MUNICIPAL CORPORATION OF DELHI(HEALTH DEPARTMENT)“Rational/Safe use of Blood & Blood Products”Presented By :Dr. P.P. Singh,Consultant Pathologist& Director Project, MCD
BLOOD INTERESTING FACTS•There is no substitute for human blood•O positive is most common blood group.•Blood group O is “ universal donor “ and is frequentlyrequired•AB negative is most rare blood type.•A person can donate blood every 3 months.•After donation , blood volume begins replacing itself withinhours.•ONE DONATED UNIT CAN SAVE SEVERAL LIVES.
INTRODUCTION•Blood Transfusion history is not very old. Occasional use of animal and human bloodwithout cross matching•1900 Karl Landestinar identified A.B.O. Grouping.•1940 RH typing•1954 Blood Banking/ Immunohemotherapy recognized•Approx. 300 type blood group systems. However, only few are important.•Safe Blood and Blood product are basic requirement of Health Care Programme.•In Delhi the requirement of Blood is approx. 3 lakhs unit per year and Collection is2.2. Lakhs. So, there is a shortage
BASIC PRINCIPLES(a) Blood Donation must be harm less to donor.(b) Blood Donated must not be harmful to Recipient ratherBeneficial.
Basic ComponentsA. Blood Banking• Collection• Processing• Preservation• Preparation & Distribution of Blood and BloodComponentsB. Hemotherapy• Selection• Preparation• Transfusion of appropriate Blood,& Blood components foreach individual patients.
Blood & Blood Products.•Antibodies•Preservatives•Antigen•Contamination• Transfer of Infection from Donor toRecipient•Any septic condition
Types of Blood Donors1. Relative Donors2. Voluntary Donors3. Professional Donors4. Self (Auto transfer)
Transfusion Re-action (CAUSES)A Hemolytic Reaction• Mismatch• Defective RBC of patients• Defective Heart Valve Prosthesis• D/W during prostate surgery• Toxins in patients like Clostridium welchi, Seversepticemia• G6PD defectB. Reaction related to Blood Components• Leukocytes/ PlateletsC. Related to Plasma ProteinD. Anticoagulant overloadE. Temperature
F. Disease TransmissionHepatitisSyphilisMalaria/FilariaAIDSBrucelosisToxoplasmosis etc.etc.
Selection of Blood DonorsEach Donor must be screened prior to each Blood Donation by MedicalHistory and Physical ExaminationAge- 18-55 yearsBody weight- 110 Lbs (45 Kg.)Temp.- Normal/Less then 37.50C or 99.50FPulse - 50-100 per minute RegularB.P. -Diastolic 50-100 mm Hg.Systolic 90-180 mm. Hg.Hemoglobin-13.0 gm./dl. (Male)12.5 gm./dl.(Female)
Deferment of DonorA PermanentMalignant TumorLeukemiaConvulsionsSever Cardio pulmonarydiseaseKnown positive HBs Ag.Post transfusion HepatitisB. TemporaryCold,Flu,Diabetes,TuberculosisSyphilis& other infections.
For 1 Year.:- Severe illness,therapeutic rabiesvaccine.For Six Months :- Close contact with Viral Hepatitis,tattoo,Injection of blood & bloodproducts, malaria.For Two Months :- German Measles vaccination.For 8 Weeks :- Previous blood donation.Foe 6 Week :- Post MTP.For 2 Week :- Vaccination Or Serum Products.For 72 Hours :- Dental or minor surgery,Test for Allergy.For 48 Hours :- Plasmapheresis, Aspirine use.
Mandatory for Blood Bank“Blood is a drug covered under the Drug andcosmetic act 1940 modified in 1989”1.License2.Testing forHepatitis B screeningHIV antibodies screeningVDRL/RPR for SyphilisTest for MalariaHepatitis C ?
Type of Blood Whole Blood Plasma (Fresh Frozen Plasma) Packed Red Cell Washed Red Cells Leukocyte poor Red Cell Platelets Concentrate Cryoprecipitate or AHF Albumin 5% , 25% Specific Immunoglobulins (Anti-Rh D) Massive Transfusion
Some facts about Blood TransfusionBlood Donation in India•Voluntary donation accounts for 40%of total blood donated ;rest are replacement donation.•Most voluntary donors are students and youths ( 40-50%).•Female donors are very small ( 2-6%).•Most people donate on humanitarian grounds ( 74.7%).•About 26% people are unfit for donation due to any reason.•Maximum blood comes from mobile vans.•Most people are unable to donate because of unsuitable timingand place.
Precautions at time of Transfusion1 Proper identification2 Intra venous fluid-- Only N/S5% Dextrose- HemolysisRinger solution – Clotting3 Filters- Standard 170 ù, Nylon Laxan Plastic MeshPlatelets- 40 ù Special - 13-100 ù4 Blood Warmer5 Speed of Infusion - 60 drops per minute or150 ml.to 250 ml. Per hours6. Monitoring of the patients.
S.No. BloodComponentsQuantity Shelf life Indication1 Whole Blood 450 ml 21 days (ACD)35 days(CPD_Adenine)Brisk activebleeding2 Red Blood Cell 280 ml - do - Anemias, slowblood loss.3 Washed RedCell250 ml 1 day. Prevention offebrile nonhemolyticreactions.4 Frozen thawedRBC250 ml 3 years in freezer1 day afterwashing.Rare blood,5 Plateletconcentrate30-50 ml 3 days Hemorrhage,Platelet disorder
S.No. BloodComponentsQuantity Shelf life Indication6 Cryoprecipitate 10 ml 1 year Factor VIII,Fibrinogen7 Factor IX 500 ml 1 year Factor IXdeficenciency8 Albumin5%,20%250-500 ml50- 100 ml3 years Burns. Hypovolemicshock,hypoprotienemia9 Immunoglobulinserum2-10 ml 3 years As antibodiessuppliment.10 Anti-Rho(D) 300 ug 1I/2 years Prevent Rho(D)immunization
Conclusion :1 Blood is life ? Or is Blood fatal ?The answered depend on the type of Blood a patientreceives - Infected with deadly virus orsafe & free from any infection.2. By Rational & Safe Blood Methods, not only re ensurethe safety of the patient but also be will have enoughblood for all needy.