Blood donation

BLOOD DONATION,
REGISTRATION,SELECTION, ADVERSE
DONOR REACTION
P SUNIL KUMAR
Haematology & Transfusion medicine
St.John’s Medical College Hospital, Bangalore10/13/2018 1
SUNIL KUMAR P , ST.JOHN'S MEDICAL
COLLEGE

• Blood collection is the most important and
essential function of blood transfusion service
and accordingly, its organization should be
given due attention.
• The source of blood for transfusion is from
blood donors.
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COLLEGE

TYPES OF BLOOD DONORS
• Voluntary donors
• Replacement or Relative donors
• Professional or commercial paid donors
• Directed Donor
• Autologous Donor
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COLLEGE

DONOR SCREENING
The donor screening process has four major aspects
• Registration
• Medical history
• Limited physical examination
• Simple laboratory tests
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COLLEGE

REGISTRATION
• Registration, consent of the donor, and
demographic information.
• Information should be complete and correct so that
the donor can be informed of any lab testing
abnormality or he/she may be called for future
donation.
• The Donors information include
Donor’s full name
Father/Husband’s name
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COLLEGE

Date of birth/Age
Gender-Male/Female
Residential and official addresses with phone
numbers
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COLLEGE

MEDICAL HISTORY
• Before taking medical history it is important to
inform all potential donors about health
conditions and high risk behaviors which make
them unsuitable to donate blood.
• The information should be displayed in the form
of posters in various languages.
• Pre-donation counselling by trained staff should
be made available, while maintaining privacy &
confidentiality.
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COLLEGE

• Pre-donation information should include:
High risk behavior and mode of transmission of
infectious agents
Donor self exclusion or confidential unit
exclusion for patient safety
Tests carried out on donated blood
Confidentiality of test results
Need for honest answers in view of window
period
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COLLEGE

Blood donation Questionnaire:
Are you at present in good health?
When did you eat last?
Are you taking any medicine?
Have you been vaccinated or immunized recently?
Have you ever suffered of fits, convulsions or
mental disorder?
Have you ever had jaundice or hepatitis?
Have you ever been positive for HBV or HCV?
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COLLEGE

Have you been in contact with a person suffering
from jaundice(hepatitis) during the past 6
months?
Do you know about AIDS?
Have you had any wrong relationship ?
Have you lost significant weight in last 6
months?
Have you ever been positive for HIV?
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COLLEGE

Advantages of standard medical
information questionnaire
It helps to collect the same information
systematically from each donor.
Donor clinic staff does not forget to ask some
important questions.
It helps donor clinic staff to make quick
assessment whether to accept, temporary defer
or permanently reject the donor.
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COLLEGE

Respiratory infections
Cold, flu, cough, sore throat or acute
sinusitis
Defer untill all symptoms subside and
temperature normal
Chronic sinusitis No deferral unless using antibiotics
Asthmatic attack 1 week after last attack if chest is clear
Asthmatics on steroids Defer
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COLLEGE

Pregnancy and Abortion
Pregnant or recently delivered Defer for 6-months after delivery
Abortion Defer 6 months after abortion
Breast feeding Defer till baby is on breast feeding
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COLLEGE

Surgical Procedures
Major surgery 6 months after recovery
Minor surgery 3 months after recovery
Open heart surgery-including By-pass
surgery
Permanently defer
Cancer surgery Permanently defer
Localized skin cancer that was removed 6 months after removal
Tooth extraction or dental manipulation Defer for 3 days
Dental surgery under anaesthesia Defer for 1 month
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COLLEGE

Heart Diseases
Has any active symptom (chest
pain,shortness of breath, swelling of
feet)
Permanently defer
Restricted activity Permanently defer
Cardiac medication Permanently defer
High blood pressure controlled with
medicine
Acceptable if B.P normal
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COLLEGE

Cardio-Vascular Diseases
Myocardial infarction Permanently defer
Coronary artery disease Permanently defer
Angina pectoris Permanently defer
Rheumatic heart disease with residual
damage
Permanently defer
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COLLEGE

Seizures
Fainting, convulsions & Epilepsy Defer, if not taking medicine or free from
seizures for more than 2 years can be
accepted after evaluation
Endocranial Disorders Permanently defer
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COLLEGE

INFECTIOUS DISEASES
Viral Hepatitis
Has had hepatitis(Jaundice) other than
Hepatitis A, Positive test for
HepatitisB(HBsAg), Hepatitis C(HCV)
Permanently defer
Exposure to hepatitis by tattoos,acupuncture
or body piercing
Defer for 12 months
Worked in renal dialysis Defer for 12 months
Received transfusion of blood and its
components
Defer for 12 months
Close contact with individual suffering with
hepatitis
Defer for 12 months
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COLLEGE

HIV Infection / AIDS
High risk group donors for HIV infection
Anti-HIV positive donor
Donors having symptoms of AIDS
Permanently Defer
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COLLEGE

Malaria 3 months after treatment(endemic)
3 years after treatment(Non-endemic)
Syphilis Defer for 12 months after rashes disappear
& completion of therapy
Tuberculosis Defer for 5 years after cessation of
symptoms and treatment
Fever Defer till fully recovered and off
medication
Kidney diseases
Acute infection of kidney
Chronic kidney diseases
Defer for 6 months
Permanently defer
Digestive system
Stomach ulcer
Chronic liver diseases with impaired organ
Permanently defer
Permanently defer
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COLLEGE

Vaccination and Inoculation
No waiting period
before donation if
symptoms free
Two weeks
deferal
Four weeks deferal Twelve months
Tetanus
Diphtheria
Typhoid
Paratyphoid
Cholera
Influenza
Pertusis
Polio(salk)
Rabies as
prophylactic
Plaque
Smallpox
Polio oral(sabin)
Measles
Mumps
Yellow fever
Anti-tetanus serum
Anti-venom serum
Anti-diphtheria serum
Anti-gas gangrene
serum
Rubella
Anti-rabis
vaccination
HBIG
Gamma globulin
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COLLEGE

Medicines
MEDICINES Accepted/ Defered
Oral contraceptives
Analgesics
Vitamins
Mild sedatives and trans
Accepted
Aspirin taken in last three days Not accepted if blood be used for preparing plt
Isotretinoin(accutane) used for acne Defer for 1 month after the last dose
Finasteride (used to treat benign prostate
hyperplasia)
Defer for 1 month after the last dose
Oral anti-diabetic drugs with no vascular
complication
Acceptable
Diabetics on insulin Defer while taking the drug
Antibiotics Defer for 4 days & till symptoms free
Cortisone Defer for 7 days after the last dose
Medicine to treat hypercholesterolemia Accepted10/13/2018 22
COLLEGE

Immunosuppressive drugs
Anticonvulsions
Anticoagulants
Antithyroid drugs
Cytotoxic drugs
Permanently Rejected
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COLLEGE

Other conditions Requiring Permanent
Deferral
• Abnormal bleeding tendency
• Blood coagulation disorder like Hemophilia
• Sever allergic disorder
• Thalassemia
• Polycythemia vera
• G6PD
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COLLEGE

PHYSICAL EXAMINATION
General appearance Good health
Age 18-60 years
Weight 45 kg-(8-9ml)-can give 350 ml
60kg or more-450 ml
Blood Pressure Systolic 100-140 mm
Diastolic 70-90 mm
Pulse 60-100 beats per min, regular
Temperature Should not exceed 37.5
Donation interval 12 weeks (Males)
16 weeks (Females)
Donor skin Free from any lesion or scar of needle
pricks10/13/2018 25
COLLEGE

LABORATORY TESTS
HEMOGLOBIN
The Hb should not be less than 12.5 g/dl and not
more than 18 g/dl.
Methods:
 Specific gravity method
Sahlis method
Cyanmethemoglobin method
Hemo-Cue method
ABO and Rh (D) Blood Grouping
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COLLEGE

Pheresis Donor Selection
• The donor selection requirements for a pheresis donor
are generally the same as those for a whole blood donor
 Weight – More than 55 kg
 Platelet count – More than 1.5 lakhs/cumm
 Interval between 2 platelet apheresis procedures:
At least 48hrs must elapse between successive apheresis
procedures and not more than twice/week and not more
than 24 times/year.
 Plasma proteins estimation should be more than 6 g/dl.
 No aspirin and related drugs within 3 days prior to
apheresis.10/13/2018 27
COLLEGE

ADVERSE DONOR REACTION
 Although the blood donation process is usually safe and
uncomplicated, occasionally donors experience adverse
reactions during or after donation; but they are usually
harmless. In general, if adverse reaction occur:
1. Remove BP cuff and withdraw needle from the donor’s
vein at the first sign of reaction. Put sterile swab and apply
pressure.
2. Call for assistance from other personnel/medical officer.
3. If possible ,remove the donor to an area where can be
attended in privacy.
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COLLEGE

Donor adverse reactions are:
Syncope (fainting or vasovagal syndrome)
Tetany (Twitching or Muscular spasm)
Nausea and vomiting
Hematoma
Convulsions
Cardiac problems
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COLLEGE

Syncope
• The symptoms may include
sweating,weakness,dizziness,pallor,loss of
consciousness,convulsions,and involuntary passage of
urine and faeces.The skin is usually cold,blood pressure
falls and the pulse becomes thready.
Management:
a. Place the donor on his/her back and raise yhe legs above the level
of the donor’s head.
b. Loosen tight clothings.
c. Ensure adequate air-way.
d. Administer inhalation of aromatic spirit of ammonia.
e. Apply cold compresses to donor’s head.
f. Check the blood pressure, pulse and respiration until donor
recover.
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COLLEGE

Tetany
• Anxiety and deep breathing may cause the
excited donor to loose of carbon dioxide,which
may cause tetany charecterized by twitching or
mscular spasm due to hyperventilation.
Management:
a) The donor is asked to breath into a paper bag
which brings prompt relief.
b) Do not give oxygen.
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COLLEGE

Nausea and vomiting
Management:
a. Make the donor as comfortable as possible.
b. Ask the donor to breath slowly and deeply.
c. Turn the donor’s head to a side to avoid
aspiration of vomits.
d. If donor vomits, provide suitable receptacle
and towel or cleansing tissues.
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COLLEGE

Hematoma
Management:
a. Remove the BP cuff. Ask the donor to open the
fist and withdraw the needle from the vein.
b. Place 3 or 4 sterile gauze pieces or cotton swabs
over the hematoma and apply pressure for 7-10
min with the donors arm held above the heart
level.
c. Apply ice to the area for 5 min.
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COLLEGE

Convulsions
• True convulsions are very rare.
Management:
a. Prevent the donor from injuring
himself/herself.
b. Place tongue blade between the teeth to
prevent him/her from biting the tongue.
c. Ensure adequate air-way.
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COLLEGE

Cardiac problems
• Serious cardiac problems are extremely rare in
the blood donor
• If the donor is in cardiac arrest, begin CPR and
continue until medical aid arrives.
• The nature and treatment of all adverse
reactions should be noted in the donor’s
record.
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COLLEGE

• Any Questions ………………..??
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COLLEGE

Referrence
• Transfusion Medicine Technical Manual by
World Health Organisation.
• Priciples & Practice of Transfusion
Medicine,Dr.(Prof.)R.N.Makroo.
• Modern Blood Banking and Transfusion
Practices, Fourth Edition by Denise
M.Harmening
10/13/2018 37
COLLEGE

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