the clear fluid in blood, is often used to help people whose blood does not clot properly, such as: Dehydration Replace clotting factors. Hypofibrinogenaemia, or afibrinigenaemia. 5- Cryoprecipitate for clotting factors disorders: Hemophilia A. Hemophilia B. Hemophilia C. Von Weill brand's disease.

30. Blood group compatibility: Before a transfusion is performed, blood is ‘cross-matched’ to ensure the donor's blood is compatible with the recipient's blood. A person cannot safely be transfused with blood of a group containing antigens to which he or she has antibodies.

31. Autologous blood transfusions People who are expecting surgery and who do not wish to receive donated blood can make arrangements to be their own blood donor. In this procedure, your own blood is collected and stored ready for use during the surgery. Also in the cases of the rare blood groups.

32. Another option for blood transfusions is called directed donation. This is when a family member or friend donates blood specifically to be used by a designated patient. For directed donation, the donor must have a blood type that is compatible with the recipient’s. He or she must also meet all the requirements of a regular volunteer blood donor. There is no medical or scientific evidence that blood from directed donors is safer or better than blood from volunteer donors.

33. Keeping Blood Transfusions Safe All the donated blood should be detected for infectious and transmissible diseases. Each unit must be tested for: 1.Hepatitis B and C viruses (HBV and HCV) 2.Human Immunodeficiency Virus (HIV 1 and 2) 3.Human T-Lymphotropic Virus, Types I and II, 4.A history of intravenous drug abuse 5.Syphilis. 6.Cytomegalovirus: 7.Malaria. 8.ABO and Rh typing.

35. Collection and storage of the donated Blood: Anticoagulants: Citrate-phosphate-dextrose + Adinine (CPDA). Citrate: Anticoagulant. Phosphate is a substrate which is used a source of energy (ATP) required for RBC. Dextrose is used as substrate. Adenine: amino acid, required for RBC viability. This is the best anticoagulant for the blood transfusion, keeps the blood for about 35 days.

36. Acid-Citrate-Dextrose (ACD): Considered the stander solution for collection blood for transfusion since 1943. Citrate remove calcium, while dextrose provides the source of energy, and citric acid using for pH adjustment. Shelf life is about 21 day.

37. Citrate-Phosphate-Dextrose (CPD): Replaced ACD. Phosphate is contributing to ATP pool and thus improves the viability of RBC. Shelf life is about 21 day. Optimal Additive Solution (OAS): Contains saline, Adenine, Glucose and Manitol. SAGM provides good storage for RBC, keeps blood for 35 days.

38. Heparin, occasionally used for the use of pediatric surgery. Anticoagulant but not preservative. Advantage: no citrate toxicity. Blood must be used immediately, within 48h. And preferably within 24h.

39. Changes in stored blood: Certain percent of RBC are destroyed, in good anticoagulant only 10-20 % of RBC are destroyed. Blood become acidic or acidotic. Elevation in K concentration which is bad for heart. Platelets will die within few hours after collection. So there will no Plts. WBC are deteriorated also (no WBC in old blood). Activity of coagulation factors will be grossly reduced (VIII, V).