Blood Donor Operations I MD0867

192 Pages·2006·1.25 MB·English

by  US Army medical department

U. S. ARMY MEDICAL DEPARTMENT CENTER AND SCHOOL
FORT SAM HOUSTON, TEXAS 78234
BLOOD DONOR OPERATIONS I
SUBCOURSE MD0867
EDITION 101
DEVELOPMENT
This subcourse is approved for resident and correspondence course instruction. It reflects the current
thought of the Academy of Health Sciences and conforms to printed Department of the Army doctrine as
closely as currently possible. Development and progress render such doctrine continuously subject to
change.
When used in this publication, words such as "he," "him," "his," and "men" are intended to include both
the masculine and feminine genders, unless specifically stated otherwise or when obvious in context.
The initial letters of the names of some products are capitalized in this subcourse. Such names are
proprietary names, that is, brand names or trademarks. Proprietary names have been used in the
subcourse to make it a more effective learning aid. The use of any name, propriety or otherwise, should
not be interpreted as endorsement, deprecation, or criticism of a product. Nor should each use be
considered to interpret the validity of proprietary rights in a name, whether it is registered or not.
The instructional systems specialist responsible for the revision of this edition was Mr. Victor A. Seely,
DSN 471-6154 or commercial [phone], ACADEMY OF HEALTH SCIENCES, MULTIMEDIA
DEVELOPMENT BRANCH, ATTN: MCCS-HLD, 2250 STANLEY ROAD (ROOM 326), FORT SAM
HOUSTON TX 78234-6130.
The subject matter expert responsible for content accuracy of this edition was Major Elaine S. Perry, DSN
471-7652 or commercial [phone], COMMANDER, U.S. ARMY MEDICAL DEPARTMENT
CENTER AND SCHOOL, DEPARTMENT OF CLINICAL SUPPORT SERVICES, ATTN MCCS-HCL,
3151 SCOTT ROAD, FORT SAM HOUSTON TX 78234-6100.
ADMINISTRATION
Students who desire credit hours for this correspondence subcourse must meet eligibility requirements
and must enroll through the Nonresident Instruction Branch of the U.S. Army Medical Department Center
and School (AMEDDC&S).
Application for enrollment should be made at the Internet website: http://www.atrrs.army.mil. You can
access the course catalog in the upper right corner. Enter School Code 555 for medical correspondence
courses. Copy down the course number and title. To apply for enrollment, return to the main ATRRS
screen and scroll down the right side for ATRRS Channels. Click on SELF DEVELOPMENT to open the
application and then follow the on screen instructions.
In general, eligible personnel include enlisted personnel of all components of the U.S. Army who hold an
AMEDD MOS or MOS 18D. Officer personnel, members of other branches of the Armed Forces, and
civilian employees will be considered eligible based upon their AOC, NEC, AFSC or Job Series which will
verify job relevance. Applicants who wish to be considered for a waiver should submit justification to the
Nonresident Instruction Branch at e-mail address: [email protected].
For comments or questions regarding enrollment, student records, or shipments, contact the Nonresident
Instruction Branch at DSN 471-5877, commercial [phone], toll-free 1-800-344-2380; fax: 210-221-
4012 or DSN 471-4012, e-mail [email protected], or write to:
NONRESIDENT INSTRUCTION BRANCH
AMEDDC&S
ATTN: MCCS-HSN
2105 11TH STREET SUITE 4191
FORT SAM HOUSTON TX 78234-5064
WARNING: BE AWARE THAT YOU MAY BE TESTED OVER THIS MATERIAL WHEN YOU ARRIVE
AT PHASE II
TABLE OF CONTENTS
Lesson Paragraphs Page
INTRODUCTION ...................................................................... iii
1 DONOR SUITABILITY AND BLOOD COLLECTION ................
Section I. Donor Suitability......................................................1-1--1-5 1-3
Section II. Blood Collection......................................................1-6--1-11 1-27
SectionIII. Autologous Blood....................................................1-12--1-16 1-42
Exercises ...................................................................... 1-46
2 COMPONENT PROCESSING, TESTING, LABELING,
STORAGE, AND DISTRIBUTION
Section I. Component Processing ..........................................2-1--2-2 2-3
Section II. Blood Donor Testing...............................................2-3--2-4 2-18
SectionIII. Review and Labeling ..............................................2-5--2-10 2-26
SectionIV. Blood Storage/Distribution......................................2-11--2-17 2-37
Exercises ...................................................................... 2-43
3 COMPATIBILITY TESTING AND BLOOD ADMINISTRATION
Section I. The Immune Response and the Interaction of
Antigens, Antibodies, and Complement in
Immunohematology................................................3-1--3-11 3-2
Section II. The Antiglobulin Test..............................................3-12--3-18 3-10
SectionIII. Red Cell Antibodies................................................3-19 3-16
SectionIV. Compatibility Testing ..............................................3-20--3-29 3-17
Section V. Blood Administration...............................................3-30--3-36 3-28
SectionVI. Investigation of Adverse Effects..............................3-37--3-40 3-43
Exercises ...................................................................... 3-51
Glossary ...................................................................... G-1
Annex A ...................................................................... A-1
Annex B ...................................................................... B-1
Annex C ...................................................................... C-1
Annex D ...................................................................... D-1
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Lesson Paragraphs Page
Annex E ...................................................................... E-1
Annex F ...................................................................... F-1
Bibliography ................................................. BIB-1
LIST OF ILLUSTRATIONS
Figure Page
1-1 DD Form 572, Blood Donor Record (front side)..........................................1-5
1-2 DA Form 572, Blood Donor Record (reverse).............................................1-6
1-3 Donor information........................................................................................1-7
1-4 Donor screening utilizing DD Form 572 (continued)....................................1-9
1-5 Bar Codes on reverse side of DD Form 572...............................................1-20
1-6 Donor screening utilizing oral questions......................................................1-22
1-7 Triple blood bag set.....................................................................................1-29
1-8 Trip balance set-up.....................................................................................1-30
1-9 Filling of sample tubes ................................................................................1-34
2-1 Fullface label for RBCs ...............................................................................2-27
2-2 ISBT 128-Specified Label ...........................................................................2-35
3-1 The four-chain structure of an IgG molecule showing both interchain
and intrachain disulfide bridges (Cbh = carbohydrate)................................3-5
LIST OF TABLES
2-1 Blood Anticoagulants/Preservatives Solution Licensed by the FDA............2-4
2-2 Amount of Glycerol Needed for Different Weights of RBC Units.................2-9
2-3 Methods for Leukocyte Reduced Red Blood Cells......................................2-12
2-4 Summary of Quality Control Requirements for Components ......................2-17
2-5 Routine ABO Grouping ...............................................................................2-20
3-1 Antihuman Globulin Reactions....................................................................3-12
3-2 Blood Choice .........................................................................................3-21
3-3 Thrombocytopenia and Platelet Therapy ....................................................3-31
3-4 Blood Component and Fractions Containing Factor VIII.............................3-34
3-5 Plasma Substitutes.....................................................................................3-37
3-6 Management of Transfusion Reactions.......................................................3-44
3-7 Schedule of Investigation of Suspected Transfusion Reactions..................3-47
MD0867 ii
CORRESPONDENCE COURSE OF THE
U.S. ARMY MEDICAL DEPARTMENT CENTER AND SCHOOL
SUBCOURSE MD0867
BLOOD DONOR OPERATIONS I
Blood for transfusion is a biologically active therapeutic substance. It has
specific effects on the human organism and dosage requirements just as any other
therapeutic substance. Blood differs, however, from other biologicals in that it must be
obtained from healthy individuals of the human race. The 1980's brought increasing
complexity of blood banking operations and problems associated with assessment and
management practices for donor suitability, deferral, and adherence to appropriate
testing practices and prevention of inappropriate release of blood and blood
components. The responsibilities of those who collect, process, and issue blood for
transfusion are tremendous.
Blood transfusion attempts are recorded as far back as the 16th century. At first,
animal blood was transfused to humans. Later, human blood was used. However, facts
concerning the characteristics of even human blood were not known, and these early
transfusions frequently caused severe reactions and often death.
The safety of blood transfusion is directly proportional to the knowledge, skill, and
sense of responsibility of the laboratory technicians. It is not sufficient to establish
appropriate procedures and techniques. Continuous instruction and training are
required to assure the highest quality and safety in performance of blood bank
procedures. That is why in this subcourse, instruction is concerned with blood donor
center and transfusion service activities, including preparation of blood products for
transfusion therapy.
Subcourse Components:
This subcourse consists of three lessons, a glossary of blood banking terms and
definitions, six annexes, a bibliography, and an examination. The lessons are:
Lesson 1,Donor Suitability and Blood Collection.
Lesson 2,Component Processing, Testing, Labeling, Storage, and Distribution.
Lesson 3,Compatibility Testing and Blood Transfusion.
Credit Awarded:
Upon successful completion of this subcourse, you will be awarded 20 credit
hours. You must receive a score of 70 percent or higher on the examination in order to
successfully complete this subcourse.
MD0867 iii
Lesson Materials Furnished:
Materials provided include this booklet, an examination answer sheet, and an
envelope. Answer sheets are not provided for individual lessons in this subcourse
because you are to grade your own lessons. Exercises and solutions for all lessons are
contained in this booklet.
You must furnish a #2 pencil to be used in marking the examination answer
sheet. You may keep the subcourse booklet.
Procedures for Subcourse Completion:
Complete the subcourse lesson by lesson. When you have completed all of the
lessons to your satisfaction, complete the examination answer sheet and mail it to the
AMEDD Center and School along with the Student Comment Sheet (if appropriate) in
the envelope provided. Be sure that your social security number is on all
correspondence sent to the AMEDDC&S. You will be notified by return mail of the
examination results. Your grade on the examination will be your rating for the
subcourse.
Study Suggestions:
Here are some suggestions that may be helpful to you in completing this
subcourse:
• Read and study each lesson carefully.
• Complete the subcourse lesson by lesson. After completing each lesson,
work the exercises at the end of the lesson.
• After completing each set of lesson exercises, compare your answers with the
solutions. If you have answered an exercise incorrectly, reread the text material
cited after the solution to determine why your response was not the correct one.
• As you successfully complete each lesson, go on to the next. When you have
completed all of the lessons, complete the examination, marking your answers in
this booklet. When You are satisfied that you have answered all of the
examination items to the best of your ability, transfer your responses to the
examination answer sheet. Use a #2 pencil to mark the examination answer
sheet.
MD0867 iv
Student Comment Sheet:
Be sure to provide us with your suggestions and criticisms by filling out the
Student Comment Sheet found at the back of this booklet, and returning it to us with
your examination answer sheet. In this way, you will help us to improve the quality of
this subcourse.
If you wish a personal reply to a question, please call or write your question on a
separate letter (not the Student Comment Sheet). The letter can be sent with the
examination answer sheet. Be sure to include your name, rank, social security number,
mailing address, and subcourse number on your letter.
MD0867 v
LESSON ASSIGNMENT
LESSON 1 Donor Suitability and Blood Collection
TEXT ASSIGNMENT Paragraphs 1-1 through 1-16.
LESSON OBJECTIVES After completing this lesson, you should be able to:
1-1. Identify clinical signs and symptoms associated
with HIV infection and AIDS.
1-2. Identify physical examination and medical
history criteria which would be cause for donor
rejection.
1-3. Identify "Confidential Unit Exclusion" (CUE)
procedure.
1-4. Identify the requirements for the Donor Deferral
Registry (DDR) and the associated codes.
1-5. Describe the donor deferral notification
process.
1-6. Match deferral codes and infectious disease
testing results using algorithms in Annex A.
1-7. Describe the donor collection procedure.
1-8. List symptoms of adverse donor reactions.
1-9. Describe treatment for adverse donor
reactions.
1-10. Identify different types of donors and
requirement variations.
1-11. Describe autologous donations.
1-12. List tests required for autologous blood
donation testing.
1-13. Identify labeling requirements for autologous
blood.
MD0867 1-1
SUGGESTION After completing the assignment, complete the
exercises at the end of this lesson. These exercises
will help you to achieve the lesson objectives.
MD0867 1-2
LESSON 1
DONOR SUITABILITY AND BLOOD COLLECTION
Section I. DONOR SUITABILITY
1-1. GENERAL
Blood donor centers and transfusion services depend on voluntary donors to
provide the blood products needed to meet the organization mission requirements. The
ultimate goal of donor centers and transfusion services is to obtain the safest blood
product possible. Donor selection is based on a limited physical examination and a
medical history done on the day of the donation. This process greatly decreases the
chance of transmission of agents that can harm the recipient. It also ensures that there
are not any negative effects on the donor. The most useful tool to accomplish the
routine screening of blood donors is the use of the Blood Donation Record, DD Form
572 (see figures 1-1 and 1-2). To meet regulatory requirements, several critical points
must be continuously managed and monitored when determining donor suitability:
predonation event, donor registration, donor screening and acceptance, and donor
deferral registry.
1-2. PREDONATION
a. To attract volunteer donors and to encourage the continued support of the
blood program, it is important that the atmosphere surrounding the blood donation be as
pleasant, safe, and convenient as possible. The donation area should be attractive,
well-lighted, clean, comfortably ventilated, and open at convenient hours. Personnel
should be friendly and understanding, professional and well trained. A Standing
Operating Procedure Manual (SOP) that covers all phases of donor activities must be
readily available.
b. Provide information to the prospective donor (figure 1-3). The information
provided must include the following.
(1) Clinical signs and symptoms associated with HIV infection and AIDS.
(a) Unexplained weight loss (10 pounds or more in less than 2
months).
(b) Night sweats.
(c) Blue or purple spots on or under the skin, eyes, or in the mouth.
(d) Swollen lymph nodes lasting more than one month.
MD0867 1-3