AMedP - 12 (A) Nato Blood Bropchure

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November 2006
PUBLICATION NOTICE ROUTING
1. AMedP-12(A), NATO BLOOD BROCHURE, is available in the Navy War-

fare Library. It is effective on receipt.
2. Summary: AMedP-12(A) defines the Blood Programmes of Nations.
Navy Warfare Library Custodian
Navy Warfare Library publications must be made

readily available to all users and other interested
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NORTH ATLANTIC TREATY ORGANIZATION
NATO STANDARDISATION AGENCY (NSA)
NATO LETTER OF PROMULGATION
June 2003
1. AMedP-12(A) - NATO BLOOD BROCHURE is a NATO/PfP UNCLASSIFIED

publication. The agreement of nations to use this publication is recorded in STANAG 2408.
2. AMedP-12(A) is effective upon receipt. It supersedes AMedP-12 which should be

destroyed in accordance with local document destruction procedures.
Jan H ERIKSEN
Rear Admiral, NONA
Director, NSA
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RESERVATIONS BY NATIONS
CHAPTER RECORD OF RESERVATIONS BY

NATIONS
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RECORD OF CHANGES
CHANGE DATE EFFECTIVE BY WHOM

DATE ENTERED DATE ENTERED
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TABLE OF CONTENTS
1. BLOOD PROGRAMMES OF NATO NATIONS
101. Belgium
102. Canada
103. Denmark
104. France
105. Germany
106. Greece
107. Iceland
108. Italy
109. Luxembourg
110. Netherlands
111. Norway
112. Portugal
113. Spain
114. Turkey
115. United Kingdom
116. United States
2. ACE EMERGENCY BLOOD SUPPORT SYSTEM

(APPENDIX 1 FROM ACE DIRECTIVE 85-2, ANNEX J)
3. STANDARDIZATION AGREEMENTS (STANAGS) ON THE BLOOD

PROGRAMME
4. BLOOD BANK EQUIPMENT AND SUPPLY EQUIVALENTS OF NATO

NATIONS
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5. INTERNATIONAL BLOOD PROGRAMMES OUTSIDE NATO
501. Council of Europe
502. International Red Cross Blood Programme
502.1 International Red Cross
502.2 International Committee of the Red Cross
502.3 League of Red Cross and Red Crescent Societies
502.4 National Red Cross/Red Crescent Societies
502.5 Points of Contact
503. International Society of Blood Transfusion Blood Programme
504. International Federation of Blood Donor Organizations
505. World Health Organization Blood Programme
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101. %(/*,$1%/22'352*5$00(%(
101 MILITARY BLOOD PROGRAMME
101.1 Concept of Operations
101.1.1 The sole Military Blood Bank is located in the Brussels

Military Hospital.
101.1.2 The red cell concentrates are provided to Brussels Military

Hospital, to operational units on deployment and to
hospitals experiencing inventory problems. Albumin is
produced from plasma by the Central Department for
Fractionation of the Red Cross, and stocked by the Medical
Service. The Military Blood Bank participates in the Belgian
National Blood Bank quality control programme.
101.2 Military/Civilian Liaison
101.2.1 Blood collections in Belgium are almost completely

delegated to the Red Cross. The Red Cross system has
3 blood transfusion centres, which all have their own
territory for collection of blood and distribution of blood
products. These centres are responsible for whole blood
and cellular components. The Brussels Red Cross Centre
fractionation plant is responsible for a myriad of products
produced from plasma. The Institute of Hygiene and
Epidemiology, Ministry of Public Health is ultimately
responsible for the quality of blood. However, the medical
instructions of the National Blood Service of the Belgian
Red Cross are usually followed.
101.3 Collection
101.3.1 In the Military, all the blood is collected at the Military Blood
Bank. The blood collecting team is mixed military and
civilian, and under the supervision of a medical officer
(clinical biologist). Each donor completes a medical
questionnaire and weight, pulse and blood pressure are
monitored. Red Blood cells are collected by apheresis
using CPD50 as anticoagulant and either leuko-depleted by
filtration and resuspended in AS1 or AS3, or glycerolised in
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closed system, frozen, thawed, deglycerolised in closed

system and resuspended in AS3. Plasma is collected by
apheresis using ACD as anticoagulant, virus-activated
using the methylene bleud/light method and stored frozen
or croydessicated The standard donation is either 300 ml of
absolute red blood cells or 660 ml of plasma with saline
compensation. All donors are volunteers. Annual 4500
apheretic donations produced approximately 9500 units.
101.3.2 In the civilian sector, approximately 75% of blood is

collected by mobile collection teams. Most blood centres
also operate donor collection rooms at the respective
centres. Donor screening and examination include medical
questionnaire, blood pressure and pulse rate. Age range is
normally 18-64 years old. Blood is collected by physicians
and nurses under the supervision of a physician. Blood is
collected in plastic bags that contain Citrate-Phosphate-
Dextrose and Saline-Adenine-Glucose-Mannitol (CPD-
SAGM) solution. Donors may donate four times a year. The
standard donation is 450m1. All donors are volunteer and
unpaid. Annual whole blood donations are approximately
600,000 units, together with some 250,000 plasma- and
cytapheresis procedures.
101.3.3 Standard cross match procedures are performed on blood

prior to transfusion.
101.4 Testing
101.4.1 In the Military Blood system, all techniques are automated.

The following tests are carried out:
101.4.1.1 ABO and Rhesus blood groups.
101.4.1.2 Hb and complete blood cell count.
101.4.1.3 Irregular and auto-antibodies screen.
101.4.1.4 ALT level.
101.4.1.5 HIV l, 2 & TO antibody, HIVp24 antigen and

HIV1 RNA screen.
101.4.1.6 Hepatitis B surface antigen (HBsAg), core

total antibody, core IgM antibody and
quantitative HBs antibody screen.
101.4.1.7 Hepatitis C antibody and RNA screen.
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101.4.1.8. Cytomegalovirus total antibody quantitative

screen.
101.4.1.9 Syphilis antibody screen by VDRL.
101.4.1.10 Human T-Lympophotropic Viruses I & II

antibody screen.
101.4.2 If required, samples can be sent to immunohaematology

and virology reference laboratories. The Military Blood
Bank is the reference laboratory for HIV, HTLV, viral
hepatitis, hantavirus and other zoonoses diagnosis.
101.4.3 In the civilian sector, there is a mixture of automated and

manual procedures, although most are manual. The
following tests are carried out:
101.4.3.2 Hb and complete blood cell count.
101.4.3.3 Irregular antibody screen.
101.4.3.4 HIV 1, 2 & TO antibody and HIV1 RNA

screen.
101.4.3.5 Hepatitis surface antigen (HBsAg) screen.
101.4.3.6 Hepatitis C antibody and RNA screen.
101.4.3.7 HBC and HBS antibody screen (first

donation).
101.4.3.8 ALT level.
101.4.3.9 Syphilis antibody screen by VDRL +/- TPHA.
101.5 Component Production
101.5.1 Whole blood is prepared into red cell concentrate and fresh
frozen plasma.
101.5.2 Blood Products Maximum Expiration Period
101.5.2.1 Red Blood cells-leukocytes removed (CPD50-

AS1 or -AS3) 35 days.
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101.5.2.2 Red Cells (CPD-SAGM) stored at 2/C to 6/C

35 days.
101.5.2.3 Glycerolised red blood cells (CPRD50) stored

at -80°C 10years and Deglycerolised red blood
cells (CPD50-AS3) stored at +2 to +6°C 14
days.
101.6 Plasma Products
101.6.1 Virus-inactivated plasma is stored at -80oC to -30oC for one

year.
101.7 Platelet Concentrates
101.7.1 Platelets are stored in special plastic bags at 20oC to 24oC

for 5 days.
101.8 Special Techniques
101.8.1 The Red Cross Blood Centres at Antwerpen and Liège

have limited red cell freezing capabilities. The low glycerol
technique is used with an open system. The Military Blood
Bank has routine and massive red cell freezing capabilities.
The high glycerol technique is used with a closed system.
101.8.2 Apheresis and human leucocyte antigen testing is

performed in several blood centres
101.9 Storage Equipment for Operational Use
101.9.1 Blood products are stored in refrigerators, freezers or

rotators.
101.10 Transportation/Distribution/Transhipment Equipment
101.10.1 Blood is transported in polystyrene-polyurethane boxes to

supported missions. For red cells transportation, cooling
units are used to maintain the temperature in the range +2
to +9°C; for plasma transportation, dry ice is used to
maintain the temperature in the range -70 to -30°C.
Transportation mode includes blood bank vehicles, trains
and aircraft.
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101.11.1 Military
Etat-Major de la Défense - COMOPSMED

Quartier Reine Elisabeth, Rue d'Evère
1140 Bruxelles, Belgium
Tel: 02-70l-1276
Hôpital Central de la Base - Reine Astrid

Centre d'Expertise
Service Militaire de Transfusion Sanguine, Rue Bruyn
1120 Bruxelles, Belgium
Tel: 02-264.4680 or 4682
EMI Tech (Belgian Military Central Pharmacy)

Chaussée de Namur 42
1470 Nivelles, Belgium
Tel: 067-892020
101.11.2 Civilian
Médecin-Directeur du Service du Sang

Croix-Rouge de Belgique
16 Rue Edmond Picard
B-1050 Bruxelles, Belgium
Tel: 02-349-5320 (French speaking)
Geneesheer-Directeur van de Dienst voor het Bloed

Rode Kruis België
Edmond Picardstraat 16
B-1050 Brussels, Belgium
Tel: 02-349-5350 (Dutch speaking)
Croix Rouge de Belgique

Siège Social
Chaussée de Vleurgat 98
Tel: 02-645-4411
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Croix Rouge de Belgique

Unité Centrale de Fractionnement
Rue J Stallaert 5
Tel: 02-349-6911
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102. &$1$',$1%/22'352*5$00(
102.1.1 All blood products are provided by the Canadian Red Cross
Transfusion Service. Blood is provided to military hospitals
in Canada by the Canadian Red Cross and outside Canada
through the CF Blood Distribution System.
102.2 Military Blood Bank Procedures
102.2.1 Collections Nil.
102.2.2 Processing Nil.
102.2.3 Components Nil.
102.2.4 Storage in Wartime Blood will be stored in mechanical

refrigerators or disposable insulated blood boxes (Collins
boxes) with ice at a temperature between 2oC and 6o C.
102.2.5 Distribution in Wartime Blood will be transported from

Canada in insulated blood boxes (21 units whole blood or
30 units red cells) through a series of Blood Handling Units
to the operating Forward Medical Equipment Depot
(FMED). Blood will be further distributed by means of
insulated blood boxes or portable refrigerators.
102.2.6 Special Techniques The National Reference Laboratory of

the Canadian Red Cross Blood Transfusion Service
functions as the World Health Organisation (WHO) National
Blood Group Reference Laboratory, and, in this capacity,
takes part in international proficiency surveys. Frozen red
cell operations, apherisi, and human leucocyte antigen
testing are performed in several centres.
102.2.7 Transfusion Practices Red cell concentrates, plasma

solutions and intravenous fluids are routinely used for
transfusions. About 90% of transfusions are concentrated
red cells. A standard crosshatch is performed on blood.
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102.2.8 Points of Contact
National Defence Headquarters

Attn: Chief of Health Services
Ottawa, Ontario, Canada
K1A OK2
Tel: 001-613-992-0431
Chairman, CFMS General Blood Committee

National Defence Headquarters
Attn: DMO
Ottawa, Ontario, Canada
K1A OK2
Tel: 001-613-996-3819
102.3 Civilian Organisations
102.3.1 Blood collections in Canada are delegated to the Canadian

Red Cross Blood Transfusion Service. The Red Cross
system is divided into seven regions and contains 17 blood
centres. These centres are linked together by computer.
Plasma fractionation is contracted with civilian fractionators.
102.4 Civilian Blood Bank Procedures
102.4.1 Collections The blood donor centre is the primary site of

blood collections. Some centres operate mobile collection
units. Minimum screening and examination include medical
questionnaire, blood pressure, pulse, haemoglobin and
weight.
102.4.2 Age range is normally 17 - 65 years. Blood is collected by

nurses under the supervision of a physician. Blood is
collected in plastic bags that contain Citrate-Phosphate-
Dextrose-Adenine (CPDA-1) Donors may donate four times
a year at prescribed intervals. The standard donation is 450
mls. All donors are volunteers. Annual whole blood
donations are approximately 1,200,000.
102.4.3 Processing Most procedures are automated. The following

tests are carried out:
102.4.3.1 ABO and Rhesus.
102.4.3.2 VDRL and ART for syphilis.
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102.4.3.3 HBs-Ag.
102.4.3.4 Anti-HCV.
102.4.3.5 Anti-HIV 1&2.
102.4.3.6 Anti-HIV-1p24Ag.
102.4.3.7 Anti-HTLV 1&2.
102.4.4 There are immunology reference laboratories in most blood

centres. Blood donor testing reveals a positive hepatitis rate
of approximately 0.3% among prospective donors.
102.4.5 Components Most blood centres produce blood

components. Plasma fractions are also available for
distribution to hospitals as required.
Red Cells (CPDA-1) 35 days.

Fresh Frozen Plasma (-20oC) 3 months.
Fresh Frozen Plasma (-30oC) 12 months.
Platelets 72 hours.*
Cryoprecipitate 12 months.
*New plastic satellite bags extend expiration date to 5 days.
102.4.7 Storage
Blood products are stored in refrigerators, freezers, or on

rotators
102.4.8 Blood Products Minimum Temperature Range
Red Cells 20 - 60C.

Fresh Frozen Plasma -300C.
0 0
Platelets 20 - 24 C.
Cryoprecipitate 20 - 60 C.
102.4.9 Distribution Blood is transported in polystyrene boxed to

service hospitals. Frozen ice packs are used to collect
blood. Transportation temperature range is generally 10-100
C. Transportation mode includes blood bank vehicles,
trains and air transportation.
102.4.10 Special Techniques The National Reference Laboratory of

the Canadian Red Cross Blood Transfusion Service
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functions as the World Health Organization (WHO) National

Blood Group Reference Laboratory, and in this capacity,
takes part in international proficiency surveys. Frozen red
cell operations, apheresis, and human leucocyte antigen
testing are performed in several blood centres.
102.4.11 Transfusion Practices Standard cross match procedures

are performed on blood. About 90% of transfusions are
concentrated red cells.
National Director
Canadian Red Cross Transfusion Service
1800 Alta Vista Drive
Ottawa
K1G 4J5
Canada
Tel: 001-613-739-2220
Executive Director
Canadian Blood Committee
8th Floor, Jeanne Mance Bldg
Tunney’s Pasture
Ottawa
K1A 1B4
Canada
Tel: 001-613-99217351
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103. '$1,6+%/22'352*5$00(
103.1.1 Denmark has no peacetime military blood programme.

Military patients are transfused in civilian hospitals. Military
personnel regularly donate blood to civilian blood centres.
103.1.2. Points of Contact
Director General Medical Services

PO Box 202
DK 2950 Vedbaek
Denmark
Tel: 42-890501
Defence Medical Training Centre

DK Denmark 2820 Gentofte
Tel: 31-681655
103.2.1 Concept of Operations All blood collections in Denmark are

conducted by hospital blood centres. The centres are
responsible for whole blood and cellular components.
Plasma is provided to the State Serum Institute
Fractionation Plant for Production of Various Products.
103.3.1 Collections About 5% of the blood is collected by mobile

collection teams. All hospital blood centres operate donor
collection rooms at the respective centre. Donor screening
and examination include medical questionnaire, blood
pressure, pulse, and haemoglobin. Age range is normally
18-66 years old. Blood is collected in plastic bags that
contain Citrate-Phosphate-Dextrose-Adenine (CPDA-1),
plus Saline-Adenine-Glucose (SAG) by nurses under the
supervision of a physician. Donors may donate four times
a year, at prescribed intervals. The standard donation is
450ml. All donors are volunteers. Annual whole blood
donations are approximately 400,000.
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103.3.2 Processing There is a mixture of automated and manual

procedures, although most are automated. Tests for ABO
blood groups, and Rhesus antigens and antibody HIV
screens are performed; Radio immune (RIA) and enzyme
procedures are performed for hepatitis. Blood donor testing
reveals a positive hepatitis rate of approximately 0.3%
among prospective donors. The routine test for syphilis is
the VDRL. There are immunohaematology reference
laboratories available in most blood centres.
103.3.3 Components
Blood Products Maximum Expiration Period

Red Cells (CPDA-1-SAG) 35 days.
Fresh Frozen Plasma 12 months.
Platelets 3 - 5 days.
103.3.4 Storage Blood products are stored in refrigerators, freezers

or on rotators.
103.3.4.1 Blood Products Minimum Temperature Range
Red Cells 20 - 60C.

Platelets 200 - 240C.
Cryoprecipitate - 600C.
103.3.5 Distribution Blood is transported in polystyrene boxes to

serviced hospitals. Frozen ice packs are used to cool blood.
Transportation temperature range is generally -10C - 10C.
Transportation mode includes blood bank vehicles and
automobiles.
103.3.6 Special Techniques Several blood centres have limited

frozen red cell operations. The high temperature/ low
glycerol technique is routinely used. Apheresis and human
lymphocyte antigen testing is performed in several blood
centres.

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Medical Director
Blood Bank
Rigshospitalet
Blegdamsvey 9
2100 Copenhagen O, Denmark
Tel: 31-396633 Ext 2031
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104. )5(1&+%/22'352*5$00(
104.1.1 Organisation France has one military blood centre, the

Centre de Transfusion Sanguine des Armées Jean Julliard,
located in Clamart near Paris, with one annex in Toulon. It
collects blood from civilians and military donors in the
Centre and in French military installations by mobile units.
Toulon locally recruit donors for local use.
104.1.2 Products Red cells, Fresh Frozen Plasma and Platelets

are provided to the military hospitals in Paris and also to
Toulon. Plasma from these collections is sent to the
"Laboratoire Français du Fractionnement et des
Biotechnologies" (LFB) for fractionation into various
products for French military forces. Additional plasma is
obtained from civilian blood centres collecting blood in
military installations.
104.2.1 Collections
104.2.1.1 Approximately 90% of the blood is collected

by mobile teams, which regularly visit military
units. The blood collection teams are
composed entirely of military nurses, male
and female, and medical officers. During
mobile collection sessions the responsibility is
assumed by the medical officer of the
collection team.
104.2.1.2 All donors are volunteers and National

Guidelines for selection of donors are used.
The quantity normally taken is 8 ml per kg
body weight with a maximum of 500 ml.
104.2.1.3 Blood is collected in plastic bags with Citrate

Phosphate Dextrose (CPD) as anticoagulant.
Saline Adenine Glucose Mannitol (SAG-M) is
used as an additive solution. All the blood is
separated into plasma, buffycoat and red cell
concentrate. The red cells are resuspended in
additive solution (SAG-M). Annual donations
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of whole blood are approximately 20,000

units. The CTSA also produces platelets and
plasma by apheresis and has a programme of
auto transfusion. Most platelets are collected
by apheresis.
104.2.2 Testing The following tests are performed by automated

procedures on all donations according to national rules:
104.2.2.1 ABO, Rh and Kell blood group.
104.2.2.2 Blood group antibody screens.
104.2.2.3 TPHA testing for syphilis.
104.2.2.4 HIV 1 & 2 antibody screen by ELISA.
104.2.2.5 Hepatitis surface antigen (HBs Ag) screen by

ELISA.
104.2.2.6 HBc antibody screen by ELISA.
104.2.2.7 Hepatitis C antibody screen by ELISA.
104.2.2.8 HTLV 1 & 2 antibody screen by ELISA.
104.2.2.9 Assay of ALAT.
104.2.3.0 NAT VIH1/VHC (Nucleic acid test)
104.2.3 Any blood donation giving any repeated positive serological

test is destroyed. All repeated positive serological tests are
confirmed: HIV and HTLV by WESTERN BLOT and HCV
by RIBA. The Centre has an immunohaematological
reference laboratory.
104.2.4 Other assays may be done in special cases e.g. CMV or

paludism.
104.2.5 Components Production
104.2.5.1 Red cells are stored between 2oC and 6oC.

Red cells in Adenine can be stored for 35 days
but this is not usual in the French Army. SAG-
M additive solution storage is normally used
when the red cells may be stored for 42 days.
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104.2.5.2 Platelet concentrates and apheresis platelets

are stored at 20oC - 24oC with agitation for a
maximum of 5 days.
104.2.5.3 In accordance with French law, Fresh Frozen

Plasma produced from apherisis plasma is
always securised by quarantine with re-
examination of donor serology from 4 to 11
months after initial donation. The Fresh Frozen
Plasma is stored at -30oC or below with a shelf
life of 1 year. In France, therapeutic plasma
may also be produced by a solvent detergent
process for virus inactivation, but this is not in
use in the French Army.
104.2.5.4 According to the French regulations, all the

blood components for transfusion are
deleucocyted with a maximum of 106/bag for
cell products and 104/l for plasma.

the hospitals. The transportation temperature range is
generally 2oC - 8oC for a maximum of 6 days. Frozen ice
packs are used to cool the containers.
104.2.7 Transfusion Practices Red cell, plasma solutions and

platelets are routinely used for transfusions. Before all
transfusions every patient is tested for irregular antibodies.
For red cells, a test of compatibility with antiglobulin is
always carried out before transfusion for multiple transfused
patients. A final verification at the patient’s bedside of the
group of the donor and the recipient is always made in
accordance with national rules.
104.2.8 Special Techniques The French Army has decided to use

"Dry Frozen Secured Plasma" in the field. This is fresh
frozen plasma pooled from eight units and lyophilised in a
200 ml volume. The C.T.S.A. also has a Frozen Red Blood
Cells Programme.
Direction Centrale du Service de Santé des Armées

BP 125
00459 ARMEES
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Centre de Transfusion Sanguine des Armées Jean Julliard

1, Rue du Lieutenant Raoul Batany
BP 410 - 92141 CLAMART Cedex
Tel: 01.41.46.72.00
104.3.1 The transfusion policy in France is defined by the Agence

Française de Sécurité Sanitaire des Produits de Santé
(AFSSaPS) which operates under the auspices of the
French Ministry of Health. This organisation oversees the
enforcement of this policy by the blood transfusion centres.
The AFSSaPS was created by the law of 1 Jul 98. The
blood transfusion network comprises 14 Blood Transfusion
Centres (Regional EFS Centres). For fractionation the
"Laboratoire Français de Fractionnement et des
Biotechnologies" (LFB), a non-profit public interest
partnership, was created by the Act of 4 Jan 93. The Act
granted the exclusive right to fractionate plasma received
from voluntary donors on French soil. All plasma collected
for fractionation by the Blood Banks is sent to LFB.
104.4.1 Collections Approximately 90% of the blood is collected by

mobile collection teams. All donors are volunteers and
National Guidelines for selection of donors is used. The age
range is 18-65 years. Blood is collected in plastic bags with
Citrate Phosphate Dextrose (CPD) as anticoagulant. Saline
Adenine Glucose Saline (SAG) or Adenine Glucose
Mannitol (SAG-M) is used as the additive solution. Male
donors may donate whole blood and cells five times a year,
and female donors may donate whole blood three times a
year and cells five times (e.g. platelets) both at respectively
prescribed intervals. The quantity normally taken is 8 ml
per kg body weight with a maximum of 500 ml. The blood is
separated into red cells, plasma and platelets. The red cells
are resuspended in additive solutions SAG or SAG-M. The
blood banks also make platelets by apheresis and
participate in auto transfusion programmes. Most platelets
are collected by apheresis. Deleucocytation is systematic
for blood products.
104.4.2 Testing The following tests are performed by automated

procedures on all donations according to national rules:
104.4.2.1 ABO, Rh and Kell blood group.
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104.4.2.3 TPHA testing for syphilis.
104.4.2.4 HIV 1 & 2 antibody screen by ELISA.
104.4.2.5 Hepatitis surface antigen (HBs Ag) screen by

ELISA.
104.4.2.6 HBc antibody screen by ELISA.
104.4.2.8 HTLV 1 & 2 antibody screen by ELISA.
104.4.2.9 Assay of ALAT.
104.4.3.0 NAT for HIV, HCV,
104.4.3 After an initial positive serological assay, all blood products

must be destroyed. All repeated positive screening tests
are confirmed: HIV, HTLV and HCV
104.4.4 Storage of Products
104.4.4.1 Red cells are stored between 2oC and 6oC for
the following times:
In CPD 21 days.
In Adenine 35 days.
In SAG-M 42 days.
104.4.4.2 Platelets are stored at 20oC - 24oC with

agitation for a maximum of 5 days.
104.4.4.3 Fresh Frozen Plasma can be stored for one

year. There is a legal requirement for it to be
securised by a quarantine or by solvent
detergent processing.

hospital services. Transportation temperature range is
generally 20 - 8oC. Frozen ice packs are used to cool the
containers.
104.4.6 Special Techniques Several blood centres have Red Blood

Cells programmes.
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104.4.7 Transfusion Practices Red cell, plasma solutions and

platelets are routinely used for transfusions. Before all
transfusions every patient is tested for irregular antibodies.
For red cells, a test of compatibility with antiglobulin is
always carried out before transfusion for multiple transfused
patients. A final verification at the patient’s bedside of the
group of the donor and the recipient is always made in
accordance with national rules.
Etablissement Français du Sang

100 Avenue de SUFFREN
75015 PARIS
Tel:
Laboratoire Français de Fractionnement et des

Biotechnologies
3 Avenue des Tropiques - BP 305
91958 LES ULIS Cedex
Tel.
1 - 19
ORIGINAL
AMedP-12(A)
105. *(50$1%/22'352*5$00(*(
105 CIVILIAN BLOOD PROGRAMME
105.1.1 About 75 % of civilian blood collections in Germany are

conducted by the German Red Cross blood centres. The
Red Cross system is divided into 8 regions and contains 36
blood donor centres. The centres are responsible for whole
blood and cellular components. Each Red Cross region is
autonomous. In the past the organization of the Red Cross
blood donation services had changed. So some regions
have built a consolidation e.g. The Red Cross blood
donation services from Hessen and Baden Württemberg.
Four of the Red Cross regions contain plasma fractionation
plants that prepare various products for the Red Cross
system. Because Red Cross centres ship red cell
concentrates to the United States as part of the Euroblood
programme, some centres have US Food and Drug
Administration Licenses. The other 25 % of civilian blood
collections are conducted by the national communal e.g.
hospital blood donation services and by the military. The
Paul-Ehrlich-Institute in Langen is ultimately responsible for
the quality of blood.
105.1.2 Civilian Blood Bank Procedures
105.1.2.1 Collections Blood is collected by Red Cross

mobile collection teams. Most hospitals
operate donor collection rooms. Minimum
donor screening and examination include
medical questionnaire, blood pressure,
haemoglobin, pulse, temperature and
physician interview. Age range is normally
18 - 68 years old. Blood is collected by
physicians and by nurses under the
supervision of a physician. Blood is collected
in plastic bags that contain Citrate-Phosphate-
Dextrose (CPD). The quadruple bag, which
contains various additive solutions (SAG-M,
PAGGS-M, ADSOL, etc.), is standard. There
is also a filter integrated in the donation set to
reduce leukocytes by the preparation. Donors
may donate four times a year for female and
six times a year for male. The standard
donation is: Red Cross 500 ml, hospitals
1 - 20
ORIGINAL
AMedP-12(A)
mostly 450 ml. All Red Cross donors are

volunteers, however, a few civilian national
communal blood donation services give
donors an expense allowance. Annual whole-
blood donations are approximately 3,500,000
units.
105.1.2.2 Processing There is a mixture of automated

and manual procedures. Most procedures are
automated. Tests for ABO blood groups,
Rhesus antigens and antibody screens are
obligatory. HIV 1 + 2 antibody testing is
performed using mostly enzyme procedures
but Radio immune Assay (RIA) is used
occasionally. Tests are also performed for
hepatitis (HBs–A, HCV-antibodies and ALAT).
Since 01.04.1999 it is obligatory by law to test
in virus genom of HCV. Tests for syphilis
include VDRL or TPHA. There are
immunohaematology reference laboratories
available in most blood centres.
105.1.2.3 Components Most Blood centres produce

blood components. Plasma is fractionated by
the German Red Cross into products for the
Red Cross system. Civilian commercial blood
centres have plasmapheresis centres in large
cities for industrial production of blood plasma
components. The Red Cross fractionation
plant is located at Springe.
105.1.2.4 Blood Product Maximum Expiration Periods
Red Cell (CPD) - 21 days.

Red Cell (CPDA-1) - 35 days.
Red Cell (SAG-M) - 36-42 days.
Red Cell (PAGGS-M) - 49 days.
Red Cell (ADSOL) - 42 days.
Fresh Frozen Plasma - 12 months.
Platelets - 72 hours.
105.1.2.5 Distribution Blood is transported in

polystyrene boxes to hospitals. Frozen ice
packs are rarely used to cool blood because
transportation time by car and train is very
short. Transportation range is generally +1oC+
10oC.
1 - 21
ORIGINAL
AMedP-12(A)
105.1.2.6 Special Techniques Red Cross blood centres

at Frankfurt, Muenchen and Springe have
frozen red cell operations. The high
temperature/low glycerol technique is used.
Also some hospitals freeze red cells for
autologous transfusions. Apheresis and
human leucocyte antigen testing is performed
in several blood centres.
105.1.2.7 Transfusion Practices Standard cross match

procedures are performed on blood. Red
cells, fresh frozen plasma, plasma solutions
and platelets are routinely used for
transfusions. Physicians are required to
perform an additional bedside cross match
(identification-test of the recipient) before
blood transfusions.
105.1.2.8 Storage Blood products are stored in

refrigerators, freezers, or on rotators
(platelets). The blood products minimum
temperature ranges are:
Red Cells 4oC ±2oC.

Fresh Frozen Plasma -30oC and lower.
Platelets 20oC-24oC under
permanent gentle
agitation
105.1.3 Red Cross Blood Centre Locations and Depots
Schleswig Berlin Bad Kreuznach

Luethjensee Dessau Mannheim
Stralsund Muenster Bremen
Oldenburg Erfurt Görlitz
Rostock Hagen Ulm
Neubrandenburg Breitscheid Bayreuth
Schwerin Kassel Wuerzburg
Frankfurt/Main Gera Nuernberg
Springe Plauen Wiesentheid
Neuruppin Dresden Regensburg
Frankfurt/Oder Chemnitz Augsburg
Potsdam Zwickau München
Cottbus
1 - 22
ORIGINAL
AMedP-12(A)
105.1.4 Civilian Points of Contact
Paul-Ehrlich-Institut
D-63325 Langen
Tel.: 0 61 03/77 Ext. 0
DRK-Generalsekretariat
Carstennstr. 58
D-12205 Berlin
Tel: 030/85404-0
Leiter
Transfusionszentrale d.
Johannes-Gutenberg-Universität Mainz
Hochhaus Augustaplatz
D –55131 Mainz
Tel: 06131/173210
105.2 MILITARY BLOOD PROGRAMME
105.2.1 Concept of Operations The blood bank at the

Zentralinstitut des Sanitaetsdienstes der Bundeswehr
(ZInstSanBw) Koblenz collects blood from military donors at
installations throughout the Federal Republic of Germany
(troop barracks). Red cell concentrates are provided to
several German military hospitals and German field
hospitals in foreign countries.
105.2.2 Military Blood Bank Procedures
105.2.2.1 Collections About 95 % of the blood is

collected by mobile units that regularly visit
military installations. Members of the blood
collecting teams are non-commissioned
military. On mobile collections, the
responsibility for donorship rests with the
physician of the respective military unit.
Minimum donor screening and examination
include medical questionnaire, pulse, blood
pressure, haemoglobin, temperatur and
physician interview based on guidelines and
laws. Blood is collected by medical officers
and by enlisted soldiers, under the supervision
of a physician. Blood is collected in plastic
quadruple bags, which contain anticoagulant
1 - 23
ORIGINAL
AMedP-12(A)
Citrate-Phosphate-Dextrose (CPD) and the

additive solution Phosphate-Adenine-
Guanosin-Glucose-Saline-
Mannitol(PAGGSM). The donation system
also contains an integrated leucocytefilter.
The leucodepletion of the whole blood by
preparation is standard since 01.10.2001.
The standard donation is 500 ml. All donors
are volunteers. Annual whole blood donations
are approximately 30.000 - 40,000 units.
105.2.2.2 Processing Automated techniques are used

in blood typing (ABO, Rhesus antigens, Kell
and antibody screen) and in screening of
infectious parameters (ALAT, Syphilis-
antibodies, HBs-Ag, Hep C- and HIV 1+2-
antibodies as well as virus genomes of HIV,
HBC and HCV). Any blood donation giving
any repeated positive serological test is
destroyed. All repeated positive serological
tests are confirmed: HIV by WESTERN BLOT,
HCV by RIBA and HBV by HbsAg-
Confirmation Test and HBc antibody screen
by Elisa. In addition any positive probe is
tested again separately in the PCR-technique.
There is an immunohaematology laboratory
available in the blood centre. Furthermore the
production process is permanently supervised
by exemplarily investigation of residual cell
count and other quality parameters.
105.2.2.3 Components Preparations of red cell

concentrates and fresh frozen plasma are
performed by the Koblenz military blood
centre. Hospitals also obtain components from
civilian sources.
105.2.2.4 Blood Product Maximum Expiration Periods
Red Cells (PAGGS-M) - 49 days.

Fresh Frozen Plasma - 24 mths.
105.2.2.5 Distribution Blood (Red Cells) is transported

in polystyrene boxes or isolated containers
that hold 10 - 25 units of blood to service
hospitals. Temperature range is generally
+1oC- +10oC. Transportation modes include
blood bank vehicles. For transport to field
1 - 24
ORIGINAL
AMedP-12(A)
hospitals by Air Force an isolated container

packed with 30-40 units is used at
temperatures of +1°C - +10°C for a minimum
of 54 hours from packing time.
105.2.2.6 Special Techniques The German Army

has decided to use “Dry Frozen Secured
Plasma” in the field.
105.2.2.7 Transfusion Practices See civilian

Practices

refrigerators and freezers.
The following are the minimum temperatures

for blood products:
Red Cells 4oC+/-2oC.

Fresh Frozen Plasma -30oC.
105.2.3 Military points of Contact
Medical Office of the Bundeswehr

IV 1.1 Dachauer Straße 128
D-80637 München
Tel: 089/1249/7433
Zentralinstitut des Sanitaetsdienstes der Bundeswehr

Blood Bank
– Andernacher Str 100
D-56070 Koblenz
Tel: 02 61- 896-7501
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ORIGINAL
AMedP-12(A)
106. *5((.%/22'352*5$00(*5
106.1.1 In the Greek Armed Forces, the Army operates as the

single service for blood supply. Blood products are also
received from civilian sources. Plasma from military
collections are sent to the National Blood Transfusion
Centre and Blood Derivatives Unit, Piraeus, for fractionation
into products for the military.
106.2.1 Hospital blood centres collect the majority of blood in

Greece. There are approximately 50 hospitals with this
capability. The Greek blood facilities are divided into
Centres (6), Stations (45) and Units (135). Regional
Centres are in Athens (4), Pireaus (1) and Salonica (1).
There is also one Red Cross Centre located in Athens.
Approximately 60% of the blood is collected by mobile
collection teams.
106.3 Collection
106.3.1 All military blood is collected in hospital blood centres. The

blood collecting team members are mixed, civilian and
military. and each team includes a medical officer. The
responsibility for donorship rests with the medical officer of
the collection team. Donor screening and examination
includes a medical questionnaire, pulse, blood pressure
and haemoglobin. The blood is collected in plastic bags,
which contain Citrate Phosphate Dextrose - Adenine
(CPDA-1) solution. The standard donation is 450 ml. All
donors are volunteers. Annual whole blood donations are
approximately 250,000 units.
106.4 Testing
106.4.1 There is a mixture of manual and automated procedures,

although most are automated. The following mandatory
tests are performed on all donations:
106.4.1.2 HIV l&2 antibody screen by ELISA.
1 - 26
ORIGINAL
AMedP-12(A)
106.4.1.3 Hepatitis surface antigen (HBsAg) screen by

ELISA.
106.4.1.5 Syphilis antibody screen by VDRL.
106.4.2 All repeated positive screening tests are sent

to specialised National Public Health
Laboratories for confirmatory tests.
106.5.1 The following red cell components are produced and are
stored at 2oC-6oC with a shelf life of 35 days:
106.5.1.1 Red Cell Concentrate with optimal additive (SAG-M).
106.5.1.2 Red Cell Concentrate with optimal additive (SAG-M) buffy

coat depleted.
106.5.1.3 Red Cell Concentrate plasma reduced without optimal

additive.
106.5.1.4 Whole blood CMV negative for neonates.
106.6.1 Fresh Frozen Plasma stored at -30oC for 1 year.
106.6.2 Cryoprecipitate stored at -30oC for 1 year.
106.7.1 Single Whole Blood donation (recovered platelets) stored at

20oC-24oC for 3 days.
106.7.2 Apheresis Platelet Donations (4-6 single units) stored at

20o-24oC for 5 days.
106.8.1 No special techniques are applied.
106.9.1 Blood products are stored in refrigerators and freezers.
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ORIGINAL
AMedP-12(A)
106.10.1 Blood is transported in polystyrene boxes to serviced

hospitals. Frozen ice packs are used to cool blood.
and aircraft.
106.11.1 Operational
Ministry of Defence
Operational Support General Staff
Hellenic Army Support General Staff
Athens, Greece
Tel: 01-646-5201.
Hellenic Army General Staff

Medical Corps Directorate/2nd Office
Athens
Greece
Tel: 01-749-4919
Fax: 01- 778-6238.
106.11.2 Scientific/Transfusion Medicine/Research
401 Army General Hospital

Athens
Greece
Tel: 01-749-4740
106.11.3 Blood and Blood Product Supply
National Blood Transfusion Centre

and Blood Derivatives Unit
Nikea General Hospital
3 Pharmerloton Str
Nikes
Greece
Tel: 01-490-7777/491-4216
1 - 28
ORIGINAL
AMedP-12(A)
Hellenic Red Cross

Blood Research Laboratory
Thalassaemia Unit
1 Erithrou Unit
Athens
Greece
Tel: 01-691-0512/692-0001
1 - 29
ORIGINAL
AMedP-12(A)
107. ,&(/$1'%/22'352*5$00(
107.1 There is no military blood programme.
107.2.1 Concept of Operations Blood collections in Iceland are

conducted by the blood centre, located at the Landspitalinn
Hospital, Reykjavik. blood is collected, processed and
distributed to all medical facilities on the island. The blood
centre operates one mobile unit. Major hospitals supported
are Landspitalinn (501 beds), Borgarspitalinn (499 beds),
Ladakot (187 beds), Akureyri (120 beds), Akranes (96
beds), and Isafjordur and Keflavik (each 120 beds.
107.3.1 Collections
107.3.1.1 Approximately 25% of the blood is collected

by mobile collection teams. The Blood Centre
also operates a donor collection room. Donor
screening and examination include: medical
questionnaire, blood pressure, pulse, weight,
haemoglobin and temperature. Age range is
normally 18-66 years old. Blood is collected
by physicians or nurses under the supervision
of a physician. Blood is collected in plastic
bags that contain anticoagulant Citrate-
Phosphate- Dextrose (CPD) an Citrate-
Phosphate-Dextrose- Adenine (CPDA-1).
107.3.1.2 Donors may donate four times a year. The

standard donation is 450m. All donors are
volunteer. Annual whole blood donations are
approximately 15,000
107.3.2 Processing There is a mixture of automated

and manual procedures. Tests of ABO blood
groups Rhesus antigens and antibody screens
are performed. Enzyme procedures are
performed for hepatitis. Post donation testing
on donors indicate the positive hepatitis rate is
approximately 0.1%. The test of choice for
syphilis is the VDRL. There is an
1 - 30
ORIGINAL
AMedP-12(A)
immunohaematology reference laboratory

available at the Blood Centre.
107.3.3 Components The Blood Centre produces blood

components.
Red Cells (CPDA) 21 days.

Platelets 72 hours.
107.3.4 Storage Blood products are stored in refrigerators,

freezers, or on rotators.
Blood Products Minimum Temperature Range
Red Cell 20 - 60C.

Platelets 200 - 240C.
Cryoprecipitate -300C.

service hospitals. Frozen ice packs are used to cool blood.
Transportation temperature range is generally 10-100C.
and aircraft.
107.3.6 Special Techniques Nil.
107.3.7 Transfusion Practices No information.
Director
Blood Bank
Landspitalinn Hospital
PO Box 1408
Reykjavik, Iceland
Tel: 0354-1-29000
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ORIGINAL
AMedP-12(A)
108. ,7$/,$1%/22'352*5$00(,7
108.1.1 The IT Armed Forces Blood System plays an autonomous

role in the National Blood Plan, and its main task is to make
the Armed Forces self-sufficient as far as blood and blood
products are concerned. Military blood banks operate in the
frame and discipline of the National Health Service and
under the guidelines and regulations given by the National
Blood Authority. Direction, co-ordination and control of the
Military Transfusion Service are provided by the General
Directorate of Military Medical Services. The Military Blood
Centres also work together with the civilian structures in
order to warrant blood supply during public emergencies.
The four military blood centres collect blood from military
donors both in their own facilities and in the barracks by
their mobile units. Red cell concentrates are stocked and
delivered to Italian military hospitals or troops in operation
according to their needs. Plasma is fractionated by industry.
108.2.1 The civilian hospital blood centres (nearly 300), Red Cross
and Volunteer Organizations with their mobile collection
teams collect most blood in Italy. Self-sufficiency and co-
ordination are organised on a regional basis. The Minister
of National Health is the National Blood Authority and has
ultimate responsibility for the quality of blood. In this
capacity he is assisted by the Superior Institute of Health
and by the National Committee for Transfusional Services.
108.2.2 Donor screening includes medical questionnaire, physical

examination and Hb blood level. Age range is normally
between 18 and 65. Blood is collected by physicians and by
nurses under the supervision of a physician. Blood is
collected in plastic bags with CPD (Citrate-Phosphate-
Dextrose) as anticoagulant. OAS (Optimal Additive
Solution) is added to red cells concentrates. Donors may
donate four times a year. The standard donation is 450 ml
All donors are volunteers. Annual whole blood
donations are approximately 1,400,000.
108.2.3 Some blood centres have frozen red cells operations. The
low temperature/high glycerol technique is used. Apheresis
1 - 32
ORIGINAL
AMedP-12(A)
and human leucocyte antigen (HLA) typing are often

performed.
108.3 Collection
108.3.1 Most blood is collected by mobile units that regularly visit

military installations. The blood collection team members
are mostly military, and each team includes a medical
officer. Donor screening includes medical questionnaire,
physical examination and Hb blood level. Blood is collected
in plastic bags, which contain CPD (Citrate-Phosphate-
Dextrose) as anticoagulant solution. After centrifugation
and plasma collection, concentrated red cells are re-
suspended in OAS (optimal additive solution)
108.4. Testing
108.4.1 Tests for ABO and Rhesus antigens are performed

according to standard procedures and with semi-automated
methods for detecting agglutination reactions.
Immunoenzymatic tests are performed for hepatitis B and C
and for HIV 1-2 antibodies. The test for syphilis is the
VDRL. An immunohaematology section is available for
each blood centre.
108.5 Components
Red Cells (CAS) 42 days.

Platelets 5 days.
108.6 Storage
108.6.1 Blood products are stored in refrigerators or freezers.

Platelets are stored in rotators at room temperature.
Blood products Minimum Temperature Range
Red cells 2oC - 6oC.

Platelets 22oC- 26oC.
108.7 Transportation/Distribution/Transhipment Equipment Special cars

equipped with refrigerated spaces both at 2oC-6oC and at -25oC are
available to transport the units of blood and blood components where
they are needed. When using other means of transportation (common
1 - 33
ORIGINAL
AMedP-12(A)
cars, ambulances, trucks, helicopters, airplanes) the original preserving

temperature of mobilized units is maintained by keeping them in
hermetic thermo-boxes (polystyrol), with additional proper refrigerating
elements inside.
108.8 Special Techniques Frozen red blood cells are produced according to
the high glycerol NBRL method. Apheresis procedures are available in
most centres.
108.9 Transfusion Practices Red cells concentrates, plasma solutions and

intravenous fluids are routinely used for transfusion. A standard cross
match is performed on blood samples.
108.10.1 Military
MINISTERO DELLA DIFESA

DIREZIONE-GENERALE DELLA SANITA’ MILITARE
Via Santo Stefano Rotondo n. 4
00184 - Roma
Tel. +39.6.4735.4993
Fax +39.6.7720.9940
BANCA MILITARE DEL SANGUE

PRESSO STABILIMENTO CHIMICO-FARMACEUTICO DI
FIRENZE
Via Reginaldo Giuliani 201
50141 - Firenze
Tel. +39.55.454610
CENTRO TRASFUSIONALE MILITARE

PRESSO POLICLINICO MILITARE DI ROMA
Via Celimontana 50
00184 - Roma
Tel. +39.6.7045.051

PRESSO OSPEDALE PRINCIPALE M.M.
Via Nicolo Fieschi 16
19123 - La Spezia
Tel. +39.187.738063
1 - 34
ORIGINAL
AMedP-12(A)

PRESSO OSPEDALE PRINCIPALE M.M.
Via Pupino 1
70100 - Taranto
Tel. +39.99.4548.237
108.10.2 Civilian
MINISTERO DELLA SANITA’

Piazzale dell’ Industria 20 (EUR)
00144 - Roma
Tel. +39.6.59941
ISTITUTO SUPERIORE DI SANITA’

Viale Regina Elena 299
00161 - Roma
Tel. +39.6.4990
1 - 35
ORIGINAL
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109. /8;(0%285*%/22'352*5$00(
109.1 There is no military blood programme.
109.2.1 Concept of Operations Blood collections in Luxembourg is

delegated to the Red Cross. There is one blood centre
located in Luxembourg City that provides blood to all the
hospitals.
109.3.1 Collections A large quantity of the blood donations are

collected by mobile collection teams. The blood centre also
operates a donor room. Donor screening and examination
include medical questionnaire, blood pressure and
haemoglobin. Blood is collected in plastic bags that contain
anticoagulant Citrate-Phosphate-Dextrose Adenine solution
(CPDA-1). The standard donation is 450ml. All donors are
volunteers. Annual whole blood donations are
109.3.2 Processing
109.3.2.1 Most procedures are manual. Tests for A, B,

and O blood groups Rhesus antigens are
performed.
109.3.2.2 Post donation testing for hepatitis B is carried

out using ELISA and indicates the positive
hepatitis rate is approximately 0.2%. The
VDRL test is performed for syphilis. HIV tests
are also performed. There is an
immunohaematology reference laboratory
available.
109.3.3 Storage Blood products are stored in

refrigerators, freezers or on rotators.
109.3.4 Distribution Blood is transported in

polystyrene boxes to serviced hospitals.
Transportation mode includes blood bank
vehicles and taxis.
1 - 36
ORIGINAL
AMedP-12(A)

are performed on blood. About 55% of the transfusions are
Armée Luxembourgeoise
Service Médical
Caserne du Herrenberg
B.P. 166
L-9202 DIEKIRCH
Grand-Duché de Luxembourg
Tel: **352 - 80 88 44 Ext: 300 or 306

Fax: **352 - 80 88 44 Ext: 309
Croix-Rouge Luxembourgeoise
Centre de Transfusion Sanguine
B.P. 404
L-2014 Luxembourg
Tel: **352 - 45 02 02 - 1
Fax: **352 - 45 72 69
Ministère de la Santé
57, Blvd de la Petrusse
L-2320 Luxembourg
Tel: **352 - 478 - 55 51
1 - 37
ORIGINAL
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110. '87&+%/22'352*5$00(1/
110.1.1 In the NL Armed Forces, the Military Blood Bank (MBB)

operates as a tri-service manager for blood products from
its only location in Leiden.
110.1.2 The MBB procures blood products (liquid red cells, FFP
and platelets) from a civilian blood bank.
110.1.3 The MBB provides these products to NL military units

abroad, either directly (liquid red cells and FFP), or after
processing to frozen products (red cells and platelets).
Military patients within the Netherlands receive blood
products from civilian blood banks.
110.2.1 The NL civilian blood transfusion organisation consists of

one integrated blood supply service, that controls the
provision of blood and the regulation: The Sanquin Blood
Supply Foundation.
110.2.2 This foundation has 4 regional blood bank divisions to

provide the local hospitals with blood products with a short
shelf life, as well as the CLB blood bank division that
provides plasma derivatives to all the hospitals.
110.2.3 The MBB operates in close co-operation with its civilian

regional partner Sanquin Blood Bank Division South West
(location Leiden), with regard to procurement of blood
components and scientific research.
110.3 Collection
110.3.1 The MBB does not collect blood.
110.4 Processing
110.4.1 The MBB performs blood group typing on all military

personnel and produces blood group identification tags.
110.4.2 The MBB processes frozen red blood cells and frozen
platelets for military operations abroad.
1 - 38
ORIGINAL
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110.4.3 The following tests are performed:
ABO and Rh D
HIV –1 p24 antigen (ELISA)
HBsAg (ELISA)
Anti-HIV 1 and 2 (ELISA)
Anti-HTLV I and II (ELISA)
Anti-HCV (ELISA)
TPHA for syphilis (ELISA)
110.5.1 The MBB produces frozen red cells and frozen platelets. It
also provides fresh liquid red cells and FFP.
110.6 Storage
110.6.1 The MBB holds a stockpile of frozen red cells and FFP. In
due time, there will also be a stockpile of frozen platelets.
110.7. Distribution
110.7.1 Liquid red blood cells are shipped on wet ice in insulated
transportation chests with a connection cable to the battery
of a ca, truck or plane. The frozen components (frozen red
cells, FFP and frozen platelets) are shipped on dry ice in
the same containers. The inside temperatures are
continuously monitored by the TempTaleTM device. Upon
arrival, this device is connected to a PC, which makes it
possible to produce a graphic readout of the measured
temperatures during transport.
110.7.2 One container and three shelters are deployable for storing
blood components and deglycerolising frozen red blood
cells.
110.8 Transfusion Practices
110.8.1 Cross match procedure (Diamed gel) is performed.
110.9. Military Blood Bank Training
110.9.1 Medical technicians and lab technicians are trained on the

MBB. Military and civilian SOP’s are used. Key personnel
routinely attend military and civilian blood transfusion
conferences.
1 - 39
ORIGINAL
AMedP-12(A)
110.10 Point of Contact
110.10.1 Military:
Commanding Officer Military Blood Bank (MBB)

Plesmanlaan 1c
2333 BZ Leiden
The Netherlands
Tel:+31 71 5685218
Fax:+31 71 5685297
110.10.2 Civilian:
Sanquin Blood Supply Foundation

Chairman of the Board
Plesmanlaan 125
1066 CX AMSTERDAM
The Netherlands
Tel:+31 20 5123000
Fax:+31 20 5123303
Medical Director CLB

Plesmanlaan 125
1066 CX AMSTERDAM
The Netherlands
Tel:+31 20 5129222
Fax:+31 20 5123332
Secretary BTC
Plesmanlaan 125
1066 CX AMSTERDAM
The Netherlands
Tel:+31 20 5123520
Fax:+31 20 5123640
1 - 40
ORIGINAL
AMedP-12(A)
111. 125:(*,$1%/22'352*5$00(12
111.1.1 In the Norwegian armed forces, the Army operates the

blood service. This includes ordering of blood from civilian
hospital blood banks, transportation to and the use of blood
at military field hospitals.
111.1.2 Blood will normally be supplied from civilian hospitals, but

field hospitals are equipped to collect blood from donors
locally in extreme emergencies.
111.2.1 To ensure effective cooperation between military and

civilian organisations/units, the programme specifies close
links at the national, regional and districts levels while
maintaining the military chain of command in authority.
111.2.2 The Norwegian blood supply is the responsibility of blood

banks established as integrated departments of each
hospital. The functions of the blood banks are supervised
by an advisory board under the National Department of
Health.
111.2.3 A national program has been established for collection of

plasma for fractionation. In this way Norway has become
self sufficient with regard to plasma fractions as well as
blood. Presently, the plasma is sent to Austria for
fractionation.
111.2.4 Machine readable barcode labels according to international

standards are used for all units of blood, platelets, plasma
and plasma fractions.
111.3 Collection
111.3.1 Blood is only collected from regular donors at the hospital

blood banks. The blood bank head physician is responsible
for all aspects of the blood bank routine, including health
control of donors. All donors are volunteers, and national
guidelines for selection of donors are used. The health
controls include a medical questionnaire, haemoglobin and
1 - 41
ORIGINAL
AMedP-12(A)
additional examinations when indicated. The standard

blood donation is 450 ml.
111.3.2 Blood is collected in plastic bags with Citrate Phosphate

Dextrose Adenine (CPDA-1) as anticoagulant. Over 90% of
the blood is separated into plasma, buffy coat and red cell
concentrate. The latter is suspended in SAG-M additive.
111.4 Testing
111.4. 1 The following tests are performed, mainly by automated

procedures on all donations:
111.4.1.1 ABO and Rh blood groups.
111.4.1.3 HIV l&2 antibody screen by ELISA.
111.4.1.4 Hepatitis surface antigen (HBsAg) screen by

ELISA.
111.4.1.6 Syphlis serology (first donation only, unless

indicated)
111.4.2 All repeated positive screening tests are confirmed by

additional methods at University Hospital departments of
microbiology.
111.5. 1 Red cell concentrate in SAG-M preservation solution;

leucocyte poor after removal of buffy coat. Maximal storage
period: 35 days.
111.5.2 Leucocyte filtered red cell concentrates. Prepared by

filtration of SAG-M concentrates within two days of blood
donation. The number of leucocytes has been reduced
sufficiently to avoid HLA immunization, febrile transfusion
reactions and transmission of CMV.
111.5.3 Red cell concentrates from CMV negative donors.
111.5.4 Irradiated red cell concentrates to prevent graft-versus-host

reactions.
1 - 42
ORIGINAL
AMedP-12(A)
111.6.1 Fresh frozen plasma, Solvent/Detergent treated for viral

inactivation. Storage time: maximum one year at -300C.
111.6.2 Fresh frozen plasma. Storage time: maximum one year at

-300C.
111.7.1 Platelets from five pooled buffy coats stored at 200C-240C

for a maximum of five days.
111.7.2 Apheresis platelets from 2-3 litres of blood stored at 200C-

240C for a maximum of five days.
111.8.1 The Ullevaal University Hospital blood bank keeps a

collection of rare bloods, using glycerol as the
cryoprotectant, in the vapour over liquid nitrogen.
111.9. 1 All the blood banks have refrigerators with temperature

recorders and alarms for the storage of at least the number
of blood units normally used during ten days of peacetime
activity.
111.10.1 Blood is transported in polystyrene boxes with frozen ice

packs as refrigerants. The insulation allows the temperature
of the blood to remain below 10oC for 24 hours when the
ambient temperature is about 20o C.
111.11.1 Military
HQ DEFENCE COMMAND NORWAY

Joint Medical Service
Oslo Military Huseby
N-0016 Oslo 1, Norway
Tel: 47 22 49 70 52
Fax: 47 22 49 73 35
1 - 43
ORIGINAL
AMedP-12(A)
111.11.2 Civilian
MINISTRY OF SOCIAL SECURITY

Directorate of Health
P.O.Box 8128 Dep
N-0032 Oslo, Norway
Tel: 47 22 34 88 88
Fax: 47 22 34 95 90
Director, Blood Bank and Department of Immunology

Ullevaal University Hospital
N-0407 Oslo, Norway
Tel: 47 22 11 88 87
Fax: 47 22 11 85 00
1 - 44
ORIGINAL
AMedP-12(A)
112. 32578*8(6(%/22'352*5$00(
112.1.1 In the Portuguese Armed Forces, the Army operates as the

single service manager for blood. Portugal has one military
blood centre located in Lisboa. This blood centre collects
blood from voluntary military blood donors. Blood is
provided to the three military hospitals in Lisboa. Other
military hospitals receive blood and blood components from
the Instituto Português de Sangue (official civilian source).
112.2. Military Blood Bank Procedures
112.2.1 Collections All blood is collected by mobile teams, which

regularly visit military units, or at the Blood Centre, located
at the Hospital Militar Principal. The blood collecting team
includes military and civilian staff. At this time there is only
one medical specialist in haemotherapy, who is a civilian
doctor. Donor screening and clinical examination include
medical questionnaire, temperature, pulse, blood pressure,
haemoglobin, and weight. Blood is always collected by
nurses under the supervision of a medical officer. Blood is
collected in plastic bags containing anti-coagulant and
additive solution Citrate-Phosphate- Dextrose (CPD)
solution and/or Sorbitol-Adenine-Guanine-Mannitol (SAG-
M). The standard donation is 450ml. All donors are
volunteers. Annual whole blood donations are
112.2.2 Processing Techniques are both manual and automated.

Tests for ABO blood group Rhesus antigens, antibody
screens detection of HIV, Ag HBs, Ac Hbe, HTLV tests are
performed. The test of choice for syphilis is ELISA. There
is an immunohaemotology and virus reference laboratory
available in the Blood Centre for full validation of all
procedures.
112.2.3 Components There is regular component preparation.

Filtration pre-storage is the predominant technique for red
cell and platelets units leukocyte depletion.
1 - 45
ORIGINAL
AMedP-12(A)
(RCC) Red Cells (SAG-M) 42 days.

(FFP) Fresh Frozen Plasma 12 months.
(PC) Platelets from Buffy-coats 5 days.
112.2.4 Storage Storage conditions for blood components

guarantee the preservation of their quality during the whole
storage period, in appropriate conditions in refrigerators or
freezers with temperature recording and alarm devices.

serviced hospitals. Transportation temperature range is
generally 1º - 10ºC. Transportation mode includes blood
bank vehicles and automobiles.
112.3.1 Concept of Operations Blood collections in Portugal are

divided among three organizations. The largest and most
prominent are hospital blood centres. There are thirteen
such blood centres located in Lisboa (7), Coimbra (2) and
Porto (4). The Red Cross has a small blood centre in
Lisboa. The government has established a national blood
programme to co-ordinate the blood services: The Ministry
of Health has ultimate responsibility for the quality of blood
through the Portuguese Blood Institute.
112.3.2 Civilian Blood Bank Procedures
112.3.2.1 Collections All blood is collected at the blood

centres. Donor screening and examination
include medical questionnaire, blood
pressure, pulse, weight and haemoglobin.
Age range is normally 18-65 years old. Blood
is collected by physicians and by nurses
under the supervision of a physician. Blood is
collected in plastic bags and disposable
bottles that contain Citrate-Phosphate-
Dextrose (CPD) and/or Sorbitol-Adena-
Guanina-Manitol (SAG-M). Donors may
donate four times a year at prescribed
intervals. The standard donation is 450ml. All
donors are volunteers. Annual whole blood
donations are approximately 130,000 units.
1 - 46
ORIGINAL
AMedP-12(A)
112.3.2.2 Processing There are both automated and

manual procedures. Most procedures are
automated. Tests for ABO blood groups and
Rhesus antigens and antibody screens are
performed. HIV 1 & 2 and HTLV 1 & 2 are
tested for using ELISA and Western Blot.
Radioimmune (RIA) and enzyme (ELISA)
assays are performed for Hepatitis B and C.
Blood donor testing reveals a positive
hepatitis rate of approximately 1.2% among
prospective donors. Tests for syphilis include
VDRL and ROR. There are
immunohaematology reference laboratories
available in most blood centres.
112.3.2.3 Components Most blood centres produce

components.
Blood Products Maximum Expiration

Period
Red Cells (SAG-M) 42 days.

Platelets 5 days.

refrigerators or freezers.
Blood Products Minimum Temperature

Range
Red Cells 2o - 6oC.

Platelets 20 - 24oC.
o
Cryoprecipitate -300C.
112.3.2.5 Distribution Blood is transported in

polystyrene boxes to serviced hospitals.
Frozen ice packs are used to cool blood.
Transportation mode includes blood bank
vehicles or automobiles.
112.3.2.6 Special Techniques Apheresis and human

lymphocyte antigen testing is performed in
several blood centres.
1 - 47
ORIGINAL
AMedP-12(A)
112.3.2.7 Transfusion Practices Standard cross match

procedures are performed on blood. About
80% of transfusions are concentrated red
cells.
112.3.3.1 Military
Ministry of Defence
DGP
AV I1ha da Madeira
1499 Lisboa, Portugal
Tel: 351-1-3010001 Ext 4503
Serviço de Imunohemoyerapia
Hospital Militar Principal
Largo da Estrela
Tel: 351-1-3970181 Ext 3446/3457
112.3.3.3 Civilian
Instituto Português de Sangue

Rua Pinheiro Chagas, 69,50.
Tel: 351-1-1573767
1 - 48
ORIGINAL
AMedP-12(A)
113. 63$1,6+%/22'352*5$00(63
113.1.1 In the SP Armed Forces, the Army operates as the single

service manager for blood supply. The military blood bank
is located in Madrid, in the Military Hospital Gomez Ulla
(Army). The blood bank primarily supplies the Armed
Forces but also supports and collaborates with civilian
blood banks and hospitals. Blood is collected from military
donors in a donor room at the bank and at military
installations in the Madrid area. The red cells are provided
to the military hospitals in Madrid. Plasma is fractionated
by the blood bank into products for the military. Other
military hospitals either collect blood for local use or are
supplied from civilian sources.
113.1.2 Civilian blood collections in Spain are carried out by two

organizations, the hospital blood centres and the Spanish
Red Cross. Hospital blood centres collect the majority of
the blood. Most hospitals in Spain have a capability to
provide blood for internal use. Large hospital blood centres
such as the three in Madrid serve as regional blood
centres. Each centre collects and provides blood to the Red
Cross and to other hospitals in their respective region.
Plasma is lyophilized in the Madrid Red Cross Blood Centre
for the Red Cross system.
113.2.1 The SP Armed Forces are supported by separate medical

organizations. The medical organization is co-ordinated by
the Central Committee of Saniti (EMAD), Ministry of
Defence, Madrid.
113.2.2 Blood collections in Civilian life are divided between two

organizations, the hospital blood centres and the Spanish
Red Cross.
113.3 Collections
113.3.1 About 78% of the blood is collected by mobile units that

regularly visit military installations. The blood collecting
team members are mostly military and each team includes
a medical officer. On mobile collections, the responsibility
1 - 49
ORIGINAL
AMedP-12(A)
for donorship rests with the medical officer of the collection

team. Donor screening and examination include medical
questionnaire, temperature, pulse, blood pressure,
haemoglobin, and weight. Blood is collected by physicians
and by enlisted soldiers under the supervision of a medical
officer. Blood is collected in plastic bags. The plastic bags
contain Citrate-phosphate-Dextrose (CPD) solution. The
standard donation is 450m1. All donors are volunteers.
Annual whole blood donations are approximately 12,000
units.
113.3.2 Approximately 90% of mobile blood collections are

performed by Red Cross mobile collection teams. All
hospital blood centres operate donor collection rooms at
their respective centres. Donor screening and examination
include medical questionnaire, blood pressure, pulse,
haemoglobin and weight. Age range is normally 18-66
years old. Blood is collected by physicians and by nurses
under the supervision of a physician. Blood is collected in
plastic bags and bottles. Plastic bags contain Citrate-
Phosphate-Dextrose (CPD) and Citrate-Phosphate-
Dextrose-Adenine (CPDA-l). Donors may donate four times
a year at prescribed intervals. The standard donation is
450m1. All donors are volunteers. Annual whole blood
donations are approximately 150,000 units.
113.4 Testing
113.4.1 Techniques are mostly automated. The following

mandatory tests are performed on all donations:
113.4.1.1 Standard blood analysis and ALT.
113.4.1.4 HIV antibodies screen by ELISA and EIA.
113.4.1.5 HBsAG, HCV-Ab, screen by ELISA and EIA.
113.4.1.6 Anti HBc.
113.4.1.7 VDRL (Syphilis).
113.4.2 There is an immunohaematology reference laboratory

available in the Blood Centre. All repeated positive
screening test are sent to physicians.
1 - 50
ORIGINAL
AMedP-12(A)
113.5.1 Red Cells are stored at 2oC- 6o C.
113.5.1.1 Red Cells (CPD), Whole blood with optimal

additive with a shelf life of 21 days.
113.5.1.2 Red Cell Concentrate (with adenine, dextrose,

mannitol, physiological solution), with a shelf
life of 42 days.
113.6 Plasma
113.6.1 Fresh Frozen Plasma at -80oC for 1 year.
113.6.2 Frozen Plasma at -40oC for 5 years.
113.6.3 Cryoprecipitate at -30oC for 1 year.
113.7 Platelet Components
113.7.1 Platelets are stored at 20oC - 24oC for 5 days.
113.8.1 Several blood civilian centres and Military Hospital Gomez

Ulla, have frozen red cell facilities. The high
temperature/low glycerol and liquid nitrogen technique is
used.
113.8.2 Apheresis and human leucocyte antigen testing are

performed in several blood centres.
113.9.1 Blood products are stored in refrigerators, freezers or on

rotators.
113.10.1 Blood is transported in polystyrene boxes to serviced

hospitals.
113.10.2 Ice packs are used to cool blood. Transportation

temperature range is generally 1oC- 10oC, with a shelf life
of 6 days.
1 - 51
ORIGINAL
AMedP-12(A)
113.10.3 Methods of transportation include, blood bank vehicle,

automobiles and aircraft. Special battery powered
thermocontainers are used.
113.11.1 Military
Seccion Central de Hematologia y Hemoterapia.

Hospital Militar "Gomez-Ulla"
28047-Madrid. SPAIN
Tel: 34-1-525 76 76
Fax: 34-1-525 37 86
113.11.2 Civilian
Ciudad Sanitaria "LA PAZ"

Paseo de la Castellana 261
28046 Madrid - SPAIN
Tel: 34-1-734 43 00 Ext. 2553
Director Nacional del Programa de Sangre

Cruz Roja Espanola
Francisco Silvela 91
28002 Madrid - SPAIN
Tel: 34-1-561 68 23
34-1-561 24 0l
1 - 52
ORIGINAL
AMedP-12(A)
114. 785.,6+%/22'352*5$00(
114.1.1 In the Turkish Forces, the military is the main source for
blood donations. Additionally, all military centres receive
donations from civilian blood donors. Military hospitals with
200 beds or more have blood collection capabilities for
internal use. The largest is the Gülhane Military Medical
Academy (GMMA) Blood Training Centre and Blood Bank
in Ankara. This Centre has a blood component production
capability for internal use. Plasma from military collections
are fractionated into products by the Turkish Red Crescent
Blood Centre in Ankara for the military.
114.2.1 Collections About 60% of the blood is collected by mobile

units that regularly visit military installations. Routine blood
donor screening includes a medical questionnaire, pulse,
blood pressure, weight, haemoglobin and physician
interview. Blood is collected by nurses under the
supervision of a physician. Blood is collected in plastic bags
with Citrate Phosphate Dextrose Adenine (CPDA-1) and
Saline Adenine Glucose Mannitol (SAG-M). The standard
donation is 450 ml. The GMMA Blood Training Centre and
Blood Bank collects approximately 10,000 units per year.
All donors are volunteers.
114.2.2 Processing Techniques are mostly automated. Tests for

ABO blood grouping, Rhesus antigens and antibody
screens are performed on all donations. The following
mandatory tests are performed on all donations:
114.2.2.1 Hepatitis B surface antigen screen.
114.2.2.2 HIV 1&2 antibody screen.
114.2.2.3 Hepatitis C antibody screen.
114.2.2.4 Syphilis testing.
1 - 53
ORIGINAL
AMedP-12(A)
114.2.3 Component Production
114.2.3.1 The following red cell components are

produced and stored at 1oC - 6oC:
114.2.3.1.1 Packed red blood cells with CPDA-1 with a

shelf life of 35 days.
114.2.3.1.2 Packed red blood cells with SAG-M with a

114.2.3.2 These products may be further made into

components, which have been filtered,
irradiated, washed etc.
114.2.4 Plasma Products
114.2.4.1 Fresh frozen plasma is stored at -18oC, or

lower, for 1 year.
114.2.4.2 Crypoprecipitate is stored at -18oC, or lower,

for 1 year.
114.2.5 Platelet Concentrates
114.2.5.1 Single whole blood donations are stored at

20oC - 24oC for 5 days.
114.2.5.2 Apheresis platelet donations are stored at

20oC - 24oC for 5 days.
114.2.6 Special Techniques Apheresis and human leucocyte

antigen testing are performed in the GMMA Blood Training
Centre and Blood Bank.
114.2.7 Storage Blood products are stored in refrigerators and

freezers.
114.2.8 Transportation and Distribution Blood is transported in

polystyrene boxes to service hospitals. The transportation
temperature range in generally 1oC - 10oC.

1 - 54
ORIGINAL
AMedP-12(A)
114.3.1 Military
Turkish General Staff HQ

Health Department
Ankara 06100
Turkey
Ministry of Defence
Health and Veterinary Department
Ankara
Turkey
Tel: 90-4-4023270
Gülhane Military Medical Academy

Institute of Field Medical Service
Ellik, Ankara
Turkey
Gülhane Military Medical Academy

Blood Training Centre and Blood Bank
Ellik, Ankara
Turkey
Tel: 90-312-3212059
1 - 55
ORIGINAL
AMedP-12(A)
115. 81,7('.,1*'20%/22'352*5$00(8.
115.1.1 In the UK Armed Forces the supply of blood and blood

products to overseas military hospitals and deployed troops
is co-ordinated and undertaken by the Blood Supply Depot
(BSD), which is located in Ludgershall, near Andover. The
BSD forms part of the tri-service Medical Supplies Agency
(MSA). Fully tested blood is obtained from civilian sources,
principally the National Blood Service (NBS) of England.
115.1.2 The BSD maintains close professional and fraternal

relationships with all UK blood transfusion services.
115.2.1 The BSD holds the following field equipment capable of

storing blood at 2-6oC:
115.2.1.1 Field Hospital Blood Banks: Working on mains

supply. Maximum holding 160 units.
115.2.1.2 Portable Field Blood Banks: Thermopol M50B

Thermoregulators, Working on mains and
generator supply. Maximum holding 70 units.
115.2.1.3 Portable Field Blood Banks: Thermopol M30B

Thermoregulators, working on mains and
generator supply. Maximum holding 50 units.
115.2.1.4 Fresh Frozen Plasma Freezers: Working on

mains supply. Maximum holding 30 units
each.
115.2.1.5 Platelet Incubator/Shaker: Working on mains

supply. Maximum holding 16 ATDs each.
115.3 Transhipment Containers
115.3.1 Blood and Fresh Frozen Plasma (FFP) are routinely

shipped worldwide in polystyrene insulated tri-wall boxes
cardboard boxes known as CIBIT (Container Insulated
Blood in Transit).
1 - 56
ORIGINAL
AMedP-12(A)
115.3.2 A CIBIT containing bagged wet ice is capable of

maintaining a blood transportation temperature of 1-10oC
for a minimum of 48 hours.
115.3.3 A CIBIT containing cardice is capable of maintaining FFP at

a minimum transportation temperature of -40oC for 48
hours.
115.3.4 CIBIT Specification
Size: 62 x 39 x 39 cm.
Volume: 0.4 m3.
Capacity: 30 units.
Total Weight: 25 kg.
115.4.1 The UK civilian blood transfusion service consists of the

following organisations:
115.4.1.1 England: The National Blood Authority (NBA)

is responsible for 10 regional transfusion
centres in the National Blood Service (NBS).
115.4.1.2 Scotland: The Scottish National Blood

Transfusion Service (SNBTS) has 5 regional
centres.
115.4.1.3 Wales: The Welsh Blood Transfusion Service

has 1 centre.
115.4.1.4 Northern Ireland: The Northern Ireland

Transfusion Service has 1 centre.
115.4.2 Machine readable barcode labels (ISBT 128) are used by

all UK transfusion centres for blood and blood components.
115.4.3 Blood is collected in plastic bags, which contain the

anticoagulant Citrate Phosphate Dextrose Adenine (CPDA-
1). The standard donation is 450ml, this is then plasma
reduced. All donors are volunteers and over 90% of the
blood is issued as Red Cell Concentrate suspended in
SAG-M additive.
115.4.4 All Red Cell preparations and components are leuco-

depleted before issue.
1 - 57
ORIGINAL
AMedP-12(A)
115.4.5 The following mandatory tests are performed on all

donations:
115.4.5.3 HIV 1 & 2 antibody screen.
115.4.5.4 Hepatitis surface antigen (HBsAg) screen.
115.4.5.6 Syphilis antibody screen.
115.4.5.7 HTLV 1 and 2 antibody screen
115.4.5.8 HCV NAT testing is carried out on all

donations in pools of 48 samples. A negative
result being a release criterion for all
components with a shelf life of <24 hours.
115.4.6 All repeated positive screening tests are sent to specialised

Health Protection Agency Laboratories for confirmatory
tests.
115.4.7 Red cells are stored at 2-6oC with a shelf life of 35 days.
115.4.8 Fresh frozen plasma is stored at -30oC or below with a shelf

life of 1 year.
115.5.1 Military
SO1 Med Inter

Defence Medical Services Department
Ministry of Defence
Room 762
St Giles Court
1-13 St Giles High Street
LONDON
WC2H 8LD
Te!: 020 7807 0365

Fax: 020 7807 8834
1 - 58
ORIGINAL
AMedP-12(A)
Officer Commanding
MSA Blood Supply Depot
Drummond Barracks
Ludgershall
Andover
Hants SP11 9UA
Tel: 01264 798664

Fax: 01264 798679
115.5.2 Civilian
Chief Executive
National Blood Authority
Oak House
Reeds Crescent
WATFORD
Herts
WDl 1QH
Te!: 01923 486800

Fax: 01923 486801
Scottish National Blood Transfusion Service

Headquarters Unit
Ellen’s Glen Road
EDINBURGH
EH17 7QT
Tel: 0131 536 5300

Fax: 0131 536 5352
Welsh Blood Service

Ely Valley Road
Talbot Green
PONTYCLUN
CF72 9WB
Te!: 01443 622000

Fax: 01443 622199
Northern Ireland Blood Transfusion Service

Belfast City Hospital Complex
Lisburn Road
BELFAST
BT9 7TS
Te!: 01232 321414
1 - 59
ORIGINAL
AMedP-12(A)
Fax: 01232 439017
1 - 60
ORIGINAL
AMedP-12(A)
116. 81,7('67$7(6%/22'352*5$00(86
116.1.1 In the US Department of Defence (DoD), the Army, Navy,

and Air Force operate blood donor Centres. Each Service is
licensed by the Food and Drug Administration with each
donor centre licensed for specific products. Each Service
has a Service Blood Programme Officer (SBPO) to oversee
their respective Service blood programmes. There are
currently 39 licensed donor centres in the Continental
United States (CONUS) and 13 donor centres outside the
CONUS. Each Unified Combatant Command has a Joint
Blood Programme Officer to coordinate their respective
command’s blood programme.
116.1.2 An Armed Services Blood Programme Office (ASBPO) is

provided at the Department of Defence level under the
Assistant Secretary of Defence for Health Affairs
(ASD(HA)). It is a Joint Health Agency, which coordinates
with the ASD(HA), the Joint Staff; the worldwide blood
programmes of the Military Departments and the Unified
Combatant Commands in peace and war. It coordinates, as
well, with other Federal agencies, other US civilian blood
agencies and military blood agencies of other countries. Its
vision is to ensure that quality blood products, blood
substitutes and blood services are provided to improve
patient care and reduce patient risk for all authorized
beneficiaries in peace, contingency, and war.
116.1.3 Joint blood doctrine has been defined to provide a blood

distribution system, which incorporates all aspects of blood
services from the donor centre to the medical treatment
facility. Blood programme policy is provided by the
ASD(HA). The military is programmed to provide the
majority of blood products to meet all operations. However,
the DoD does have contingency contracts with US civilian
blood agencies in case of need
116.2.1 The US civilian blood agencies include:
1 - 61
ORIGINAL
AMedP-12(A)
116.2.1.1 The American Red Cross The American Red

Cross provides approximately 45 percent of
blood products for the US.
116.2.1.2 The Council of Community Blood Centres

The CCBC is an organization, which
represents the majority of independent blood
donor centres in the US, which provide
another 45 percent of the blood products in
the US.
116.2.1.3 The American Association of Blood Banks

The AABB is a national organization which
has as its members: blood donor Centres,
blood transfusion centres and individuals. Its
main mission is to provide standardisation
within the blood services through standards
and technical procedures.
116.2.2 The ASBPO maintains close professional relationships with

these civilian blood agencies. Many of the AABB
committees have DoD Liaisons.
116.2.3 The DoD blood programme uses machine readable

barcode labels (Codabar) and is working with the ICCBBA
in changing over to ISBT 128 labelling systems in the near
future.
116.2.4 The ASBP maintains its own blood computer system

named Defence Blood Standard System (DBSS). This
system is used at donor centres and transfusion services. It
has been deployed to all peacetime donor centre and
transfusion services and is being deployed to theatre
assets.
116.3 Collection
116.3.1 The Services’ blood donor centres collect approximately

150,000 to 175,000 units of blood per year. Routine donor
screening includes a medical questionnaire, haemoglobin
screening, weight, temperature, blood pressure and a brief
medical screening. Donors may self-exclude themselves
and/or their blood products for transfusion purposes. The
majority of blood is collected in plastic bags with Citrate
Phosphate Dextrose Adenine (CPDA-1). Some blood is
collected with ADSOL as the anticoagulant. The standard
donation is 450 ml. All donors are volunteers.
1 - 62
ORIGINAL
AMedP-12(A)
116.4 Testing
116.4.1 The following mandatory tests are performed on all

donations:
116.4.1.3 Syphilis testing.
116.4.1.4 HIV 1&2 antibody screen.
116.4.1.5 HIV P24 antigen screen.
116.4.1.6 Hepatitis B Surface antigen screen.
116.4.1.7 Hepatitis B core antibody screen .
116.4.1.9 HTLV 1&2 antibody screen.
116.4.2 All repeatably reactive screening tests are confirmed by

military and/or contracted civilian laboratories that are FDA
Licensed.
116.5.1 The following red cell components are produced and stored
at 1oC-6oC:
116.5.1.1 Packed red blood cells with CPDA-1 with a

116.5.1.2 Packed red blood cells with ADSOL with a

116.5.2 These products may be further made into components,

which have been filtered, irradiated, split, washed, CMV
tested, etc.
116.6.1 Fresh frozen plasma stored at -18oC or lower for 1 year.
116.6.2 Cryoprecipitate stored at -18oC or lower for 1 year.
1 - 63
ORIGINAL
AMedP-12(A)
116.7.1 Single whole blood donation (platelet concentrate) stored at

116.7.2 Apheresis Platelet Donations (4-6 single units) stored at

116.8.1 The US DoD has a frozen blood programme which consists

of frozen blood product depots stationed throughout the
world for contingency operations and peacetime surgical
use. There is a requirement for storage of 67,000 units of
frozen blood. The frozen blood is stored in glycerol and
must be washed prior to transfusion. The frozen blood is
licensed for 10 years storage at -65oC or below.
116.9.1 The US DoD has the following blood storage equipment

capable of storing blood at 1oC-6oC:
116.9.1.1 ISO Containers Working on mains or

generator. Maximum holding 3600 units.
116.9.1.2 Blood Bank Refrigerators Working on mains

and generators with a maximum holding 480
units. Provided in DEPMEDS hospital units.
116.9.1.3 Thermostabiliser units Working on mains and

12V/24V batteries. Maximum holding 50 units.
116.10.1 Blood and FPP are routinely shipped worldwide in

polystyrene insulated boxes known as Collins Boxes.
116.10.2 The box containing bagged wet ice (14 pounds) is capable
of maintaining 30 units packed red cells at temperatures of
1oC-10oC for a minimum of 48 hours from packing time.
116.10.3 The box containing dry ice is capable of maintaining 24

units FFP and 12-15 units frozen red cells at temperatures
of -40oC for 48 hours from packing time.
1 - 64
ORIGINAL
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116.10.4 Collins Box Specifications
Size: 18 x 18 x 17 inches (45.75 x 45.75 x 43.2 cm).

Volume: 3.4 Cubic Feet ( 9 m3 approx).
Capacity: 30 units packed red cells.
Total Weight: 45 pounds (20.4 Kg)
116.10.5 The Air Force maintains blood transhipment centres (BTCs)

at fixed airheads within the Unified Combatant Commands.
These BTCs can store up to 7200 units of packed red cells.
The Air Force will be deploying transportable blood
transhipment centres (TBTCs) to the Unified Combatant
Commands, which can be deployed to remote locations for
storage and distribution of blood products. They will have
ice making capability and 7200 packed red cell storage
capability.
116.11.1 Department of Defence
Director
Armed Services Blood Programme Office
5109 Leesburg Pike, Room 698
Falls Church, VA 22041-3258
Tel: (703) 681-8024

Fax: (703) 681-7541
116.11.2 Services
ARMY
Commander
U.S. Army Medical Command
ATTN: MCHO-CL-R (Army Blood Program)
2050 Worth Road
Ft. Sam Houston, TX 78234-6000
Tel: (210) 221-7132

Fax: (210) 221-6614
1 - 65
ORIGINAL
AMedP-12(A)
NAVY
Chief (ATTN: MED.273 (Blood Program)

Bureau of Medicine and Surgery
Navy Blood Program
2300 E Street, N. W.
Washington, DC 20372-5120
Tel: (202) 762-3434

Fax: (202) 762-3425
AIR FORCE
HQ USAF/SGXR
Air Force Blood Program
110 Luke Ave, Rm 400
Billing AFB, DC 20332-0750
Tel: (202) 767-5054

Fax: (202) 767-4841
U.S EUROPEAN COMMAND
HQ USEUCOM/ECMD
Joint Blood Program, USEUCOM
APO AE 09l28
Tel: 011-49-711-7166
Fax: 011-49-711-680-7459
1 - 66
ORIGINAL
AMedP-12(A)
&+$37(5
$&((0(5*(1&<%/22'68332576<67(0
201 Purpose. To provide information and guidance to establish a voluntary

emergency blood support system for ACE nations in wartime.
202 Policies. SACEUR’s minimum requirements for blood support include:
202.1 A national system able to provide an adequate blood supply.
202.2 Adequate prepositioned stocks of materiel to collect, process, and

distribute blood.
202.3 Adequate numbers of personnel trained in blood bank techniques and

blood logistics.
202.4 A plan that identifies requirements, capabilities, and procedures to

acquire blood.
203. Responsibilities
203.1 SACEUR
203.1.1 Peacetime
203.1.1.1 Establish in consultation with MSCs and a

designated national blood expert, policies, and
procedures for blood support, which include
reporting and requesting assistance for blood in
accordance with existing logistical procedures.
203.1.1.2 Establish objectives, review MSC planning and

evaluations of exercises involving blood
programmes.
203.1.2 Wartime:
203.1.2.1 SHAPE medical staff will provide medical advice

to the ACE Logistics Co-ordination Centre in
processing emergency requests for blood.
2-1
ORIGINAL
AMedP-12(A)
203.2 Major Subordinate Commands (MSCs)
203.2.1 Peacetime
203.2.1.1 Establish, in consultation with nations and

designated national blood experts, policies and
procedures for blood support which include
reporting and requesting assistance for blood, in
accordance with existing logistical procedures.
203.2.1.2 Establish objectives, review national planning

and evaluate exercises for blood support, to
include interoperability and emergency requests.
203.2.2 Wartime
203.2.2.1 MSC Medical staffs will provide medical regional

comments on emergency blood requests to the
ACE Logistics Co-ordination Centre (LCC) based
on LOGASREQ a procedures outlined in ACE
Directive (AD) 85-6 as appropriate. Procedures
within the SC (i.e. at PSC level) will be as
defined in MSC/PSC operating procedures.
203.3 Nations
203.3.1 Peacetime
203.3.1.1 Provide blood to medical facilities using national

systems and procedures per STANAG 2939.
203.3.1.2 Develop wartime blood plans that identify

requirements, capabilities, operational
procedures and emergency blood supply in
sufficient quantities to meet wartime need.
203.3.1.3 Establish bi-lateral and/or multi-lateral blood

assistance agreements/arrangements.
203.3.1.4 Establish agreements/arrangements with

national civilian blood programmes to
supplement military blood programmes.
203.3.1.5 Conduct exercises to test the operational

capability of the blood programme.
2-2
ORIGINAL
AMedP-12(A)
203.3.2 Wartime
203.3.2.1 Provide blood to medical facilities using national

systems and bi-lateral and/or multi-lateral
agreements/ arrangements.
203.3.2.2 Use the ACE Emergency Blood System as

required.
203.3.2.3 Arrange for emergency air shipments of blood in

accordance with ACE Directive 85-5, Annex C.
Nations will advise MSC of emergency blood
requests submitted to ACE LCC.
204 Procedures: Blood requirements which exceed normal national blood supply
capability may be obtained by:
204.1 Unit to Unit Submit blood requests directly to adjacent NATO units,
(STANAG 2135).
204.2 Unit to Major Subordinate Commands As appropriate and based on

MSC/PSC procedures, contact the MSC/PSC to request blood from
MSC component nations.
204.3 Nations to ACE LCC National MOD/CHOD may submit blood requests
to the ACE LCC using procedures established in AD 85-6.
204.3.1 Blood requests will be reviewed by the SHAPE medical desk

officer in the Logistics Readiness Centre.
204.3.2 The following actions will occur (AD 85-6):
204.3.2.1 ACE LCC will initiate a search procedure through

LCC national representatives.
204.3.2.2 The ACE LCC national representatives will co-

ordinate, through logistical channels, with the
respective MOD/CHOD medical and national
military blood programme office, to ascertain
blood surplus.
204.3.2.3 The ACE LCC will consolidate all offers of blood

assistance from the nations, and initiate action
between offering and recipient nation(s) to
transfer blood stocks.
204.3.2.4 Air movement will be initiated by the recipient

nations (AD 85-5, Annex C).
2-3
ORIGINAL
AMedP-12(A)
204.3.2.5 A transfer complete message will be originated

by the recipient MOD.
205 Reports/Requests AD 85-6 defines procedures for reporting blood deficiency

and also for requesting assistance at the national level. Since blood does not have a
NATO stock number the following format will be used when reporting or requesting
blood in accordance with AD 85-6.
Blood (QTY) Units
/O POS(QTY)/O NEG (QTY) /A POS (QTY)/A NEG (QTY)
/B POS (QTY)/B NEG (QTY)/AB POS (QTY)/AB NEG (QTY)
TOTAL (QTY)
206 References NATO and ACE documents relating to this appendix are:
206.1 AD 85-5, Allied Command Europe Air Transport Directive.
206.2 AD 85-6, Organization and Standard Operating Procedures of the Allied

Command Europe Logistics Co-ordination Centre.
206.3 STANAG 2135, Procedures for Requesting and Providing Logistic

Assistance.
206.4 STANAG 2361, List of Minimum Essential Supply Items.
206.5 STANAG 2939, Medical Requirements for Blood, Blood Donors, and
Associated Equipment.
206.6 STANAG 3093, NATO Air Transport Request and Answer to Air
Transport Request (NARAT and TRANSAR).
206.7 QSTAG 815, Blood Supply in the area of Operations.
206.8 QSTAG 850, Blood, Blood Donor and Transfusion Equipment

Requirements.
2-4
ORIGINAL
AMedP-12(A)
&+$37(5
67$1'$5',=$7,21$*5((0(17667$1$*217+(%/22'

352*5$00(
301 The Military Agency for Standardization (MAS) was established in 1951 to foster
military standardization with the aim of enabling NATO forces to operate together in the
most effective manner. The agency consists of representatives of all participating
nations and is served by an international staff. The Chairman of MAS has the sole
promulgating authority for all standardization agreements and is responsible directly to
the NATO Military Committee. The MAS consists of Navy, Army and Air Force boards.
The boards manage working parties, which include a General Medical Working Party,
with a Naval Sub-Committee, and an Aeromedical Working Party.
302 The process of standardization includes the submission of a proposal, either

through the national representatives or NATO commands and major subordinate
command headquarters to the MAS, or directly to MAS. The proposal is reviewed by
the MAS and assigned a number, if accepted for study. A working party will draft the
agreement and staff it among respective nations for approval. It will designate a
national custodian for the proposal. Once approved, the STANAG to be implemented
must be incorporated in national orders or instructions. Additionally, STANAGs can be
expanded into allied publications, which can be issued to all NATO unit levels.
303 Medical working parties currently have produced over 140 medical STANAGs.
The principal STANAG related to blood is STANAG 2939 "Medical Requirements for
blood, Blood Donors and Associated Equipment"
304 COMMITTEE OF THE CHIEFS OF THE MILITARY MEDICAL SERVICES OF

NATO (COMEDS)
304.1 With the inception of the new NATO Standardisation Organisation

(NSO) in 1996, areas requiring standardisation will now be identified
after scrutiny of the NATO DPQs. These will be incorporated into a
NATO Standardisation Programme (NSP) and allocated to the
appropriate authority to staff.
304.2 Subsequent to the introduction of this new approach, COMEDS has

been formally identified as a Tasking Authority for medical
standardisation. COMEDS Working Groups will be tasked by COMEDS
to study areas identified in the NSP as standardisation objectives. The
WGs will then be responsible for producing STANAGs.
304.3 An MOU has been agreed between COMEDS and the MAS. Both
authorities will continue to produce and sponsor STANAGs at present
and the MAS secretariat will provide assistance to the COMEDS
staffing of STANAGs initially.
3-1
ORIGINAL
AMedP-12(A)
304.4 The NSO has identified blood and blood products as an area where
standardisation would be beneficial. COMEDS has tasked its Military
Medical Materiel and Pharmacy Working Group with reviewing this
STANAG after ratification.
305 QUADRIPARTITE STANAG (QSTAGs)
305.1 The American, British, Canadian and Australian (ABCA) Army

Standardization Programme is designed to provide military
standardization among the four English-speaking countries. NATO
STANAG and QSTAG are exchanged between each group for
comparison and comment. The process of QSTAG promulgations is
similar to that of NATO STANAG. The Primary Standardization Office,
in Falls Church, Virginia, USA, co-ordinated the QSTAG programme.
Current QSTAGS that relate to blood are QSTAG 289, Minimum
Essential Characteristics of Whole Blood Shipping Containers; QSTAG
406, Transfusion Equipment for Medical Use; and QSTAG 580, Medical
Requirement for Blood and Blood Donors.
306 POINTS OF CONTACT
North Atlantic Treaty Organization

Military Agency for Standardization
1100 Brussels, Belgium
Tel: 02-241.00.40/241.44.00
Primary Standardization Office

Nassif Boulevard
5611 Columbia Pike
Falls Church, Virginia 22041
Tel: 202-756-1376
COMEDS Secretariat
Etat-Major du Service Medical
Staff Medical Service
Quartier Reine Elisabeth, Rue d'Evère 1
B-1140 Brussels
Belgium
Tel: (32) 2 701 3066
3-2
ORIGINAL
AMedP-12(A)
&+$37(5
%/22'%$1.(48,30(17$1'6833/<(48,9$/(176
2)1$721$7,216
401 Allied Publications 1 (A Med P-1D) contains a list of supply items from various
NATO countries that are considered equivalent to supply items, which can be
requisitioned through regular supply channels. Blood bank related equipment
supplies are listed here.
Item Name Country Pack Unit Issue Stock No

of Origin
Albumin Bovine Solution
Albumina Bovina Sterile IT 50cc NR

Albremina Do Plasma Bovideo PO 20ml frasco
Albumin Bovine Polymerized UK 10ml vial 6505-99-211-9586
Plasma
SOPP 4% : Stabiele Oplossing van BE 400ml 6505-70-280-5355

Plasma Proteïnen
SSPP 4% : Solution Stable de BE 400ml 6505-70-280-5355
Proteines Plasmatiques
Plasma Serum Flydente Humant DA
Plasma Humain Desseche Pour FR 3 350cm N 697.331.080.002
Plasma Ematos Xiro Me Dialiti GR 176-22
Plasma Umano, Liofilizzato IT NR SO-300-4161
Plasma-Eiwitoplossing NL doos 6505-17-046-7480
Plasma Humano PO frasco 6505-27-000-6897
Kuru Normal Plasma TU
Blood Grouping Serum,

Anti A and Anti B:
Gel-tests voor gecombineerde BE 4x12EA 6550-70-280-5870

bloedgroep- bepaling ABO/D+
Gel-tests pour groupage sanguin BE 4x12EA 6550-70-280-5870

combiné ABO/D+
Serum Til Blodtypebestemmelser DA B 101

SS., Anti "A" ,Anti "B" DA B 102
Oros Anti-A GR 196-35

Oros Anti-B GR 196-35A
Oros Prosdiorismou
Omadon Ematos Anti A & b gr 196-35b
Siero Emodiagnostico IT fiala SO-300-3562

IT fiala
Siero Anti A E Anti b IT Scatola NR
4-1
ORIGINAL
AMedP-12(A)

of Origin
Testserum, Bloedgroeponderzoek NL doos 6505-17-029-6171

NL doos 6505-17-046-8826
NL doos 6505-17-046-8827
Sera Blodtype
Anti A NO rÖr 6505-25-721-6040
Anti B NO rÖr 6505-25-721-6050
Serum, Blodtype NO
esk 6505-25-721-6060
Soros Para Classificacao DE PO
Grupos Sanguineos, Anti-B
E Anti-B embalag
Anti B Blood Grouping
Serum Human PO
Anti A Blood Grouping
Serum Human
Serum Anti-A, Serum Anti-A TU each 6505-27-000-6878
Blood Grouping Serum UK 5ml vial 6550-14-211-3896

UK 5ml vial 6550-14-211-3897
UK 10ml vial 6550-14-211-6356
Blood Grouping Serum Usp

Anti A US pkg 6505-00-159-8410
Anti BQ US pkg 6505-00-159-8380
Blood Grouping Serum /

Antiserum Rhesus D and E:
Serum voor bepaling van Rh BE 4x12EA 6550-70-280-5871
subgroepen en Kell
Serum pour determination des sous- BE 4x12EA 6550-70-280-5871

groupes Rh et Kell
Serum Test Anti-Rhesus

Anti D Lyophilise FR N 6505-14-416-0272
Anti C D E Lyophili FR N 6505-14-416-0273
Oros Anti-D (RH) GR 196-45
Siero Emodiagnostico IT fiala
Testserum, Bloedgroeponderzoek NL doos 6505-17-046-8831

NL doos 6505-17-046-8830
Anti Rho (Anti D Serum Human) PO

Blood Grouping Serum UK 10ml vial 6550-99-898-5421
Blood Collecting-Dispensing
Bag and Donor Set:
CPD-SAGM Triple Blood Bag System BE 450ml 6530-70-280-5892
4-2
ORIGINAL
AMedP-12(A)

of Origin
Bag and Donor Set CA 12’s PK 6515-00-879-9908
Blood Transfer-Dispensing Bag, CA EA 6515-00-890-1866

Indirect Transfusion
Eengangs-Donorsaet DA EA 6515-22-111-4935
Poche Simple A Prelevement

De Sang Avec Cpda FR N 6515-14-404-3572
Poche Simple A Prelevement
De Sang Avec Cpd FR N 6515-14-362-9505
Solutio Natrii Citratis

Et Glucosi Et Acidi Citrici NL 12 stel doos 6505-17-046-7479
Blood Collecting
Administering Bag UK each 6515-99-210-4252
Blood Collecting
Administering Bag UK 12’s pack 6515-99-212-0589
And Donor Set UK 12’s cont 6515-99-210-4249
Bag and Donor Set UK 4’s can 6515-00-664-2734
Blood Testing Kit,

Blood Grouping
Gel-tests voor gecombineerde BE 4x12EA 6550-70-280-5870
bloedgroep- bepaling ABO/D+
Gel-tests pour groupage sanguin BE 4x12EA 6550-70-280-5870

combiné ABO/D+
Blood Testing Kit DA 100st PG

Blood Grouping
Serum Test
Desseche A-B-ab FR 50st Kit 6505-14-289-1944
Blood Testing Kit

Blood Grouping TU 100st Adet
Pump, Pressure Transfusion

Rotary
Blodtransfusionspumpe DA stk 653.265.232
Pump, Pressure Transfusion, Rotary UK each 6515-99-210-5112
Infusor, Pressure, Blood

Colleting-Dispensing Bag US each 6515-00-584-2893
4-3
ORIGINAL
AMedP-12(A)

of Origin
US EQUIVALENTS
Blood Substitutes/Blood Donor/Infusion Material

Ringers Inj Lac 6505-00-083-6537
Dextrose Inj 6505-00-083-6538
Sodium Chl Inj 0.9% 6505-00-083-6544
Albumin Human 6505-00-299-8179
Heparin Sod Inj 6505-00-579-8432
Tetanus Toxoid 6505-00-685-5189
IV Inj Sets 6515-00-117-9021
IV Inj Sets 48’s 6515-00-140-0888
Blood Donor Bags, CPDA-1,6’s 6515-01-128-1407
Blood Bag Segment Stripper, Crimper, Cutter 6515-01-140-5267
Albumin, Reagent 6550-00-890-1639
Anti-D, Typing Sera 6550-01-057-2775
Anti-A, B, Typing Sera 6550-01-057-2641
Anti-A, Typing Sera 6550-01-057-2642
Anti-B, Typing Sera 6550-01-057-2643
Anti-B, Typing Sera 6550-01-057-7364
Coombs Reagent 6640-00-782-6008
PIPENTS, DISP. 5-3/4" 6640-01-119-0013
Test Tubes 12 X 75 Mm 6510-01-113-9208
Frep/Sep Arm Prep Kit 6630-00-245-1137
Red Top Tubes 7 ml 7690-01-132-5527
Label, Red Blood Cell, CPDA-1, O Pos 7690-01-132-0251
Label, Red Blood Cell, CPDA-1, O Neg 7690-01-432-0252
Label, Rd Blood Cell, CPDA-1, A Pos 7690-01-132-0253
Label, Red Blood Cell, CPDA-1, A Neg
4-4
ORIGINAL
AMedP-12(A)
&+$37(5
,17(51$7,21$/%/2''352*5$00(62876,'(1$72
501 The Council of Europe
501.1 Blood Programme
501.1.1 Founded in 1949, the Council of Europe was established to

foster greater unity and co-operation between the people and
nations of Europe. The Council presently has twenty-one
member nations.
501.1.2 One of the major areas of co-operation deals with health

care, which includes blood. An emergency system to make
supplies of blood and blood products obtainable with
minimum delay, but in standardization of blood bank
techniques, abolishment of custom duties, and the uniform
labelling of blood products. A European bank of frozen rare
blood groups has been established at central laboratory of
the Netherlands Red Cross Blood Transfusion Centre.
501.1.3 There is an annual closed meeting of member nation’s blood

bank experts, hosted by different host nations. The council
has several sub-committees working on different areas such
as quality control, automation and computerization. The
council has published several manuscripts that establish the
minimum standards for blood donor centre operation.
501.1.4 Council members include:
Austria Iceland Norway

Belgium Ireland Portugal
Cyprus Italy Spain
Denmark Liechtenstein Sweden
France Luxembourg Switzerland
Germany Malta Turkey
Greece Netherlands United Kingdom
5-1
ORIGINAL
AMedP-12(A)
Council de l’Europe*
Boite Postale 431 R6
Health Division
F-67006 Strasbourg Cedex
France
Tel: 088-614961 Ext 2968
*All requests must be forwarded through official diplomatic channels. References:

various Council of Europe publications.
502 The International Red Cross Blood Programme
502.1 The International Red Cross is composed of three separate, but closely
co-ordinated organizations. Included are the International Committee of
the Red Cross, the League of Red Cross Societies, and National Red
Cross and Red Crescent Societies.
502.1.1 International Committee of the Red Cross (ICRC) The ICRC

acts as a neutral intermediary in humanitarian matters during
international conflicts, civil wars, and internal disturbances.
Blood is provided to all victims, with the technical support of
the League of Red Cross and Red Crescent Societies.
502.1.2 League of Red Cross and Red Crescent Societies The

league is the permanent liaison body of national societies
and acts as their spokesman and representative
internationally. The league is responsible for medical help in
times of natural disasters. Blood is provided to medical
facilities through the affected nation’s Red Cross/Red
Crescent Blood Programme or from other societies. The
Director, Blood Programme of the League co-ordinates these
efforts.
502.1.3 National Red Cross/Red Crescent Societies There are one

hundred and thirty-one countries that have Red Cross/Red
Crescent Societies. There are society blood programmes in
fifty-eight of the countries. In twenty-three countries, the
society is the national blood programme. There is an annual
meeting of international Red Cross blood transfusion experts
in which there is collaboration in the field of blood
transfusion.
5-2
ORIGINAL
AMedP-12(A)
International Committee of the Red Cross Medical Division

17, Avenue de la Paix
CH-1211 Geneva DL
Switzerland
Tel: 022-346001
League of Red Cross Societies

PO Box 276
CH-1211 Geneva 19 DL
Switzerland
Tel: 022-320225
503 International Society of Blood Transfusion Blood Programme
503.1 The International Society of Blood Transfusion (ISBT) is a scientific

society of international blood bank experts. The ISBT carries out
research, improves techniques and the uses of blood products. Among
the publications provided by the ISBT are:
Guide 1: Criteria for the Selection of Blood Donors.

Guide 2: Hazards of Blood Transfusion.
Guide 3: Quality Assurance in the Blood Transfusion Laboratory.
Guide 4: Safety Precautions for Blood Transfusion Laboratories.
Guide 5: Diagnosis and Management of Haemolytic Disease in the
New Born
Guide 6: Blood Component Therapy
Guide 7: Use of Plasma Derivatives Containing Coagulation Factors.
503.2 In addition, the ISBT has published a blood bank code of ethics, which
sets minimum standards for blood donations, blood transfusions and
system quality control. The society is divided into six geographical
regions. There is a meeting of the society in different host nations every
two years.
International Society of Blood Transfusion

6, Rue Alexandre Cabanel
75739 Paris Cedex 15
France
Tel: 01-3067000
5-3
ORIGINAL
AMedP-12(A)
504 International Federation of Blood Donor Organizations
504.1 The International Federation of Blood Donor Organizations (FIODS)

was founded in Luxembourg on December 4, 1955. The Federation
unites twenty-one national member organizations located in Europe,
Africa, South America, and Asia. In addition, there are seventeen
associated organizations around the world.
504.2 The aim of the FIODS is the promotion of voluntary blood donation and
worldwide co-operation of all national donor organizations. The
Federation organizes international congresses and issues a quarterly
publication, called "FIODS REVUE". A representative of the FIODS
attends International Society of Blood Transfusions meetings as an
observer.
International Federation of Blood Donor Organizations

Francisco Silvela 91
Madrid - 6 Spain
Tel: 01-261-2401/61823
505. World Health Organization Blood Programme
505.1 The World Health Organization (WHO) consists of one hundred and
sixty five countries co-operating in the field of health, and is the
directing and co-ordinating authority on international health work. The
organization is divided into six regions. The countries in each region
formulate policies and adopt programmes of a regional character, to
implement and monitor these programmes.
505.2 The WHO, which establishes norms and standards in a variety of fields,
including blood, and the laboratory/blood bank service, has, in co-
operation with various international blood experts, published several
standards in the field of immunohaematology and blood banking.
505.3 Key publications include: A Guide to the Formation and Operation of a

Transfusion Service, and the Collection, Fractionation, Quality Control,
and Uses of Blood and Blood Products. In addition, several courses
have been established to provide training in quality control, laboratory
management and blood bank readout production.
5-4
ORIGINAL
AMedP-12(A)
World Health Organization

Laboratory Service
Ave Appia
1211 Geneva 27
Switzerland
Tel: 022-913644
World Health Organization

Information Service
Ave Appia
1211 Geneva 27
Switzerland
Tel: 022-912929
5-5
ORIGINAL
AMedP-12(A)
5-6
ORIGINAL
NATO/PfP-UNCLASSIFIED
AMedP-12(A)
NATO/PfP-UNCLASSIFIED

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NATO/PfP UNCLASSIFIED

PUBLICATION NOTICE ROUTING

1. AMedP-12(A), NATO BLOOD BROCHURE, is available in the Navy War-

2. Summary: AMedP-12(A) defines the Blood Programmes of Nations.

Navy Warfare Library Custodian

Navy Warfare Library publications must be made

Note to Navy Warfare Library Custodian

NORTH ATLANTIC TREATY ORGANIZATION

NATO STANDARDISATION AGENCY (NSA)

NATO LETTER OF PROMULGATION

1. AMedP-12(A) - NATO BLOOD BROCHURE is a NATO/PfP UNCLASSIFIED

2. AMedP-12(A) is effective upon receipt. It supersedes AMedP-12 which should be

CHAPTER RECORD OF RESERVATIONS BY

CHANGE DATE EFFECTIVE BY WHOM

1. BLOOD PROGRAMMES OF NATO NATIONS

115. United Kingdom

116. United States

2. ACE EMERGENCY BLOOD SUPPORT SYSTEM

3. STANDARDIZATION AGREEMENTS (STANAGS) ON THE BLOOD

4. BLOOD BANK EQUIPMENT AND SUPPLY EQUIVALENTS OF NATO

5. INTERNATIONAL BLOOD PROGRAMMES OUTSIDE NATO

501. Council of Europe

502. International Red Cross Blood Programme

502.1 International Red Cross

502.2 International Committee of the Red Cross

502.3 League of Red Cross and Red Crescent Societies

502.4 National Red Cross/Red Crescent Societies

502.5 Points of Contact

503. International Society of Blood Transfusion Blood Programme

504. International Federation of Blood Donor Organizations

505. World Health Organization Blood Programme

101 MILITARY BLOOD PROGRAMME

101.1 Concept of Operations

101.1.1 The sole Military Blood Bank is located in the Brussels

101.1.2 The red cell concentrates are provided to Brussels Military

101.2 Military/Civilian Liaison

101.2.1 Blood collections in Belgium are almost completely

closed system, frozen, thawed, deglycerolised in closed

101.3.2 In the civilian sector, approximately 75% of blood is

101.3.3 Standard cross match procedures are performed on blood

101.4.1 In the Military Blood system, all techniques are automated.

101.4.1.1 ABO and Rhesus blood groups.

101.4.1.2 Hb and complete blood cell count.

101.4.1.3 Irregular and auto-antibodies screen.

101.4.1.4 ALT level.

101.4.1.5 HIV l, 2 & TO antibody, HIVp24 antigen and

101.4.1.6 Hepatitis B surface antigen (HBsAg), core

101.4.1.7 Hepatitis C antibody and RNA screen.

101.4.1.8. Cytomegalovirus total antibody quantitative

101.4.1.9 Syphilis antibody screen by VDRL.

101.4.1.10 Human T-Lympophotropic Viruses I & II

101.4.2 If required, samples can be sent to immunohaematology

101.4.3 In the civilian sector, there is a mixture of automated and

101.4.3.1 ABO and Rhesus blood groups.

101.4.3.2 Hb and complete blood cell count.

101.4.3.3 Irregular antibody screen.

101.4.3.4 HIV 1, 2 & TO antibody and HIV1 RNA

101.4.3.5 Hepatitis surface antigen (HBsAg) screen.

101.4.3.6 Hepatitis C antibody and RNA screen.

101.4.3.7 HBC and HBS antibody screen (first

101.4.3.8 ALT level.

101.4.3.9 Syphilis antibody screen by VDRL +/- TPHA.

101.5 Component Production