What is BLOOD? What are the differents components and their functions in the living beings.

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DauRam Chandravanshi B.Pharma 3rd Sem. S.V.I.T.S. BILASPUR (C.G.) Page1
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Introduction
Each year more than 14½ million units of whole blood are collected and 5 million patients
are transfused with blood components in the United States. (Source: The 2007 National
Blood Collection and Utilization Survey Report; 2007 is the most recent year for which
data are available.) Each unit is generally divided into three components: red cells,
platelets and plasma. Most of the red cells are transfused to patients undergoing surgical
procedures. Patients with leukemia, lymphoma, myeloma, myelodysplastic syndromes and
myeloproliferative neoplasms (blood cancers) frequently receive platelets and some red
cells; they may require more blood components overall than surgical patients because their
need is likely to continue over a period of weeks or longer. In addition, most patients who
undergo marrow or blood stem cell transplantation will be transfused.
The most frequently asked questions about blood transfusion relate to
the safety of the blood supply (see page 8)
Diseases that can be transmitted by blood components (see page 9)
Other complications that may occur following blood transfusion and what is being done to
reduce those risks (see page 16).
Sticky, opaque fluid with a metallic taste (Fe2+)
•Varies from scarlet (PO2= 100) to dark red (PO2= 40)
•pH is between 7.35 and 7.45
•Average volume in an adult is 5 L (7% of body weight)
–2 L = blood cells (formed elements)
–3 L = plasma fluid portion of blood (ECF)
•Functions include:
–Substance distribution
–Body protection (clotting and immunity)

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Components of Blood
Centrifugation separates blood based on density
•Plasma (least dense) ~58% of whole blood volume–92% H2O, 7% Proteins, 1% dissolved
substances (organic molecules,ions, gasses)•Formed Elements(cells)–Buffy coat(platelets
and leukocytes (WBCs))•less than 1% of whole blood volume –Erythrocytes (red blood
cells (RBCs))(most dense)•42% of whole blood volume–Hematocrit(Hct)–1 μL =
1/1,000,000 L of blood contains:•5,000,000 RBCs•4,000 –11,000 WBCs•150,000 –
450,000 platelets
Blood Cell Formation (Hemopoiesis)
elements is accomplished by the processes of mitosis and differentiationof stem
cellscalled hemocytoblastsin red bone marrowof the humerus and femur, flat bones and
coxa
•The pathway of differentiation of hemocytoblasts depends on the levels of circulating
hormones or growth factors that guide the hemocytoblastdown a particular line of
development

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rythrocytes (RBCs)
iconcavedisc shape with a diameter of 7.5 μm,
•Very flexible
–folds in order to move through some blood vessels that have a diameter smaller(5.0 μm)
than the RBC
•Membranous “bags” filled with enzymes and Hb
–no mitochondria (anaerobic fermentation only)
–no nucleus or endoplasmic reticulum
•no protein synthesis to make new enzymes, Hbor membrane components
•leads to increased loss of membrane flexibility making older cells more fragile and prone
to rupture
–life span of an erythrocyte in circulation is ~120 days whereby they are removed by
macrophages of the spleen and liver

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Erythropoiesis
•In a healthy adult, the number of new RBCs entering circulation equals the number of old
RBCs removed from circulation (approximately 2,500,000 per second)
•An increase erythropoiesisis required during times of lowoxygen content in blood
(hypoxemia) due to:
–decreased RBCs (anemia)
–decreased oxygen availability (at high altitudes)
–increased tissue demand for oxygen (exercising)
•The liverand kidneyssecrete the hormoneerythropoietin(epo) in response to hypoxemia
–erythropoietin stimulates the differentiation of hemocytoblasts into erythrocytes
•increases RBCs
•increases the oxygen carrying ability of the blood

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Platelets
•Cell fragments of a megakaryocytein bone marrow–contain many granules filled with
clotting proteins and cytokines–activated following blood vessel damage •release clotting
proteins and cytokines to participate in blood clotting (hemostasis)
Hemostasis
Bleeding stops in a 3 step process
•Vascular spasms
–vasoconstriction temporarily decreases blood flow in damaged blood vessel limiting
blood loss
•Platelet plug formation
–platelets in the vicinity of the injured blood vessel become activated which causes them
to stick to the collagen and one another
•Coagulation
–series of enzymatic reactions that activates blood proteins called clotting factors
–ends in the formation of fibrin (protein fiber mesh that stabilizes the platelet plug)

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–substances called anticoagulantsinterfere with coagulation can be used inside or outside
of the body

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Leukocytes (WBCs)
Primary cells for the immune systemresponse that functions to protect the body from
foreignantigens(substances that trigger an immune response)
–pathogen
•disease producing biological agent
–allergen
•substance that causes an allergic reaction
•Exit blood vessels functioning extravascularlywhere they live within tissues for a few
hours to many months
•Leukocytes found in blood in the following proportions:
–60% NeutrophilsNever
–30% LymphocytesLet
–8% MonocytesMy
–2% EosinophilsEngine
–0.4% BasophilsBlow
Agranulocytes–lack visible cytoplasmic granules–have spherical (lymphocytes) or kidney-
shaped (monocytes) nuclei

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Lymphocytes
•B lymphocytes
–develop in bone marrow where they may be dormant or active
–active B cells differentiate into plasma cellswhich secrete antibodies into blood to bind to
and immobilize foreign invaders
•Antibodies are Y-shaped protein molecules which recognize and bind to foreign antigens
–Y-shape enables molecule to bind to 2 antigens simultaneously
•When an antibody binds to an antigen it causes agglutination
–clumping of cells, held together by antibodies as observed in a blood transfusion reaction
–cells are then typically destroyed by the cells of the immune system
When an antibody binds to an antigen it causes agglutination–clumping of cells, held
together by antibodies as observed in a blood transfusion reaction–cells are then typically
destroyed
Blood Disorders

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Blood is essential for life. It carries oxygen and nutrients to every part of the body. Blood
also fights infections and heals injuries. Therefore, disorders of the blood can have a great
effect on your health.You can protect your health by understanding the symptoms of
common blood disorders. If you think you may have one of these conditions, talk to your
doctor. With early diagnosis and the right treatment, many women with blood disorders
are able to live full and healthy lives.
Blood disorders are diseases that af-fect one or more parts of the blood. The symptoms
depend on the part of the blood affected:l Bleeding disorders prevent the blood from
forming clots, which
stop bleeding after an injury. (See pag-es 106 and 107 for more information on different
bleeding disorders.)l Clotting disorders cause blood to clot too easily, creating a condition
called thrombophilia (throm-boh-FIL-ee-uh). (See page 109 for more information
Causes OF blood disorders
Many blood disorders are inherited. If you have a history of a blood disorder in your
family, you might have a higher risk of developing the disorder yourself or carrying the
gene for the disorder. Blood disorders may also be caused by:l other diseases or
conditionsl the side effects of medicationsl a lack of certain nutrients in your dietBlood
disorders can be acute or chronic. Acute blood disorders occur suddenly and last a short
time. For example, rapid or excessive blood loss may cause acute anemia. Once the
bleeding is stopped and blood levels return to normal, the anemia is cured.A chronic blood
disorder is a disorder that develops slowly or lasts a long time. Many chronic disorders,
such as sicklecell anemia, cannot be cured. But the symptoms can be treated.It is important
to have blood disorders diagnosed and treated as early as pos-sible. Proper treatment can
relieve symp-toms and prevent complications.

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Bleeding disorders
If you have a bleeding disorder, your blood may not clot normally. The chart on pages 106
and 107 describes several common bleeding disorders that affect women.
Causes of bleeding disorders
Some bleeding disorders are inher-ited, including von Willebrand disease (vWD)
and hemophilia (hee-muh-FIL-ee-uh). If there is a history of bleeding problems in
your family, talk to your doctor. You may need to be tested.Other factors that
prevent or slow clot-ting include:
certain types of drugs—including as-pirin, nonsteroidal anti-inflammatory drugs
(NSAIDs), antibiotics, and che-motherapy drugsl a lack of vitamin Kl other disorders,
including autoimmune (aw-toh-ih-MYOON) diseases, bone marrow disorders, leukemia,
thyroid disease, Cushing syndrome, and liver and renal diseases
Symptoms of bleeding disorders

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Bleeding disorders often cause unusual bleeding of the female reproductive system. You
may have heavy menstrual bleeding. If you have a reproductive disorder that causes
bleeding, such as endometriosis (EN-doh-MEE-tree-OH-suhss), a bleeding disorder can
make your symptoms worse. (See page 158 of the Reproductive Health chapter for more
information.)
Other symptoms of bleeding disorders are:
l bleeding or bruising easily
l bleeding too much or for a long time
l nosebleeds
Getting diagnosed
Mild bleeding disorders often go undiagnosed. Because women normally bleed with
menstruation and childbirth, it may be hard for you or your doctor to recognize abnormal
bleeding.
Discuss your symptoms with your doctor. You may need to be tested for a bleeding
disorder if you:
l have heavy menstrual bleeding
l have a history of bleeding disorders in your familyThese are symptoms that your
menstrual bleeding might be heavier than normal:
l soaking through a pad or tampon every hour for 2 to 3 hours in a row
l blood clots more than 1 inch in diameter
l anemia (See page 109 for more information.)
You may need to consult a hematologist, a specialist in blood disorders, for additional
blood tests. Tests for one of the most common disorders, vWD, may be uncertain. You
may need repeated testing to find out if you have vWD.
Pregnancy

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Pregnancy boosts levels of proteins that help the blood to clot. This may help control
bleeding. However, levels of these clotting proteins will still be lower than normal. If
you have a bleeding disorder, you may be at risk for problems during pregnancy such
as:
• miscarriage or stillbirth
• bleeding during pregnancy
• heavy bleeding after childbirth

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Treating bleeding disorders
Inherited bleeding disorders cannot be cured. But treatments can:l relieve symptomsl prevent
dangerous bleeding during or after surgery or dental workl prevent complications during and
after pregnancyThe treatments below can reduce blood loss. Your treatment plan will depend on
the type of bleeding disorder you have and your symptoms.l Birth control pills may help reduce
menstrual bleeding.l Desmopressin acetate (dess-moh-PRESS-uhn A-suh-tayt) is a drug that can
control menstrual bleed-ing and prevent excessive bleeding during and after surgery or dental
work.
l Antifibrinolytics (an-teye-FEYE-bruhn-uhl-IHT-ihks) are drugs that keep clots from breaking
down. They can help reduce menstrual bleeding, nosebleeds, and excess bleeding from surgery
or dental work. l Clotting factor concentrates—medi-cines that provide extra factors to help
blood clot—may improve symptoms when other treatments don’t work.Heavy menstrual
bleeding can interfere with your personal and professional life. If the treatments above don’t help
con-trol this symptom, there are surgeries that can permanently stop menstruation. However,
these surgeries will cause you to be unable to get pregnant.Talk to your doctor about the risks
and benefits of treatments. You may need to try several treatments to find out what works best
for you.
Common Bleeding Disorders in Women
von Willebrand Disease (vWD)
Causes vWD is the most common inherited bleeding disorder. It is
caused by deficiencies or defects in von Willebrand Factor
(vWF). vWF is a substance in the blood that helps clots to form.
Symptoms
•
Heavy bleeding during periods (the most common symptom)
• Bruising easily
• Prolonged or excessive bleeding after dental work or surgery
•
Excessive postpartum bleeding
Diagnosis
•
Blood tests can measure vWF activity in your blood.
• Hormones and medications affect vWF levels, making
diagnosis difficult.
• If you have symptoms but your blood tests are negative for
vWD, you may need to be tested again.
Treatments
vWD cannot be cured, but the following treatments may relieve
your symptoms:
• Birth control pills
• Desmopressin acetate

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• Antifibrinolytics
• Clotting factor concentrates
• Surgery to stop menstruation
Common Bleeding Disorders in Women
Hemophilia Carrier Status
Causes Hemophilia is caused by an inherited genetic mutation on the X
chromosome. If men inherit this trait, they have hemophilia, a
severe bleeding disorder. Women who inherit this mutation are
carriers of the disease—they do not have hemophilia, but they
may pass the disease on to their children.
Symptoms Most hemophilia carriers do not have symptoms. Some women
have mild bleeding symptoms, such as:• Heavy bleeding during
periods• Prolonged or excessive bleeding after dental work,
surgery, serious injury, or childbirth
Diagnosis If you have a family history of hemophilia, genetic testing can
determine whether you are a carrier.
Treatments Hemophilia cannot be cured. The following treatments can stop
or prevent excessive bleeding:• Birth control pills•
Desmopressin acetate • Antifibrinolytics• Clotting factor
replacementScientists are studying gene therapy, which may
treat, or even cure, hemophilia in the future.
Thrombocytopenia
Causes Thrombocytopenia (throm-buh-syt-uh-PEE-nee-uh) is a condition
in which there are too few platelets in the blood. It is caused by
medications and by other diseases, including:• Anemia•
Leukemia• HIV• Disorders such as Gaucher’s disease that
cause the spleen to become enlarged and trap platelets•
Disorders in which platelets break down too quickly
Symptoms • Bruising easily• Heavy bleeding during periods• Bleeding
under the skin and bleeding of the gums and digestive tract
Diagnosis Blood tests can detect low platelet levels. Additional testing
may be needed to find the cause.
Treatments The underlying cause must be treated.

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Clotting disorders
If you have a clotting disorder, your blood may clot too easily. This condition is called
thrombophilia (throm-boh-FIL-ee-uh). It may cause blood clots to form in veins and sometimes
in arteries.
These clots can move through the blood-stream and block small blood vessels.
Causes of thrombophilia
Thrombophilia may be inherited or ac-quired. Common causes include gene
mutations, protein deficiencies, and cer-tain autoimmune disorders.If you have thrombophilia,
some condi-tions or drugs can increase your risk of clotting
: heart failurel obesity, which puts pressure on veinsl pregnancyl using the birth control pill or
meno-pausal hormonal therapyYour risk can also be raised by sitting or lying in one position for
a long time, such as during recovery from surgery or sitting still during a long
Symptoms of thrombophilia
The main symptom is clotting in veins or arteries. Clots may cause swelling, pain, or
redness.Thrombophilia may cause blood clots to form in veins deep inside the leg. This is called
deep vein thrombosis (throm-BOH-suhss), commonly known as DVT. These clots can break
loose and block blood vessels in the lung. This is called a pulmonary embolism (PE). Symptoms
of PE are shortness of breath or sharp chest pains, especially when you inhale. Because the clot
stops the flow of blood,
PE can damage lung tissue and even cause death.Thrombophilia is a common disorder, affecting
about 1 in every 5 Americans. Many people with thrombophilia never develop clots. Because
pregnancy and medications that contain hormones in-crease the risk of blood clots, women are at
higher risk for clotting than men.
Gettingdiagnosed
If you have a personal or family his-tory of blood clots, DVT, or PE, talk to your doctor about
whether you should be tested for thrombophilia. You should also talk to your doctor before using

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the birth control pill, birth control patch, or menopausal hormone therapy. Finding out whether
you have the disorder can help you get the proper treatment.
Treatingthrombophilia
Inherited thrombophilia cannot be cured. However, blood-thinning drugs prevent excessive
clotting. You may need these drugs only when you are at high risk of clots—during pregnancy,
for in-stance. Some women need to take these drugs throughout their lives.
Common Clotting Disorders in Women
Thrombophilia
Causes Inherited conditions that cause
thrombophilia include:
• Mutated genes, such as Factor V
Leiden (LAY-din) mutation and
prothrombin (proh-THROM-bin) 20210
mutation
• A lack of certain blood proteins,
including protein C, protein S, and
antithrombin
• Hyperhomocysteinemia (heye-pur-
hoh-moh-siss-tuh-NEE-mee-uh), an
increase in an amino acid in the blood
caused by a mutation in the MTHFR
gene
Scientists are still studying how genes
contribute to thrombophilia. This
research may help to improve
diagnosis and treatment.
Thrombophilia may be caused by some
autoimmune disorders (see the
Autoimmune Diseases chapter on
page 83 for more information about
these diseases):
• Antiphospholipid (an-teye-FOSS-foh-
lip-ihd) antibody syndrome
• Systemic lupus erythematosus (LOO-

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puhss ur-ih-thee-muh-TOH-suhss)
Symptoms • Blood clots in veins or arteries, such
as deep vein thrombosis
• Pulmonary embolism
Diagnosis Blood tests can diagnose
thrombophilia and determine its
cause.
Treatments • Blood thinning drugs heparin and
warfarin can prevent future clots.
• Some women need to take blood
thinners only when they are at high
risk of a clot.
• Some women may need continuous
treatment.
Disseminated Intravascular Coagulation (DIC)
Causes DIC is a type of acquired
thrombophilia. Excessive clotting
depletes platelets and clotting
factors. DIC may be caused by:
• Severe infections
• Cancer
• Pregnancy complications, such as
placental abruption (the breaking
away of the placenta from the womb)
or a dead fetus that remains in the
womb
This clotting removes platelets and
clotting factors from the blood,
causing uncontrolled bleeding.
Symptoms • Blood clots throughout the
bloodstream
• Excessive bleeding
Diagnosis Blood tests
Treatments The cause of DIC must be treated.
Platelets and clotting factors are
administered to

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Anemia
Anemia is caused by a lack of healthy red blood cells. It is a common disorder, affecting
more than 3 million Americans. Women, especially women of childbearing age, are
more likely to have anemia than men. This is because women lose blood during
menstruation and childbirth.
Causes of anemia
There are many different types of anemia and a variety of causes, including:
l major blood loss
l lack of iron, vitamin B12, folic acid, or vitamin Cl diseases that damage bone marrowl inherited
disorders that cause defects in red blood cells l disorders that cause your immune sys-tem to
attack red blood cells
Symptoms of anemia
Anemia is a condition in which the number of healthy red blood cells in your blood is lower than
normal. This lowers oxygen levels in the blood. If you have mild anemia, you may not have
symptoms, or you may have symptoms only when you are physically active.
sickle celldiseas
Sickle cell disease is an inher-ited blood disorder. It
causes red blood cells to be crescent-shaped instead of
round. These sickle cells break down more quickly than
normal cells, causing ane-mia. Sickle cells may also block
blood vessels, a condition called a sickle cell crisis. Crises
cause pain and complications such as stroke, infections,
and organ damage.If you inherit two sickle cell genes, one
from each parent, you will have sickle cell disease. If you
inherit only one gene, you will have the sickle cell trait.
Although women with sickle cell trait may not have any
symptoms, they can pass the trait on to their
children.People whose ancestors are from sub-Saharan
Africa have the greatest risk of the disease.

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Symptoms include fatigue, dizziness, and shortness of breath
Getting diagnosed
If you experience these symptoms, talk to your doctor. Blood tests can find out whether you have
anemia. Additional tests may be needed to find the cause.
Treating anemia
Your treatment will depend on the type of anemia you have. In some cases, treat-ing the cause
will cure anemia. Inherited forms of anemia, such as sickle cell dis-ease, cannot be cured, but
treatments can relieve the symptoms and prevent com-plications. Scientists are studying new
medicines and treatments such as gene
therapy and bone marrow transplants. These may provide even better treat-ments for anemia in
the future.

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Bone marrow disorders
Some disorders damage bone marrow, where blood cells are produced. This may increase or
decrease the number of healthy cells in your blood, causing ex-cessive bleeding or clotting,
anemia, or increased fevers and infections.Myeloproliferative (MEYE-uh-loh-pruh-LIF-uh-ruh-
tiv) diseases and myelodysplastic (MEYE-uh-loh-diss-PLASS-tik) syndromes are bone
marrowdisorders that are most common among older adults. l Myeloproliferative diseases cause
too many blood cells to be produced. These cells may be red blood cells, white blood cells, or
platelets.l Myelodysplastic syndromes reduce the number of healthy blood cells. You may have
too few red blood cells, white blood cells, or platelets.
These disorders may turn into leukemia, a cancer that affects the bone marrow. (See page 58 of
the Cancer chapter for more information.)
Fertility and pregnancy
Many blood disorders cause complica-tions during pregnancy. You may also worry about
passing these disorders on to your children. Getting diagnosed be-fore you conceive can help you
protect your health and the health of your chil-dren. The following chart describes com-mon
fertility and pregnancy issues that women with blood disorders may face
Get diagnosed. If you have a family or personal history of blood disorders or symptoms, talk to
your doctor. You may need to be tested.l
. l Get the treatment you need. Al-though many blood disorders cannot be cured, treatments
can relieve your symptoms and help you feel better.

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Take care of your health. For some disorders, there are steps you can take to prevent symptoms
and dangerous complications.

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Iron
Present in all cells of the human body, iron is a mineral that has several vital functions. As the
major part of hemoglobin in red blood cells, it carries oxygen from the lungs to all parts of the
body and facilitates oxygen use and storage in muscles. Every cell in the body needs iron to
produce energy.
Iron Deficiency
When a person has used up the iron stored in her body, she is said to be “iron deficient.” Iron
deficiency doesn’t always result in anemia, but it may cause other health problems such as
lethargy or a weakened immune system. Iron deficiency occurs when the diet does not include
enough iron rich foods, if there is blood loss, or if there is an increased need for iron in the body,
such as during adolescence and pregnancy.
When the body does not get enough iron, it cannot make enough red blood cells to adequately
carry oxygen throughout the body. The condition of having too few red blood cells is called
“anemia.” A person with anemia may look pale and feel tired. Severe anemia can lead to an
irregular or increased heart rate as the heart must pump more blood to make up for the lack of
oxygen.
Consequenes of Iron Deficiency
In the early stages of iron deficiency, a person may experience tiredness, decreased intellectual
performance, reduced resistance to infection, and increased susceptibility to lead poisoning.
Later stages may result in irritability, pallor, decreased tolerance for exercise, appetite loss, rapid
heart action (tachycardia), enlargement of the heart (cardiomegaly), and risk for other nutrient
deficiencies (see the Vegetarian Teens section).
In pregnancy, iron deficiency increases the risk of low birth weight and potentially pre-term
delivery and perinatal mortality.

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During pregnancy and at other times, people who are iron-deficient may have intense cravings to
eat non-human foods, such as dirt. This can be a symptom of iron deficiency and can pose a
danger to one’s health. A healthcare provider should be contacted if this behavior is suspected.
Iron is Enough
Good Sources of Iron
Lean red meat, fish, poultry and iron-fortified grains, such as WIC-approved cereals, are good
sources of iron.
Legumes and dark green vegetables, such as kale, collard greens and spinach, are part of a
healthy diet. They also have iron. It is easier for the body to use the iron in meat than the iron in
plant foods. To help the body use iron from plant foods, vitamin-C-rich foods, such as citrus
fruits/juices, or a small amount of meat should be eaten at the same meal.
Table I-1 Recommended Daily
Dietary Reference Intakes for
Iron (milligrams per day)
Age Females Males
9-13 8 8
14-18 15 11
19-30 18 8
Pregnancy
14-18
19-30
27
27
Lactation
14-18
19-30
10
9
Source: Institute of Medicine,
Foodand Nutrition Board,

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Using cast-iron skillets for cooking can add iron to the food cooked.
Coffee, tea, soda, and excessive milk intake can reduce iron absorption and should be avoided,
especially at mealtimes. Note that iron absorption varies from person to person, which means
that different people can eat the same foods but have different levels of iron in their bodies.
Iron absorption often increases significantly when iron stores are low.
Iron Supplements
During pregnancy, some teens may need a supplement containing iron to reduce their risk of
adverse birth outcomes. This should be discussed with the primary healthcare provider at
prenatal visits.4,6
Do not recommend iron supplements unless a healthcare provider prescribes them. Consuming
more iron than needed may be unhealthy. In fact, too much iron can be harmful or fatal. Just 10
iron pills can kill a child!
Screening
Use the How Much Iron Am I Getting? handout to help the client determine how much iron she
is getting from her diet. You can use the sheet to help her identify iron-rich foods.
Has the client ever been told by her healthcare provider that she is anemic If yes, what
information and/or counseling was she given?
Iron Am I Getting
In the list below, foods with the most iron per serving are at the top. The foods at the bottom of
the list have less iron. But, they are still good iron sources.
Help your body use iron by eating some meat or a food that has vitamin C at the same time as a
food that has iron. For example, eat tomatoes with beans or cereal with strawberries.
Amount of Iron in Some Good Iron Foods
Iron Food Serving Size Approximate Iron My Serving My Iron Intake

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ods rich in iron
Meats
Organ meats (liver, giblets); no more than once a week
Beef
Duck
Lamb
Shrimp
Fish
Shell fish, such as clams and oysters
Non-Meats
WIC-approved cereals
Fortified instant cereals
Soybeans
Pumpkin/squash seeds
Dry beans, cooked
Lentils
Contents (mg) Size/Day (mg)
Clams, canned, drained 3 oz. 24
WIC-approved cereals, dry 50g (about 2 oz.) At least 14
Oysters, cooked 3 oz. 10
Organ meats: liver/giblets 3 oz. 5-10
Fortified instant cereals, cooked 1 packet 5-8
Cowpeas (blackeye peas), cooked 1 cup 4
Beans, cooked (pinto, kidney,
garbanzo, lima, navy, white)
1/2 cup 2-4
Chili with meat and beans 1 cup 3
Lentils, cooked 1/2 cup 3
Tofu, firm 1/2 cup 3
Spinach, cooked, drained 1/2 cup 3
Ground beef, 15% fat, cooked 3 oz. 2
Prune juice 3/4 cup 2
Rice/pasta, cooked 1 cup 1-2
Chicken, turkey 3 oz. 1
Tuna, canned in water 3 oz. 1
Salmon, cooked 3 oz. 1
Corn or flour tortillas 1 tortilla 1
Bread, enriched 1 slice 1
Dried fruit (apricots, apples,
plums)
About 10 pieces 1
Peanut butter 2 Tbsp. 1
Egg 1 1
Enter total here →

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Spinach
Dark green leafy vegetables, such as collard and spinach
Eggs
Bread/tortillas
Rice/pasta
Tomato paste
Prune juice
Dried fruit
NeedIron
Iron is a mineral found in some foods. If you do not eat enough foods high in iron each day, you
may:
• Look pale, feel tired, and act cranky
• Not feel like eating
• Have headaches and get sick more easily
• Have trouble learning and do poorly in school or work
If you are pregnant, your baby could be born too small or too soon
Look at the pictures below for examples of foods with iron.
Fish, chicken or other lean meats Egg yolks Fortified cereals, such as WIC
cereal

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arkgreen leafy vegetables Cooked dry beans

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DOSAGE FOFMS
e t Red Cell Pack
Follow the colour coding on this red cell
blood pack to find the following attributes:
Leucocyte Depleted, Irradiated,
Blood Pre-ad
Irradiated’ St ickers
‘Irradiated’ stickers are placed on red cell and platelet packs before irradiation.
hown below is an example of an ‘irradiated’ sticker. Prior to irradiation it has a red area where
the word ‘NOT’ can be seen. The operator and date areas remain blank. Once the pack has
been irradiated the red area turns black and the sticker will be signed and dated by the operator.

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ation Identity Checks of Patient and B
lood Product
Irradiated
Irradiation will reduce the shelf-life of red cells.Carefully check the expiry dates/times on
the irradiated red cell Blood Pack Label/Patient Compatibility Label. If unsure of expiry dateand
time contact the transfusion service provider.
Leucocyte Depleted
All red cells and platelets issued by the AustralianRed Cross Blood Service are leucocyte
depleted
Red Cells blood wastage.
Visually inspect pack to ensure:
Bag intact – no leaks including at the ports and
pack seams or evidence of tampering.
No clots, unusual discolouration or turbidity which
could indicate bacterial contamination.
No significant colour difference between tube
segments and red cell pack.
Contact/return to the transfusion service provider

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if any of the above are detected.
Paediatric Red Cell Pack
A red cell pack can be divided into four small volume
paediatric packs by the Australian Red Cross Blood
Service or transfusion service provider. These paediatric
packs are used for neonates and small infants to
prevent multiple donor exposures if more than one
transfusion is required for the patient. Paediatric packs
also reduce blood wastage.
Blood Fridge
WARNING
Emples:ed Cells

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20When removing a red cell
pack from a blood fridge
it is essential to take documentation with you to
the fridge detailing the patient’s full name, date of
birth and medical record number. This is to ensure
the right pack is collected for the right patient.
GER
PRIOR TO COLLEC TION OF RED CELL PACK
Ensure prescription complete and informedconsent documented.Explain procedure to patient,
including symptomsof possible transfusion reactions. Ensure IV access patent. Record
baselineobservations (TPR and BP) andgeneral patient status including pre-existing rashes.
Ensure circumstances/situation appropriate toproceed, including staff availability.
Checkresuscitation equipment, including oxygenand adrenaline are available and in working
orderand emergency medical support is readily available.
Pre-administration checks at patient’s
side MUS T include
:
Check ID band is securely attached to patient’s body.Ask the patient (if conscious and rational)
to stateand spell their family name and given name in full,and date of birth (whenever possible).
If the patientis unable to state and spell their name, ask a parent,guardian or carer (if present and
able to do so), toverify the patient’s identity.
Ensure that the stated full name and date of birth are
identical to those on the ID band and confirm correct
spelling of names.
Ensure that ALL details on the ID BAND (full name,
date of birth, medical record number) are:

BLOOD
— identical to those on the PRESCRIPTION, and
— identical to those provided on the PATIENT
COMPATIBILITY LABEL attached to the pack
(family and given name, date of birth, and medical
record number if included).
Blood product type is the same on the prescription,
on the product and the Patient Compatibility Label.
Special product requirements on the prescription
are met (eg. irradiated, CMV negative).
Blood group and donation number on the
Patient Compatibility Label are identical to that
on the Pack Label.
Blood group on the red cell pack is compatible with
the blood group of the patient as indicated on the
Patient Compatibility Label attached to the pack; if
not identical, the transfusion service provider MUST
make a specific comment to indicate it is compatible
(or most suitable available).
Red cell pack has not passed its crossmatch expiry
or pack expiry date and time.
Red cell pack has no signs of leakage or damaged
packaging, clumping of the contents, evidence of
haemolysis, unusual discolouration or turbidity.
IV BLOOD LINE
Use a new blood administration set
(with 170–200 micron filter).
Blood administration sets must not be
‘piggy-backed’ into other lines.

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Change blood administration set every 12 hours if
continuing to transfuse, or with new IV fluids, with
platelet transfusion or on completion of transfusion
of the pack(s), whichever comes first.
One blood administration set may be used for
administration of multiple packs of red cells provided
flow rate remains adequate and manufacturer’s
recommendations are not exceeded.
Red Cells
CAUTION
DANGER
DO NO T infuse with or through a
line that has previously contained:
Electrolyte and colloid solutions containing any
calcium (eg. HAEMACCEL®, Hartman’s solution or
lactated Ringer’s solution or GELAFUSAL® [available
in New Zealand]) – these should not be administered
with blood components collected in an anticoagulant
containing citrate as they may cause clotting of the
infusion line.
5% glucose (dextrose) in water or hypotonic sodium
solutions, as they may cause red cells to haemolyse
.

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Summary
Blood is essential for life. It carries oxygen and nutrients to every part of the body. Blood also
fights infections and heals injuries. Therefore, disorders of the blood can have a great effect on
your health.Red blood cells carry oxygen from the lungs to cells throughout the body. White
blood cells help fight infections. Platelets help form clots to stop bleeding. Plasma, the liquid
part of blood, contains many types of proteins. These include proteins that help the blood to
clot and proteins that protect the body from viruses and infection. Plasma also contains
substances such as dissolved salts, sugars, and hormones. In most countries, some aspects of
each of the main types of interventionwill be needed to control the problem of iron deficiency.
Particular attentionis devoted to micronutrient complementarities in
programmeimplementation.It summarizes regional prevalences ofanaemia, and briefly
discusses the principal factors affecting its prevalence

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conclusion
There has been a significant positive evolution in the percentage of respondents who
report having given bloodThe results regarding perceptions of the safety of blood transfusions
are encouraging
a majority of think that the safety of transfusions has improved over
the past ten years. The proportion of interviewees who perceive blood transfusions to
be safer or as safe as they were ten years ago has remained relatively stable from the
2002 to the 2009 Eurobarometer. This suggests, then, that campaigns focusing on the
need for transfusions, and more specifically blood donors, may be successful in
encouraging increased levels of blood

BLOOD
References
1. Centers for Disease Control and Prevention. Iron and Iron Deficiency. Nutrition for Everyone
2011; http://www.cdc.gov/nutrition/everyone/basics/vitamins/iron.html, 2012.
2. Iron deficiency anemia. Medline Plus 2012;
http://www.nlm.nih.gov/medlineplus/ency/article/000584.htm.
3. Pediatric Nutrition Surveillance - California. Table 17C: Anemia Indicators by Race/Ethnicity
and Age. 2010. http://www.dhcs.ca.gov/services/chdp/Documents/PedNSS/2010/17C.pdf.
4. Kaiser L, Allen LH. Position of the American Dietetic Association: nutrition and lifestyle for a
healthy pregnancy outcome. J Am Diet Assoc. Mar 2008;108(3):553-561.
5. Institute of Medicine (U.S.). Panel on Micronutrients. DRI : dietary reference intakes for
vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum,
nickel, silicon, vanadium, and zinc : a report of the Panel on Micronutrients ... and the Standing
Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board,
Institute of Medicine. Washington, D.C.: National Academy Press; 2001:
http://www.nap.edu/openbook.php?isbn=0309072794.
6. Office of Dietary Supplements, National Institutes of Health. Iron. 2007; http://ods.od.nih.gov
7. Chien YW, Rate controlled drug delivery systems, 2nd edition, Marcel Dekker, New York,
revised and expanded, 2005.
8. Chauhan MJ, Patel SA. A Concise Review on Sustained Drug Delivery System and Its
Opportunities. Am. J. PharmTech Res. 2012; 2(2): 227-238.
9. Chugh I, Seth N, Rana AC. Oral sustained release drug delivery system: An overview.
IRJP 2012; 3(5): 57-62
.10. Bhalla N, Deep A, Goswami M. An Overview on various approaches to oral controlled drug
delivery system via Gastroretentive Drug Delivery System. IRJP. 2012; 3(4): 128-133
. 11. Dusane RA, Gaikwad PD, Bankar VH, Pawar SP. A Review on: Sustained release
12. Jain KK, Drug delivery system, Methods in molecular biology, Humana Press, 2008, 218
.
13. Wani MS, Controlled Release System-A Review, 2008, 6 (1),

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www.pharmainfo.net/review
14. Bechgaard H, Nielson G H. Controlled release multiple units and single unit dosage. Drug
Dev.
& Ind. Pharm. 1978; 4(1): 53-67.
15. Aulton ME, Modified release peroral dosage forms, Pharmaceutics- The science of Dosage
form Design, 2nd edition, Churchill Livingstone, New York, 290.
16. Marroum PJ. Bioavailability/Bioequivalence for Oral controlled release products, Controlled
release drug delivery systems:
17. Scientific and Regulatory Issues. Fifth International Symposium on Drug Development,
East Brunswick, NJ. May 1997; 15–17.
18. Banker GS, and Rhodes CT, Sustained and Controlled drug delivery system, Modern
Pharmaceutics, 4th edition, Marcel Dekker, New York, 2002.
19. Shargel L, Pong SW, and Yu AB, Modifiedrelease drug products, Applied
Biopharmaceutics & Pharmacokinetics, 5th Edition, August 2004
.
20. Devraj, Bhatt DC. Studies on enteric coated sustained timed-release tablets of
Metronidazole. J. Chem. Pharm. R

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