PRIN 2_L12_Blood Donor Phleb

• goals of performing blood donor phlebotomy:

  1. Ensure the safety of the donors
  2. Minimize and prevent contamination in the donated blood which may come from external sources
  3. Conduct safe selection of donated blood for therapeutic purposes especially during its shelf life
  4. Make sure that other personnel are well-trained and qualified to do the venipuncture procedure for blood donation
• Collection of blood and blood components for transfusion must abide to:

  • FDA guidelines
  • AABB guidelines
• Components of the Blood Unit Volume:

  • 405 to 495 mL of blood
  • 63 mL of anticoagulant (CPDA-1)
• The blood donation process

  • Usually takes 45 to 60 minutes
  • Donors should be at least 16 yrs. old weighing 110 pounds  at the minimum & should be generally healthy
• Basic requirement of a potential blood donor according to the National Voluntary Blood Services Program (NVBSP)

  • Weight: at least 110 lbs (50 kg)
  • blood volume collected will depend mainly on your body weight
  • pulse rate: between 60 and 100 beats/minute with regular rhythm
  • blood pressure: between 90 and 160 systolic and 60 and 100 diastolic
  • hemoglobin: at least 125 g/L
• Donor Screening

  • The donor is asked about his/her health, lifestyle, and disease risk factors.
  • All details provided are confidential.
• Donor Registration

  • The donor needs to complete a donor registration, which includes his/her name, address, and other demographic information.
• Medical History

  The donor will have to confirm if he/she has any health issues and disease risk factors.

  • Past and current medications
  • Drug/infectious agent exposure
  • History of venereal disease
  • Social habits
• Donor Interview

  • The donor will have a brief interview with the healthcare personnel to ensure he/she has met the general donor reqts.
• Physical Examination

  • A short health exam (pulse, temperature, BP) will be conducted and a drop of blood from the donor’s finger will be tested to ensure that his/her blood iron level is suitable for donation.
• Guidance on Venipuncture for Blood Donation

  • A short briefing on the procedure will be given by the health personnel.
• Preparing the Venipuncture Site

  • The donor will be led to the donor area where the arm is cleaned with antiseptic and the vein for venipuncture is selected.
• Collecting the Unit

  • The unit of blood will be collected by the health personnel.
• Adverse Events in Blood Donation

  • The healthcare personnel will have to monitor the donor for adverse effects during and after blood collection.
  • Donor should remain seated for a few minutes before leaving the room to ensure that he/she is not suffering from dizziness.
• Donor Care Post Phlebotomy

  • Venipuncture site should be inspected and refreshments should be offered to the donor before he/she leaves the area.
• Donor Blood Processing

  • Collected blood unit is prepared and placed in the proper container for transport to the processing area.
• Donor Blood Labeling

  • The information indicated on the label found in the blood unit must be double-checked, complete & accurate.
• Whole Blood Donation

  • Donation frequency: Every 56 days
  • You must be in good health and feeling well
  • You must be at least 16 years old in most states
  • You must weigh at least 110 lbs
• Power Red Donation

  • Donation frequency: Every 112 days, up to 3 times/year
  • You must be in good health and feeling well
  • Male donors+ must be at least 17 years old in most states, at least 5'1" tall and weigh at least 130 lbs
  • Female donors + must be at least 19 years old, at least 5'5" tall and weigh at least 150 lbs
• Platelet Donation

  • Donation frequency: Every 7 days, up to 24 times/year
  • You must be in good health and feeling well
  • You must be at least 17 years old in most states 
  • You must weigh at least 110 lbs
• Donation Intervals

  • Wait at least 8 weeks between whole blood donations.
  • Wait at least 7 days between platelet (pheresis) donations.
  • Wait at least 16 weeks between Power Red (automated) donations.
• Infectious Diseases Tested for on Each Unit of Donor Blood

  • Chagas disease (Trypanosoma cruzi)
  • HIV 1 and 2
  • Hepatitis B (HBV)
  • Hepatitis C (HCV)
  • Syphilis
  • West Nile virus (WNV)
  • Human T-cell lymphotropic virus (HTLV)
• Required pieces of equipment

  • BP monitors
  • Scales
  • Donor couches
  • Chairs
  • Beds
  • Blood collection mixers
  • Blood bag sealers
  • Blood transportation boxes
  • Blood bank refrigerators
• It is important that furniture & equipment in blood donation and processing areas are made of cleanable surfaces such as vinyl, kept clean & disinfected by sodium hypochlorite bleach sol’n
• • Fabric or textile carriers should be machine-washable
  • Closed collection system (sterile blood collection bag containing anticoagulant with attached tube and needle) should be used.
  • Diversion pouches could also be used to minimize contamination from skin flora and to obtain the first 20 ml of blood.
  • For hemoglobin test, a sterilized lancet is utilized, & the collected blood should be immediately placed in a safety box.
• Donor Collection

  • Cleansing (One-step procedure and Two-step procedure)
  • Needle sizes - usually 15-17 G
  • Veins of choice (veins of the antecubital fossa)
  • Fist clenching (speed flow of blood)
  • Completion of donation
• One-Step Procedure of Cleansing (Recommended)

  Duration: about 1 minute

  Material: combine 2% chlorhexidine gluconate in 70% isopropyl alcohol

  Procedure:

  • Wash the site using firm gentle pressure from the center of the site, then move downward and outward
  • Make sure that the whole skin site is covered and in contact with the disinfectant for a minimum of 30 seconds
  • Site should be allowed to dry completely or for at least 30 seconds
• Two-Step Procedure

  Duration: about 2 minutes

  Material: 70% isopropyl alcohol and tincture of iodine or chlorhexidine (2%)

  Procedure:

  • Follow the steps in the one-step procedure.
  • Use either tincture of iodine or chlorhexidine (2%).
  • Wash from the center, then move downward, and outward applying firm but gentle pressure.
  • Contact should be about 30 seconds.
  • Then, allow the area to dry completely or for about 30 seconds.
• Venipuncture

  • Performed in the usual manner and when blood appears in the tubing, the needle is securely taped to donor’s arm
  • After removal of needle, donors are instructed to elevate arm and apply firm pressure to the puncture site
  • After confirming that bleeding has stopped, phlebotomist should place a sterile gauze/bandage and instruct the donor to keep it on for 4 hours
• Reminders/Caution

  • Use a 16-gauge needle (usually attached to the collection bag).
  • Cut off the needle at the end of the procedure.
  • Make the donor open and close his/her fist slowly during the collection (10-15 seconds).
  • Remove the tourniquet after the blood flow is established or after 2 minutes.
  • Repeat disinfection procedure if the site has been touched.
• Apheresis•

  • Desired component in the patient’s blood is removed and the remainder is returned to the donor (Red cell, platelets, or plasma)
  • Phlebotomist must have additional training
• Autologous donations

  Purpose:

  • Patient is scheduled for surgery;
  • Donates own blood for own use
  • Prevention of transmission of blood-borne pathogens
• Autologous Donations Qualifications

  • Time between donations (as often as 72 hours– w/doctor’s approval)
  • Hemoglobin level - at least 11.0 g/dL
  • Hematocrit : 33%
  • Autologous units are only designated to autologous donor
• Autologous -Involving one individual as both donor and recipient

  • An autologous blood transfusion
  • An autologous bone marrow transplant
• Therapeutic treatment - Removal of blood; Formerly termed as bloodletting

  Used to treat:

  • Polycythemia (increased RBC’s)
  • Hemochromatosis (increased iron levels)
  • Documentation of compliance with regulations by AABB and FDA
• Patient Instruction

  1. Collection instructions (Verbal and Written)
  2. Prepared to answer questions
  3. Collection on site or at home