Clinical Internship 1
Internship 1 - EACMED
TOPIC: BLOOD DONATION
Speaker: Hadassah Gallego, RMT
BLOOD DONATION
- refers to the process of testing, collecting, preparing and
storing of blood components
STEPS
Donor Registration
1
 Pre-donor counseling
2 Physical Exam = conducted by physician
3 Hemoglobin determination
4 Blood Collection = venipuncture
5 Post-donor care and counseling
1. DONOR REGISTRATION
- to have a standardized and documented policy and
procedure on donor registration. It covers the explanation
about blood donation criteria and obtaining donor’s
consent.
 Ex. fever, cancer, leukemia = deferred
 Assess donor if qualified to donate blood
- Donor Recruitment Officer will conduct pre-donation
counseling for the blood donors
- Filling out the required data in the registration sheet for
donors and provide Blood Donor History Questionary
(DHQ) to assess their present and past health status
- All prospective donors who met the general criteria for
donation such as age and good health should be
registered when they attend a blood donation session,
even if they are subsequently not accepted for donation
- Each donor must be clearly and uniquely identified so
that a specific donor can be traced through the entire
process and if necessary, recalled
- The DRO instructs the donor to read and understand the
criteria
 Date and Time of donation
 Name LN, FN, MI
 Address
 Gender
 Date of Birth/Age
- Minors may be accepted only if written consent of
parent/guardian is obtained
 16-17yrs old
-DRO explains about the donor’s consent. Elements of the
donation procedure shall be explained, including the info
about significant risks of the procedures and tests to be
performed to reduce the risk of TTI’s to the patient
- DRO instructs the donor to sign the DONOR’S
CONSENT
 Must be obtained before the donation
PRE-DONATION COUNSELING
- Confidential dialogue bet a blood donor and trained
counsellor about issues related to the donor’s health and
the donation process
- Includes
 Donor’s right and responsibility
 Blood donation process
 Potential-donation related complication
 Risks
Transcribed by: AAA
 Tests done and why
 Uses
 Steps
 Importance of regular donation
 Donation Intervals
 Importance of maintaining healthy lifestyle
 Window period of infection
 TTI and how they can be avoided
 High-risk behavior
 Means of self-deferral
-The DRO should achieve the ff during pre-donation
cousneling
 Enable self-deferral by person with high risk
behavior or have travelled to high risk areas
 Identify medications being taken
-During pre-donation counseling
 Discuss and educate the voluntary donor with
basic blood donation info and blood donation
educ materials and instruct the voluntary do not
to sign on the applicable section of the BDHQ to
acknowledge full understanding of blood
donation process and consent to donate
 Donor assessment shall include the criteria for
the protection and health of both donor and px
 Donor interview and physical exam must be done
in area which ensures visual and auditory privacy
o Openness, warmth and non-judgmental
attitude
 Donors who are deferred are given a full
explanation of the reason and informed as to
when they can follow up
2. PHYSICAL EXAM
- Physician checks and records the physical health status
of the potential blood donors and determine the eligibility
before proceeding with collection procedures
- evaluated using the A-Z guide to Medical Assessment of
Blood Donors
- Deferred blood donors shall be counseled by the Blood
Bank Physician
 includes
o Accepted
o Temporarily Deferred
o Permanently Deferred
o Reason for Deferral
3. HEMOGLOBIN DETERMINATION
- using the EKF HEMO CONTROL PHOTOMETER
 POCT Hgb analyzer designed to provide
quantitative lab quality Hgb results w/n 25
seconds
Hgb > 12.5g/dL = QUALIFIED
-OTHERS
 <12.5g/dL = counseled for deferral
3. BLOOD COLLECTION
- Preparation of Materials for Blood Collection/Phlebotomy
 Phlebotomist prepares the blood collection
materials, ensures that the DHQ, blood bags,
test tubes are correctly labeled
o Must contain the same serial numbers
PROCEDURE
 Clinical Internship 1
Internship 1 - EACMED Transcribed by: AAA
1 Proper identification = state full name  Avoid lifting heavy weights or strenuous activities
2 Check DHQ if properly filled out for 24 hours
3 Explain procedure and ensure donor’s comfort  Leave dressing or bandage on for minimum for
Prepare needed supplies and materials 24 hours
 Check condition of bags and tubes  Apply pressure for 2-5 minutes on venipuncture
4
o Appearance of anticoagulant, site
leakage, and expiry date  Lying down with legs elevated, if he/she feels
Prepare donor’s arm dizzy or lightheaded
 Scrub site (2x2 in) for 30sec  Encourage the donor to become a regular donor
 Aqueous POVIDONE IDONE SCRUB soln and remind him to come back after 3 months
(10%)
5
o Iodophor = polyvinylpyrol-iodine, CRITERIA FOR DEFERRAL
designed to remove dirt, oil, and 1. AGE
loose skin cells - 18 to 65 yrs old
o Apply to stand for 30secs  16-17 years old = consent
Phlebotomy  1st time donor >60yrs or regular donors 65yrs old
 Apply tourniquet, clip bag before opening, may be accepted
pull the skin taut, insert needle bevel up 2. APPEARANCE AND INSPECTION
and proper needle angle. Check and make - should be accepted only if they appear to be in good
sure the flow is fairly rapid and steady, health and comply with donor selection criteria
6
cover the punctured site by cotton or gauze 3. MINOR ILLNESSES
to keep the site clean - RECENT INFECTION = 14 days following full recovery
o Slow flow = prone to clotting and cessation of any therapy (ex. antibiotics)
 Instruct the donor to squeeze stress ball 4. WEIGHT
every 10-12 seconds during collection - at least 50kg to donate 450mL ± 10%
- Mix the blood bag gently every 45 secs, and label 5. VITAL SIGNS
the blood bag properly (date and time of collection, Temperature 37 C or 99 F
date of expiration and name of BSF). Use ball point Systolic 100-140 mmHg
pen for labelling Diastolic 60-90 mmHg
 CPDA-1 = 35 days Pulse rate 60-100 per minute
o Ex. Oct. 9 date of collection  6. IRON
Nov. 13 expiration date MALE FEMALE
7
 On the DHQ note of the segment number, >12.5g/dL >12.5g/dL
time started and ended, and name of 7. FLUID INTAKE AND FOOD
phlebotomist - 500mL of water before blood donation
o >20 minutes = hemolyzed 8. GENDER
 Weigh bag and collect desired volume. - FEMALE DONORS
o Whole blood = 570 grams  ACCEPT during menstruation
o Volume blood = 450mL  DEFEER during pregnancy and up to 6 mos
Advise donor that you will remove needle. Clamp the after delivery
tubing at the distal end, release the tourniquet. 9. OCCUPATION AND LEISURE ACTIVITIES
Stabilize needle at the hub and remove tape. Apply - Hazardous work not to resume work for at least 24
8 light pressure to site before removing the needle. hours after blood donation
Withdraw the needle and advise the donor to apply
light pressure to the site because it is still bleeding, - HCW, police, military personnel, workers with animals
re-cap needle using 1-hand scoop technique carry and INCREASED RISK TO BLOOD-BORNE
Collect sample from donor bag for blood typing and INFECTIONS, although confirmed transmission is rare,
serologic screening such individuals should have been immunized against
 Evacuated tube should be used to not relevant diseases, should be questions about possible
9
compromise the sterility of blood units and exposure
should be barcoded  6-12 months based on incubate period
 Tightly knot the distal end
Packaging = make sure that the cold box are clean - SEX WORKERS = not accepted
and follow cold chain instruction during mobile 10. NON-COMMUNICABLE DISEASE
1
 Transport = 1-10C 11. HEMATOLOGIC DISORDER
0
 Storage = 2-6C --need to avoid any risk of anemia, bruising, and
 Standing indirectly with ice packs hematoma or thrombosis

4. POST-DONATION CARE AND COUNSELING -CHRONIC ANEMIA = not suitable

-explain CEU confidential exclusion unit and provide 12. CARDIOVASCULAR DISEASE (CVD)
refreshments - HYPERTENSION
 ACCEPT = stable uncomplicated hypertension
-Before allowing the donor tot leave the area, inform them controlled by medication
the ff.  DEFER = anti-hypertensive medication or
 No smoking for more than 1 hour adjusted
 Do not drink alcoholic beverage before next meal o Defer for 28 days and stabilized BP
 Drink more than usual amount of fluids. Ave  DEFER PERMANENTLY = hypertensive heart
something to eat or drink before leaving the or renal disease
donor area 13. RESPIRATORY DISEASES
 Clinical Internship 1
Internship 1 - EACMED Transcribed by: AAA
-ASTHMA = asymptomatic, maintenance dose or non-
steroid or inhaled steroid medication is ACCEPTABLE
14. GIT DISEASE
- based if malabsorpition and or acute or chronic blood
loss
15. METABOLIC AND ENDOCRINE DISEASE
-DIABETES MELLITUS
 Defer PERMANENTLY = insulin-dependent
 ACCEPT = well-controlled by diet or oral
hypoglycemic medication provided they have no
history of orthostatic hypotension and no
evidence of infection neuropathy or vascular
disease
16. RENAL AND URINARY TRACT INFECTION
- Lower UTI = defer 14 days

- Acute self-limiting renal disease (ACUTE RENAL

NEPHRITIS) = defer for 5 years 23. DIAGNOSTIC AND SURGICAL PROCEUDRES
defer
- CHRONIC KIDNEY DISEASE (CKD) = defer  Minor = endoscopy
PERMANENTLY  Invasive = 12 months
17. PSYCHIATRIC  Dental treatment
-ACCEPT = anxiety of mood affective disorders o Simple = 24 hours
(depression, bipolar disorders) o Endodontic (root canal) = 7 days
24. HEPATITIS A/E
-defer PERMANENTLY = psychotic disorders requiring
- defer = active HAV, HEV = 12 months
maintenance treatment
18. MEDICAL AND SURGICAL INTERVENTION
- close contact = 12 months
-Post exposure prophylaxis
25. VIRAL INFECTIONS
 HEPA B and RABIES = defer for 12 months A. HIV
after exposure - accept = household contacts
19. LIVE ATTENUATED VIRAL AND BACTERIAL - defer = current or former sexual contact (12 mos)
VACCINES - permanently = individual w/ HIV
- defer for 28 DAYS
B. HERPES
-Live attenuated viral -accept = no active lesions
 Hepa A -defer = symptomatic (except HHV8) = at least 28 days
 Japanese encephalitis -permanently = individual HHV8, current and former
 Influenza
 Measles RATIONAL BLOOD USE
 Mumps 1 Limited blood availability
 Rubella 2 Many involving complication of BT
20. INACTIVATED VACCINE 3 Increased cost
- non-live vaccine = ACCEPTED
 Cholera KEY POINTS
 Diphteria - transfuse only if with specific well-established indications

- routine vaccines defer for 14 days - transfuse blood components rather than WB
 Except HBV  WB prone to CMV
21. BLOOD TRANSFUSION AND
RETRANSPLANTATION - obtain informed consent except in life-threatening
-ACCEPT = sexual partners receive blood transfusion emergencies

-DEFER -BLOOD COMPONENTS are preferred because each

 Recipient = 12 mos component has specific optimal storage condition and
 Former sex contact = 12 months after last minimizes the use of blood donation
contact
22. MEDICATIONS -MAJOR INDICATIONS
 Restore and maintain blood volume
 Improve oxugen-carrying cpacitiy
 Blood coag

- Advantages
 less volume is transfused
 correct dose of specific component
 lesser risk of BT reactions
 labile coagulation factors and can be
concentrated
 Clinical Internship 1
Internship 1 - EACMED Transcribed by: AAA
- RISK PACKED RBC
 TTI red cell concentrate
Form
o HIV, Hepa B , Hepa C, syphilis, malaria, plasma-reduced blood
Chagas d Volume 230-330mL
 Platelets are higher risk of bacterial open (24 hours),
Shelf-life
contamination close system (same as mother bag)
o Stored in room temp Storage Temp 2-6 C
symptomatic anemia,
BLOOD TRANSFUSION REACTION acute blood loss,
ACUTE Mild allergic or urticarial Indications CHF
febrile non hemolytic, Hemoglobin <6g/dL (6-10g/dL =
MODERATE depends)
bacterial contamination
LIFE-THREATENING Acute intravascular ↑1g/dL Hgb
Response
DELAYED TTIs ↑3% Hct
Transfusion time 4 hours
SAFE BLOOD PRODUCTS
-properly screened, typed, and crossmatched FRESH FROZEN PLASMA
collected from single donor units or
- Hiv- 26 per day (2016) Form apheresis
 TYPE SPECIFIC
-VOLUNTARY, NON RENUMERATED BLOOD FONOR Volume 180-300mL
FROM LOW RISK POPULATION Shelf-life 1 year, 6 hours after thawing
-18 to -30 C
BLOOD STORAGE
BLOOD AND Storage Temp frozen w/n 8 hours of collection
STORAGE TEMPERATURE  Loss of labile factors (V, VIII)
BLOOD PRODUCTS
Whole Blood  thawed at 37 C
2-6 C
Packed RBC DIC,
Fresh Frozen Indications Coagulation deficiencies,
-20 C or lower TTP
Plasma (FFP)
20-24 C w/ continuous ↑0.5g/dL Hgb
Platelets Response
agitation ↑1.5% Hct
Cryoprecipitate Below -30 C If not for Factor VIII replacement =
- Ward or Domestic Refrigerators Transfusion time stored at 4 C provided transfusion is
 NOT suitable for blood product storage completed within 24 hours
*Notes Contains coagulation factors
- Storage conditions and expiry dates
 Strictly followed PLATELET CONCENTRATE
RANDOM APHERESIS
BLOOD COMPONENTS >5.5x1010 platelets in 3.0x1011 in 250 mL
Contains
Red Cell Whole Blood 50 mL plasma
Components Packed RBC 9 ↑ 30-60 x 109/L =
Response ↑ 5-10x10 = FAST
Fresh Frozen Plasma (FFP) w/n 2-4 hours
Plasma Storage 20-24 C with constant agitation
Cryoprecipitate
Platelet Platelet Concentrate Shelf life 5 days
thrombocytopenia, DIC, patients with
Indications
WHOLE BLOOD abnormal platelet function, DENGUE
Form Unprocessed Blood
Volume 450mL + 63mL anticoagulant
Dependes on anticoagulant
Shelf-life  CPDA-1 = 35 days
 ACD-CPD = 21 days
Storage Temp 2-6 C
hemorrhage >50% of blood in <3
Indications
hours
↑0.5g/dL Hgb
Response
↑1.5% Hct
Transfusion time 4 hours
No functional platelets and labile
coagulation factors (V, VIII)

*FRESH WHOLE BLOOD

*Notes  <24 hours old
 no ref
 very risky (spirochetes, CMV)
 no indication

MANUAL OPERATIONS FOR DTL

 Clinical Internship 1
Internship 1 - EACMED Transcribed by: AAA
RA 10856 (ANTI DRUNK AND DRUGGED DRIVING ACT
OF 2023) – remove the mandatory drug testing for driver’s
license

POSITIVE UNCHALLENGED = 15 DAYS THEN DISPOSED

POSIITIVE CHALENGGED = INDEFINITE STORAFE