Blood banks use various processes to try to prevent infections that can be transmitted by infected blood donation. One important measure to prevent infection is to recruit donors from populations that are known to have low rates of infection for blood borne diseases, such as voluntary, unpaid donors and people with no history of intravenous drug use.The process for collecting blood from donors is similar to that used for blood sampling; however, a few additional measures are required for collection of donated blood. These measures are primarily to to minimize exogenous contamination of a donated blood unit or its derived components, particularly contamination from the skin flora of the donor's arm. Because of the volume or blood collected and the length of storage, pathogens can multiply during storage. Safe collection ensures that the blood products are safe for therapeutic use throughout their shelf life. Skin flora is a common source of contaminants; it is therefore important to use an effective antiseptic on the donor's arm before blood donation. Transfusion with blood components that are contaminated with exogenous bacteria or other agents can cause fatal complications ., the recommended option for skin antisepsis for blood donation is the one-step application of a combination of 2% chlorhexidine gluconate and 70% isopropyl alcohol for 30 seconds, followed by 30 seconds drying time . Blood donations should be collected only by trained and qualified blood transfusion services personnel. Equipment: All equipment used for collection of blood donations should be regularly calibrated, maintained and serviced, as required. Such equipment includes blood pressure monitors, scales, donor couches or chairs, blood collection monitors or mixers, blood bag tube sealers, blood transportation boxes and blood bank refrigerators.Equipment: All equipment used for collection of blood donations should be regularly calibrated, maintained and serviced, as required. Such equipment includes blood pressure monitors, scales, donor couches or chairs, blood collection monitors or mixers, blood bag tube sealers, blood transportation boxes and blood bank refrigerators. –Furniture and equipment in the area of blood donation and processing should be made of cleanable surfaces (e.g. vinyl rather than fabric). Containers used to transport supplies and specimens should also be cleanable by disinfectants such as sodium hypochlorite bleach solutions. Fabric or textile carriers should be machine washable.WHO has developed a set of basic requirements for blood transfusion services, which cover the steps to take before donation . Blood donation should be voluntary; it should not involve duress, coercion or remuneration. Also, potential blood donors should be selected carefully, according to the national criteria for donor selection.Step 2. Select the vein Select a large, firm vein, preferably in the antecubital fossa, from an area free from skin lesions or scars. Apply a tourni

1. BLOOD COLLECTION
PROCESS
PRESENTED BY – DR PRAGYA BHARDWAJ
MODERATED BY – DR AAKRITI BAIJJAL

2. CONTENTS
Registration
Donor selection-
• Medical history
• physical examination
Collection of blood
• Materials
• Method of venepuncture
Precautions to be taken while collecting blood
Storage
Post donation care and advice
Adverse donor reaction
Duties of blood bank
Referral mechanism of HIV sero- reactive blood donors to ICTC
Referral mechanism of other TTI sero- reactive blood donors to clinicians

3. MOST IMPORTANT AND ESSENTIAL
FUNCTION OF BLOOD
TRANSFUSION SERVICE.

4. REGISTRATION
 Confirm donor’s identity and link him to existing
records.
 Photographic identification – driver’s license,
passport, school identification card.
 Previous deferral if any.

5. THE REGISTRATION MUST INCLUDE THE FOLLOWING
INFORMATION:-
 Name (first, last, MI)
 Date and time of last donation
 Age( >/= 18)
 Gender
 Address
 Telephone
 Informed consent

6. ADDITIONAL INFORMATION:-
 Any other name used during previous donation.
 Race : for matching specific phenotypes
 In case of directed donations-
 Name and other identifiers of recipient.
 Order from recipient’s physician.
 If donor is blood relative then cellular component must be
irradiated.
 Unique characteristics- to make optimum use donation.
 Blood from donors who are seronegative for CMV/ who are O RH
negative is often designated for neonatal patients.
 Donors with clinically significant antibodies- their blood can be
processed in components that contain only minimal amount of
plasma.

7. DONOR SELECTION
 Based on two important things :
 Medical history
 Preliminary medical examination

8. MEDICAL HISTORY
 Give pre donation information before taking maedical
history.
 If the donor appears healthy
Medical history questionnaire is filled by donor or the
clinical staff( interviewer)
Evaluated by medical officer.

9. ADVANTAGES OF STANDARD MEDICAL
QUESTIONNAIRE
 Helps to collect same information systematically from
each donor.
 Clinical staff does not forget to ask important
questions
 Helps to make quick assessment whether to accept,
temporary defer or permanently reject the donor.

11. MEDICAL
QUESTIONNAIRE

12. PHYSICAL EXAMINATION
 It is important to make preliminary health check of
donors before donation and solely depend upon the
medical history told by the donor.
 The following parameters are checked
 General appearance
 The donor should be in good health.
 Age
 Between 18-65 years
 Weight
 45-55kg : 350 ml blood
 >/=55 kg: 450 ml blood
 Blood pressure
 Systolic : 100-140 mm Hg
 Diastolic : 60-90 mm Hg

13. PHYSICAL EXAMINATION
 Pulse
 60-100 bpm and regular
 Temperature
 Oral temperature not more than 37.5 degree celsius
 Physical assessment
 Check for skin rashes and swollen glands
 Check for needle prick marks at venepuncture sites
 Haemoglobin estimation
 12.5 g/dl – 17 g/dl

14.  Based on the medical history and examination,
the donors should be :
 Accepted
 Temporarily deferred
 Rejected

15. COLLECTION OF BLOOD
The area should be-
To make donors comfortable and relaxed

17. MATERIALS AND
METHOD

18. MATERIALS
 BLOOD COLLECTION
BAGS: 350 ML &
450ML( Single, double,
triple, triple ADSOL/
SAG-M, quadruple
ADSOL/ SAGM with or
without integral filter)
 anticoagulant in primary
bag – CPD or CPDA-1

20.  SPHYGMOMANOMETER
 STETHOSCOPE
 VACUTAINER TUBES FOR SAMPLE COLLECTION
 TEST TUBE RACKS
 COTTON WOOL SWABS
 SCALE FOR WEIGHING THE BLOOD COLLECTED IN
BAGS
 BLOOD MIXER
 TUBE SEALER, ROLLER, & CUTTER (DIELECTRIC
SEALER)

23.  ARTERY FORCEPS AND SCISSORS
 NEEDLE DESTROYER/ SHARP CONTAINER
 ANTISEPTIC SOLUTION
 BAND-AIDS
 SYRINGES & NEEDLES ( DISPOSABLE)
 EMERGENCY DRUGS ( FIRST AID KIT)
 LABELS

24. BEFORE STARTING THE PROCEDURE
 IDENTIFICATION:
 The blood collection bags & pilot tubes should be
identified by a specific donor registration number, so it
can be traced back to the donor and also to the
recipient.
 Review the donor records and ensure that the donor
name and the identification number match.

25.  LABELING:
 The phlebotomist should ask the donor to spell
his/her name.
 At this time, he must attach all labels to blood bags,
donor record and pilot tubes.
 The date of collection and expiry should be written
on the label of the bag.
 INSPECTION:
 Inspect the blood bags for any leakage, defects and
discoloration.

26. METHOD OF
VENEPUNCTURE
Inspect both the arms of donor
carefully and select a suitable large,
firm vein in the antecubital area.
The area should be free of any skin
lesions or scar marks.
Make the donor lie down on donor
couch accordingly.

27. Apply the cuff of BP apparatus
just above the cubital fossa
and inflate to 60-70 mm Hg
Ask the donor to make a fist to
make the vein more prominent.
Examine and palpate the
selected vein.
Release the pressure of cuff
and prepare the venepuncture
site.

29. ARM PREPARATION
Scrub an area of 3-4 inches dia in concentric spiral
manner from central to periphery first with spirit
iodine/ betadine leave for 30 sec scrub with spirit
again.
A LA injection of 1% lignocaine( 0.3 ml) may be given
intradermally at the site of venepuncture by 26 guaze
needle , local anesthetic spray can also be used.
Check the id number on donor bag and donor
registration card again
Position the bag below the level of donor arm on
weighing balance

30. If biomixer is used, adjust it for the amount of
blood to be drawn , pass the donor tubing through
the automated clamp and start the mixer.
Raise the pressure of the cuff to 70 mm hg to make
the vein prominent.
Clamp the tubing of the blood bag just close to the
needle and remove the needle cap.
Introduce the needle into the vein, remove the
clamp.
Now reduce the pressure of BP apparatus to 40-50
mm hg to allow free flow of blood into the bag.

31. To reduce bacterial contamination of blood , some
blood collection bags have sample diversion
satellite bag for collection of first 15 to 20 ml of
blood which is used for testing
Hold the needle in position with 2 pieces of tape on
the hub of the needle .
Ask the donor to open and close his /her hand by
squeezing rubber ball.
Ensure proper mixing of blood throughout donation
by biomixer or by gentle and periodical shaking.
Monitor the donor throughout the collection
process.

32. When the primary bag has tripped the
scale ,the donor can stops squeezing
and tubing can be clamped
The volume of the blood bag can be
indirectly inferred by weighing the blood
bag
The factor to convert the blood volume
to weight is 1.05 that is 1ml of blood =
1.05 g of blood
This formula can be used to calculate
the amount of blood to be collected
Total weight of bag =
(350x1.05)+Weight of empty blood bag
(450x1.05)+ Weight of empty blood bag

33. After required amount of blood is
collected in proportion with the amount of
anticoagulant, clamp the tube of the bag .
Deflate the cuff
Place the sterile swab on venepuncture
site , apply little pressure and remove the
needle from the vein.
Ask the donor to apply pressure over the
swab by the finger of the other hand
Collect sample from the tubing in pre
labelled pilot tubes.

34. Seal the tubing and cut distal to the seal to
separate the needle.
Strip the tubing with roller so that blood in the
tubing gets mixed with the blood in the bag.
Make a few segments in the tubing by
dielectric sealer or by clip . These segments
are used for compatibility testing.
Dispose off the needle safely in a sharp
container /destroy by needle destroyer before
putting it into a puncture proof container.
The blood bag is kept at 4-6 degree celcius
immediately after collection.

35. If platelets are to be harvested - kept at room
temp( 20-24 degree celcius) until platelets are
seperated.( done within 6-8 hrs of collection).
Collection process may mildly vary depending on
the type of blood bag being used.
Ask the donor to rest for atleast 5 min on bed,
check the venepuncture site for any bleeding and
apply bandaid .
Thank the donor for his / her contribution and
escort him / her to refreshment room .
Donor should take rest for minimum of about 15 –
20 min so that the body can adjust to the loss of
blood. He/ she should be encouraged to be a
regular donor.

36. PRECAUTIONS TO BE TAKEN WHILE
COLLECTING BLOOD FOR BLOOD
COMPONENTS.
 The blood is collected in blood bags with integral filter
containing suitable anticoagulant.
 Venepuncture should be clean with minimum trauma to
tissue to prevent initiation of blood clotting .
 The flow of blood - rapid and uninterupted .
 The collection should be completed in less than 15 min .
 The blood bags should be constantly but gently agitated
so that blood and anti coagulant are mixed thoroughly.
 The ratio of blood to anticoagulant should be correct ie.
 350 ml should contain 350 ml +/-10% of blood
 450 ml bag should contain 450 ml +/- 10% of blood .

37. STORAGE
 For preparation of FFP , Frozen plasma and
cryoprecipitate , the blood should be stored at
4-10 degree celcius till processed .
 For platelet rich plasma, platelet concentrate
and buffy coat , the blood should be stored in
an air conditioned room at 22-24 degree celcius
till processed.

38. POST DONATION CARE AND ADVICE
 Drink more fluids in the next 4 hrs.
 If there is bleeding from venepuncture site, raise the arm and
apply pressure until the bleeding stops.
 If bleeding continues, donor should contact the blood bank.
 If the donor feels dizzy, he should be made to lie down with
both legs raised( if symptoms persist, donor should contact
blood bank).
 Remove band aid after 10-12 hrs.
 Donor should avoid strenuous exercise for the next 24 hrs post
donation.
 Avoid smoking for half an hour after donation.
 Don’t consume exessive alcohol before the next meal.
 TAKE NOTE OF ANY ADVERSE REACTION IN THE DONOR
RECORD SO THAT DUE CARE CAN BE TAKEN AT THE
NEXT DONATION.

39. ADVERSE DONOR REACTIONS
 Rare but can occur either during donation or after
donation.
 The clinical staff should be well trained to recognise
and treat them without delay .
 Common problems encountered in donation –
1. Difficulty in blood flow.
2. Vasovagal syndrome with or without loss of
consciousness .
3. Hyperventilation
4. Convulsions
5. Accidental puncture of artery

40. DIFFICULTY WITH BLOOD FLOW
 It may be due to
 Spasm of the vein
 Reduced cuff pressure
 Occlusion of the lumen of the needle by vein wall or by the valve
within the vein.
MANAGEMENT
Give reassurance to the donor and check the cuff pressure.
 Do little positioning of the needle.
 Avoid excess manipulation as this can result in hematoma.
 If it does not help, remove the needle and discard the bag.
 If donor agrees , further venepuncture on the other arm
may be attempted provided a suitable vein is found.

41. HEMATOMA
 It is a localised collection of blood under the skin ,
resulting in bluish discoloration
 Caused by needle going through the vein with leakage of
blood into the tissue .
MANAGEMENT
 Stop the donation and give reassurance to the donor.
 Place a sterile guaze over hematoma and apply firm
pressure until blood stops oozing.
 Apply anti inflammatory cream and pressure bandage for
24 hrs.
 Suggest NSAID in case there is pain.

42. VASOVAGAL SYNDROME( REACTIONS)
MILD CASES- MODERATE CASES
 Sweating - Loss of consciousness
 Anxiety - Nausea and vomiting
 Rapid thready pulse
 Pallor and dizziness
 Cold skin with fall in BP.

43. MANAGEMENT
 Stop donation
 Raise the legs of donor and lower the head
 Loosen tight clothing
 Ensure adequate airway
 Provide suitable receptacle if donor vomits, turn his/
her head on one side to avoid aspiration of vomitus.
 Move the donor to another room to prevent other
donors from apprehention.

44. HYPERVENTILATION
 Hyperventilation results in lowering of CO2
 This may lead to twitching or tingling sensations.
MANAGEMENT
 Ask the donor to breathe quickly and slowly.
 If this fails to relieve the spasm ,ask the donor to
breathe into a paper bag ,it will bring prompt relief.

45. CONVULSIONS
 Associated with vasovagal syncope or reduced blood flow
to the brain.
MANAGEMENT-
 Prevent the donor from injuring himself.
 Keep a tongue depressor between the teeth to prevent
the donor from biting his tongue.
 Ensure adequate airway.
 Put screens around to maintain privacy.
 Check the pulse frequently.
 Loosen tight clothing.
 Doesn’t stop after 5 minutes, call medical specialist.
 After recovery, give reassurance to the donor and advise
him not donate blood in future.

46. ACCIDENTAL PUNCTURE OF ARTERY
 Very rare.
 There is fast flow of bright red blood.
MANAGEMENT:-
 Stop donation immediately.
 Apply hard pressure to puncture site for min. 15-20 minutes.
 Raise the limbs above the heart level.
 Give reassurance to the donor and record the finding in
donor card.
 Allow the donor to leave only when senior member of
clinical team is satisfied about his well being.

47. DUTIES OF A BLOOD BANK
 Not the primary duty of blood bank or BTS to confirm the
diagnosis of the TTI screened for.
 Sero- reactive blood units should be discarded complying
with biomedical waste management rules 2016.
 Sero- reactive donors shall be recalled & offered post
donation counselling.
 They are then referred for further counselling, confirmation &
management to appropriate facility.
 Results shall not be disclosed over the telephone.

48.  A standard referral format should be used.
 Blood bank shall maintain all records of recall and
referral.
 Signatures are to be taken on consent form so as to
avoid litigations in the future if screening test results
are found to be false positive during confirmatory
tests.
 If the initial sero- reactive donor does not return to
blood bank after 3 consecutive weekly attempts, the
list of HIV sero- reactive blood donors should be
shared with the linked ICTC under shared
confidentiality under guidance from state AIDS
control society.

49. REFERRAL MECHANISM OF HIV SERO-
REACTIVE BLOOD DONORS TO ICTC:
 Testing strategy used in blood bank “Strategy 1”
 The blood unit is subjected to a high sensitivity test for
HIV reactivity.
 If non reactive - free for HIV.
 HIV positive blood donors referred to ICTC for
counseling and confirmation.
 Maintain confidentiality

50. REFERRAL MECHANISM OF OTHER TTI
SERO-REACTIVE BLOOD DONORS
 Blood donors, found sero-reactive for HBV, HCV,
Syphilis, Malaria are referred to clinicians for
assessment and retesting.
 Blood Bank shall fill referral form as per standard
format.
 Maintain Confidentiality.

51. .

52. BIBLIOGRAPHY
Modern blood banking & transfusion
practices- DENISE M. HARMENING
Principles & practice of transfusion
medicine- DR R. N. MAKROO
AABB Standards for blood banks and
transfusion services