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  • 1. Unit Tabung Darah, Hospital Sultanah Nora Ismail DOCTORS REFERENCES FOR MOBILE BLOOD DONATION
  • 2. Unit Tabung Darah, Hospital Sultanah Nora Ismail
  • 3. Unit Tabung Darah, Hospital Sultanah Nora Ismail BLOOD DONATION PROCESS • Blood Donation Process begins from donor registration until the completion of blood donation. • Each Blood Donation process estimated about 30mins to 1 hour for each donor depends on numbers of donors. BLOOD DONOR REGISTRATION HB & BLOOD GROUPING BP MEASURING & COUNSELLING BLOOD DONATION BEG DISTRIBUTION AWAITING TURN FOR BLOOD DONATION BLOOD DONATION IN PROGRESS (5-10Mins)
  • 4. Unit Tabung Darah, Hospital Sultanah Nora Ismail
  • 5. Unit Tabung Darah, Hospital Sultanah Nora Ismail BASICS REQUIREMENT AGE > 18 ------------------------------------------------------------------ Follow Malaysian Regulation Healthy, No sign of Infection, and Free from any sickness WEIGHT > 45kg ---------------------------------------------------------- Blood Volume depend on weight and body surface HB > 12.5 g/dL ----------------------------------------------------------- Standard Hemoglobin level for blood donation Last donation at least 2 -3 month (8weeks) apart ------------- To give adequate duration for the blood volume to recovered after last donation GENERAL QUESTION • Donor is well • Enough sleep • Not empty stomach. WHY: To ensure donor is general well enough to sustain stress during blood donation PLEASE ASK THE DONOR • Any problem during last donation? • Do she / he receive any call from blood bank before, because of reactive results? • Do she / he received any counseling session before and was informed that she / he was permanent deferred form blood donation NOTES  Donor must be healthy on day of donation  Do not accept for donor with • Fever , Flu • Productive cough, sore throat • Any sign/symptoms of infections WHY: We want to make sure the donated blood is free from any infectious disease, which may bring harm to the patient. Blood Pressure, High Acceptable as long as your blood pressure is below 140 systolic and below 100 diastolic Blood Pressure, Low Acceptable as long as you feel well when you come to donate. If your blood pressure normally runs low, it may be more difficult for your body to adjust to the volume loss following donation, especially if you are dehydrated. Drinking extra water before and after donation is important. MEDICATIONS / INJECTIONS CHRONIC DISEASE – DM/HPT Acceptable for donation if on mono-therapy and without complication (Eg: DM with ESRF) Not allow for donation if already on multiple drugs ON ANTIBIOTICS Only allow for donation 1 week after completed antibiotics and completely recovered from underlying infection. VACINATION / IMMUNISATION Only can allow for donation, if already > 3 – 4 weeks
  • 6. Unit Tabung Darah, Hospital Batu Pahat NOT ALLOW FOR DONATION IF : • During menstrual period – Must at least 5 days after & before menstrual bleeding. • During pregnancy (only allow donation, after 6 months post-delivery) • Lactating women (Blood donation may influence affect breast milk product) • Major operation / Blood Transfusion (only allow donation after 6months) • Recent dental surgery (only allow for donation if > 3 months) • Recent tooth extraction (only allow for donation if > 24hours) • Underlying Hematological Disorder (G6PD deficiency, Thalassemia Major/Minor/Traits, Bleeding disorder) – not allow for donation • History of malignancy/ Cancer / Tumor – not allow for donation • High risk behaviors – not allow for donation ACCEPTABLE FOR BLOOD DONATION : Hypercholesterolemia Acceptable. Medications to lower the cholesterol level do not disqualify you from donating. Bronchial Asthma Acceptable as long as you are not having difficulty breathing at the time of donation and you otherwise feel well. Medications for asthma do not disqualify you from donating. Hormone Replacement Therapy (HRT) Women on hormone replacement therapy for menopausal symptoms and prevention of osteoporosis are eligible to donate. Birth Control (OCP) Women taking birth control pills are acceptable. Menopause Women Acceptable for Donation INFECTIOUS DISEASE (Please refer to the guidelines by Pusat Darah Negara for other infections/diseases) • Chicken Pox / Measles — Acceptable for donation if already recovered & more than 3 months • Dengue Fever – Acceptable for donation if already recovered & more than 6 weeks • Tuberculosis – Acceptable for donation if already completed TB treatment & no relapse for more than 5 years NOTES: 1) For donor with borderline Hb, please supply donor with iron tablets and other vitamin 2) Donor with suspected Hypertension, please refer to Klinik Kesihatan for monitoring and further management IMPORTANCE : • Donor may fainted during after donation • Often due to vasovagal attack • Usually donor will regained consciousness within 5 minutes • Please lie down the donor, raise up the lower limbs and assess the conscious level of the donor
  • 7. Unit Tabung Darah, Hospital Sultanah Nora Ismail 45kg & above Last Donation > 8week Make sure all donor personal details was completely filled and clearly written
  • 8. Unit Tabung Darah, Hospital Sultanah Nora Ismail
  • 9. Unit Tabung Darah, Hospital Sultanah Nora Ismail Keterangan berkenaan Soalan 14 telah di jelasakan dan difahami oleh Penderma. --------------------- --------------------- Tandatangan Tandatangan Penderama Penderma 1 2 3
  • 10. Unit Tabung Darah, Hospital Sultanah Nora Ismail Allow 300ML • Body weight < 50kg • Hb < 12.8 • First time donation for female Allow 450ML • Body weight > 50kg • Hb > 12.8 Please write down the reasons if the donor was not allow for blood donation. 4
  • 11. Unit Tabung Darah, Hospital Sultanah Nora Ismail BLOOD DONATION CRITERIA (Alphabetical Order)
  • 12. Unit Tabung Darah, Hospital Sultanah Nora Ismail A Acupuncture Donors who have undergone acupuncture treatments are deferred from donating for 6 months. Age You must be at least 18 years old to donate. Alcohol Acceptable as long as you are not under the influence of alcohol, because alcohol intoxication can affect ability to understand and answer the donor questionnaire and declaration, and to tolerate blood withdrawal. Allergy, Stuffy Nose, Itchy Eyes, Dry Cough Acceptable as long as you feel well, have no fever, and have no problems breathing through your mouth. Antibiotics Acceptable after week completed antibiotics. Because certain antibiotics may be teratogenicity. Angina To protect your health and safety, you are not eligible to donate blood Antidepressants Taking an antidepressant is generally not a cause for deferral as long as you are physically well. However, if you are taking a dosage above the recommended maximum prescribed level you may require assessment. Aspirin See “Medications” Asthma Acceptable as long as you are not having difficulty breathing at the time of donation and you otherwise feel well. Medications for asthma do not disqualify you from donating. Auto immune Diseases You are not eligible to donate if you have some types of generalized auto immune disease such as multiple sclerosis.
  • 13. Unit Tabung Darah, Hospital Sultanah Nora Ismail B Birth Control Women taking birth control pills are acceptable. Breast Feeding Lactating women with child less than 4months are not allow for blood donation, because breast production required good blood supply and adequate nutrition. Blood donation can cause temporary reduction in breast milk supply. Blood Pressure, High Medicines for the control of blood pressure are acceptable, providing your blood pressure is adequately controlled, stable and you are not experiencing any side effects related to your medication. Blood Pressure, Low Acceptable as long as you feel well when you come to donate. If your blood pressure normally runs low, it may be more difficult for your body to adjust to the volume loss following donation, especially if you are dehydrated. Drinking extra water before and after donation is important. Blood Transfusion Wait for 6 months after receiving blood transfusion. Concerning of blood transfusion transmitted infectious diseases. Blood pressure is partly determined by your blood volume. If you suddenly remove a pint of blood without replacing the volume, it is normal for BP to go down (less blood in the same space = lower pressure) Your BP is low, but that is probably normal for you, and is just fine. Taking a pint out, though, would likely drop your BP to the point where you won’t adequately perfuse your vital organs. This can cause fainting, heart problems, kidney damage and other bad things. If you were injured and had a major blood loss, you might see adverse effects more quickly. However, if you are young and otherwise healthy, your sympathetic nervous system would kick in big time and the adrenaline would probably keep your BP high enough to keep you going. People who have high blood pressure are at risk if they lose a lot of blood because of something called auto regulation. Their organs are used to the higher pressures, and they are unable to tolerate pressures that would be normal for you.
  • 14. Unit Tabung Darah, Hospital Sultanah Nora Ismail C Cancer In most cases, the Blood Service accepts people who remain free of cancer 5 years after the completion of treatment. The 5 year deferral is to protect the donor's health by ensuring as far as possible that the cancer is gone and will not recur. 5 years is the period most often used by cancer doctors to define a presumed cure. However, people with a history of cancers such as leukemia, lymphoma and myeloma that involve the blood production system directly, are permanently excluded from donating for the benefit of their own health. Cholesterol, high Acceptable. Medications to lower the cholesterol level do not disqualify you from donating. Clotting Disorders If your blood does not clot normally, you should not donate since you may have excessive bleeding where the needle was placed. For the same reason, if you are taking any "blood thinner" (such as coumadin or heparin) you should not donate. If you are on aspirin, it is OK to donate blood. However, you must be off of aspirin for at least 36 hours in order donate platelets by apheresis. Cold, Flu, Sore Throat Wait if you have a fever or a productive cough Wait if you feel unwell on the day of donation. Wait until you have completed antibiotic treatment for sinus, throat or lung infection. Creutzfeldt-Jakob Disease (CJD) If you ever received a corneal (eye) transplant, a dura mater (brain covering) transplant or human pituitary growth hormone, you are not eligible to donate. Those who have a close blood relative who had Creutzfeld-Jacob disease or who is in a family that has been told they have a genetic risk for Creutzfeld-Jacob disease are also not eligible to donate. Learn more about CJD. Creutzfeldt-Jakob Disease, Variant (vCJD); "Mad Cow Disease" See under Travel Outside of U.S. Learn more about vCJD and blood donation.
  • 15. Unit Tabung Darah, Hospital Sultanah Nora Ismail D Dental Procedures Acceptable after teeth cleaning, scaling, root canal, fillings and tooth extractions as long as there is no infection present. Wait until 1 week after finishing antibiotics for a dental infection. Depression, Anxiety Acceptable as long as you feel well and comfortable with the blood donation process. Medications for depression or anxiety do not disqualify you from donating. Diabetes mellitus Acceptable for blood donation if on not more than one type of OHA Not acceptable for blood donation if already on insulin therapy. Not acceptable for blood donation if already with underlying diabetic complications (E.g. DM with ESRF) Donation Intervals Wait at least 8 weeks between whole blood (standard) donations.
  • 16. Unit Tabung Darah, Hospital Sultanah Nora Ismail E Epilepsy, Seizures Yes, if you have not had a seizure for at least 3 years. In some cases we may require a letter of approval from your doctor.
  • 17. Unit Tabung Darah, Hospital Sultanah Nora Ismail H Heart Disease In general, acceptable as long as you have no restrictions on your physical activities, take no medications for heart disease other than aspirin, and have no current (within the last 6 months) heart-related symptoms such as chest pain. Hematological malignancy/disorder Not eligible for donation Hemoglobin, Hematocrit, Blood Count Acceptable if you have hemoglobin at or above 12.5 g/dL. Hepatitis, Jaundice If you had hepatitis (inflammation of the liver) caused by a virus, or unexplained jaundice (yellow discoloration of the skin), since age 11, you are not eligible to donate blood. This includes those who had hepatitis with infectious mononucleosis. Hepatitis Exposure Wait 6 months after close contact with someone who is sick with viral hepatitis. Close contact is defined as sexual contact or sharing the same household, kitchen, dormitory, or toilet facilities HIV, AIDS No eligible for blood donation Hormone Replacement Therapy (HRP) Women on hormone replacement therapy for menopausal symptoms and prevention of osteoporosis are eligible to donate.
  • 18. Unit Tabung Darah, Hospital Sultanah Nora Ismail I Immunization, Vaccination Refer to Blood Donation Guidelines of National Blood Bank Intravenous Drug Use No eligible for blood donation
  • 19. Unit Tabung Darah, Hospital Sultanah Nora Ismail M Medications In almost all cases, medications will not disqualify you as a blood donor. Your eligibility will be based on the reason that the medication was prescribed. As long as the condition is under control and you are healthy, blood donation is usually permitted. There are a handful of drugs that are of special significance in blood donation. Persons on these drugs have waiting periods following their last dose before they can donate blood: Accutane (isoretinoin), Proscar (finasteride), and Propecia (finasteride) - wait 4 weeks. Avodart (dutasteride) - wait 6 months from the last dose. Aspirin, no waiting period for donating blood. However you must wait 48 hours after taking aspirin or any medication containing aspirin before donating platelets by apheresis. Chemotherapy-type drugs used for conditions other than cancer ( examples: bleomycin, interferon, methotrexate) - wait 4 weeks from last dose. Coumadin, heparin or other prescription blood thinners- you should not donate since your blood will not clot normally. If your doctor discontinues your treatment with blood thinners, wait 5 days before returning to donate. Human pituitary-derived growth hormone at any time - you are not eligible to donate blood. Lupron used for condition other than cancer - wait 4 months from last dose. Plavix - wait 48 hours after taking this medication before donating platelets by apheresis. Soriatane (acitretin) - wait 3 years. Tegison (etretinate) at any time - you are not eligible to donate blood. Ticlid wait 48 hours after taking this medication before donating platelets by apheresis. If you ever took Tegison (etretinate), you are not eligible to donate blood. If you ever took human pituitary-derived growth hormone, you are not eligible to donate blood. If you take aspirin, you can donate blood. However you must wait 48 hours after taking aspirin or any medication containing aspirin before donating platelets by apheresis. If you take Ticlid or Plavix, wait 48 hours after taking these medications before donating platelets by apheresis. If you are taking prescription blood thinners such as Coumadin or heparin, you should not donate since your blood will not clot normally. If your doctor discontinues your treatment with blood thinners, wait 5 days before returning to donate. Menopause women Acceptable for donation Menstruation Not advisable for donation
  • 20. Unit Tabung Darah, Hospital Sultanah Nora Ismail P Piercing (ears, body), Electrolysis Wait for 6 months. This requirement is related to concerns about hepatitis. Learn more about hepatitis and blood donation. Pregnancy Persons who are pregnant are not eligible to donate. Wait 6 months after delivery.
  • 21. Unit Tabung Darah, Hospital Sultanah Nora Ismail S Skin Disease, Rash, Acne Acceptable as long as the skin over the vein to be used to collect blood is not affected. If the skin disease has become infected, wait until the infection has cleared before donating. Taking antibiotics to control acne does not disqualify you from donating. Surgery Acceptable for blood donation after 6 months post-surgery.
  • 22. Unit Tabung Darah, Hospital Sultanah Nora Ismail T Tattoo Wait for 6 months after a tattoo. This requirement is related to concerns about hepatitis. Learn more about hepatitis and blood donation. Transfusion Wait for 6 months Transfusion. This requirement is related to concerns about blood transfusion transmitted infectious disease. Tuberculosis Completed TB treatment and no relapse for 5 years
  • 23. Unit Tabung Darah, Hospital Sultanah Nora Ismail W Weight The amount of blood your body contains is proportional to your weight. Where a standard donation represents too high a proportion of your blood volume, you will be unable to donate. If you donate whole blood you need to weigh at least 45kg, and if you donate plasma or platelets by apheresis, you need to weigh at least 50kg. If your weight is less than 45kg you are not eligible to donate, because both blood service and international experience has shown that young donors who weigh less than 50kg are at increased risk of fainting during or following blood donation
  • 24. Unit Tabung Darah, Hospital Sultanah Nora Ismail GUIDELINES FROM PUSAT DARAH NEGARA
  • 25. Unit Tabung Darah, Hospital Sultanah Nora Ismail
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  • 27. Unit Tabung Darah, Hospital Sultanah Nora Ismail
  • 28. Unit Tabung Darah, Hospital Sultanah Nora Ismail
  • 29. Unit Tabung Darah, Hospital Sultanah Nora Ismail Drugs That Affect Platelet Function* Nonsterodial anti-inflammatory drugs (NSAIDs) Psychotropics and anesthetics Aspirin Tricyclic antidepressants (ie, imipramine) Ibuprofen Phenothiazines (ie, chlorpromazine) Mefenamic acid Local and general anasthesia (ie halothane) Indomethacin Cox-2 inhibitors Chemotherapeutic agents Mithramycin Antimicrobials Daunorubicin Penicillins Carmustine Cephalosporin Nitrofurantoin Miscellaneous agents Hydroxychloroquine Dextrans Amphotericin Radiographic contrast Quinidine Cardiovascular agents Ethanol B- Adrenergic blockers (ie, propanol) Vasodilators (ie, nitropursside, nitroglycerin) Foods Diuretics (ie furosemide) Caffeine Calcium channel blockers Garlic Cumin Anticoagulants Turmeric Heparin Coumadin Antiplatelet drugs Lepirudin Phosphodiesterase inhibitors Argatroban Dipyridamole Bivalirudin Cilostazole Thrombolytic agents Adenosine diphosphate receptor antagonists Streptokinase Ticlopidine Urokinase Clopidogrel Tissue plasminogen activator Glycoprotein lib/lilA antagonists Abciximab Eptifibatide Tirofiban *Adapted from George JN, Shatt1l SJ. N Engl J. Med. 1991; 324:27-39.

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