Flashcards in Lecture 12 Deck (42)
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1
how much is 1 unit of blood
1 pint= 450 mL or 1/10th of blood volume
4.6 units of blood are required per patient
2
Blood to be transfused is mixed with
with 63 ml Citrate Phosphate Dextrose (CPD) anticoagulant or Acid Citrate Dextrose (ACD)
3
Blood Donor Requirements
o Personal identification information
o at least 17 years of age
o every 56 days for males and every 84 days for females since last donation
o 72 hrs since dental surgery, extraction or root canal
o 6 months since tattooing , ear or body piercing
o < 6mths in malaria area- after one year upon returning to Canada
o > 6 months in malaria area- 3 years upon returning to Canada
o Donor must be in good health
o Weight 50 k
o Full recovery from cold , flu or sore throat
o Cannot donate if had malaria
o Some cancer- After 5 years treatment cancer free ( These include breast, prostate, colon, thyroid and uterine cancer)
o Skin cancer – after treatment
o Homosexual males- I year waiting period
o Male Hgb= 130 g/L – quick test with CUSulf ..sinks too much hemo
o Female Hgb = 125g/L
4
Ineligible to Donate
• Creutzfeldt jakob disease
Mad cow
• Zika Virus
o People who have taken money or drugs for sex, since 1977 cannot give blood.
o Intravenous use of illegal street drugs
• Disease-e.g. Lupus
• Diabetes ( treated with insulin )
• Chronic Fatigue Syndrome (xenotropic murine leukemia virus-related virus (XMRV).
• Trans individual -Donated Blood is tested for
5
Donated Blood is tested for
ABO and Rh group, - HOSIPITAL ( Canadian blood services does the rest)
Red cell antibody screening
Syphilis, Hepatitis B (viral DNA) and C( HVC)
Human immunodeficiency virus - HIV 1 and HIV 2,
Viral RNA- HIV 1 and HCV
Human T-Cell lymphotropic viruses HTLV I and II
West Nile Virus ( when increased risk is present)
Cytomegalovirus ( CMV) antibody and IgA
6
EXTRACTION
Blood is centrifuged
The red blood cells and plasma are both extracted, leaving the buffy coat layer
Pooled buffy coat is then centrifuged a second time, and the platelet rich plasma is extracted through a leukoreduction filter to produce a pooled platelet concentrate.
7
leukoreduction
a filtration process whereby white blood cells are removed. White blood cells often carry viruses and bacteria.
8
Whole Blood shelf life
35 days at 1-6ºC
Red blood cells can be used to help accident victims, surgical patients and people with anemia
9
Packed Red Blood Cells shelf life
Shelf life: 42 days at 1-6ºC (not all cells are brand new , so keep for half the days so the patient gets almost new cells if they live for 120 days. You cant give a patient blood cells that are 110 days old.
Frozen< -18°C: 10 years
10
plateletpheresis
Donation of platelets
The platelets are collected and the rest of the blood is returned to the donor through the same needle
Up to 5 times more platelets can be recovered for a donor
Takes about 75-100 mins
Can donate every 2 weeks
Shelf life: 5 days at 20-24C(RT) with agitation
Platelets can be used to treat leukemia, cancer and thrombocytopenic patients
11
Albumin donation
for volume replacement
12
Cryoprecipitate donation
AHF) concentrate of factor VIII, factor XIII, von Willebrand factor and fibrinogen; used for hemophilia A and fibrinogen replacement
Frozen up to one year : stored < -18°C or thawed: stored 20-24C
13
Factor VIII Concentrate donation
for hemophilia A
14
Factor IX Concentrate donation
for hemophilia B
15
Immunoglobulins donation
for immunodeficiency or exposure to infectious diseases such as hepatitis
16
Plasmapheresis
Blood from donor is collected, centrifuged and the cells are returned to donor through the same needle.
Only plasma is collected
Yields double the volume of a unit of blood
Products: plasma, platelet concentrate, WBCs (to harvest stem cells)
• Donation monthly up to weekly
Fresh frozen plasma: 1 year stored at < -18°C
Thawed plasma < 24 hours stored at 1 to 6C
Plasma is effective in treating patients suffering from burns or shock
Plasma serves as a source of plasma proteins for patients who are deficient in or have defective plasma proteins
Given to patients who require replacement of multiple plasma coagulation factors.
17
Hematopoietic Progenitor Cells (HPC), Cord Blood
• HPC, Cord Blood contains hematopoietic progenitor cells collected from the umbilical cord and placenta immediately after delivery of a baby
• The cryopreserved HPC, Cord Blood product in the Canadian Blood Services’ Cord Blood Bank (CBB) is stored in liquid nitrogen at -196°C and does not have an expiry date
18
The HPC, Cord Blood is tested for the following
• ABO group
• Rh type
• Abnormal Hemoglobin
• HLA typing
• Microbial culture testing
19
The HPC, Cord Blood may be used to treat:
• Malignant hematological and non-malignant diseases
(e.g. leukemia, lymphoma, multiple myeloma, hemoglobinopathies, inherited metabolic disorders)
• Post chemotherapy for cancer treatment).
20
Blood Bank Component Quality Assurance
Note: All blood received from Canadian Blood Service are visually inspected for deterioration
• bacterial contamination
• discolouration - hemolysis
• Fibrin and clot
• Lipemia
• Icterus
Monitor and record refrigerator and freezer temperatures; refrigerators have continuous monitors and alarm systems.
21
Blood Collection Principle
5–10 ml of the patient’s blood
should be collected into a pink top or red top tube in order to ensure that plasma or serum, is available for carrying out the compatibility test.
22
Cross-match
The testing of the patient’s serum against the donor red cells and the donor serum against the patient’s red cells, before transfusion.
it is important that blood of the correct ABO group is used.
must be ABO and Rh compatibility
23
Patient Identification
blood sample should be clearly labelled with the patient’s full name, hospital unique ID number, ward and signed by the person taking the blood. Sent blood sample immediately to the laboratory, together with a completed blood request form.
The signature of the person taking the blood sample must be on the label and requisition. Samples are rejected if there are no signatures.
24
INPATIENT
1. Print and take computer bar code blood labels to the patient’s bedside
2. Check computer blood labels with patient’s armband.
3. Ask the patient to spell their name and state their DOB to compare with computer blood label and requisition form when possible.
25
OUTPATIENT
4. Ask the patient to spell their name and state their DOB to verify with blood computer label, requisition form and Health Card. MANDATORY
5. Draw blood samples
6. Label blood samples at the patient’s bedside (inpatient).
7. Label at the patients phlebotomy chair (outpatient)
8. Date and sign the BTL requisition / label(full name)
26
Manual Specimen Labels
Patient first and last name
Patient age
Unique ID number
Specimen date.
Collection time.
Phlebotomist full name and initial
The specimen number.
27
Patient’s requisition.
First and Last name
Unique identification number
The required blood component or blood product and dosage
Date and time of intended transfusion if available
Special requirements, if applicable
Patient’s location
Name of the ordering physician
Patient’s date of birth
Diagnosis and reason for transfusion/infusion
Priority
Transfusion history and Pregnancy history
Signature of the doctor requesting the transfusion
28
Retention
• Healthcare employee signatures, initials and computer identification are retained for ten years or according to established SOP
29
Blood Component Labeling Standard- ISBT
An international standard for the transfer of information associated with tissue transplantation, cellular therapy and blood transfusion , bar coding
30
