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Blood bank--blood sources and pretx testing
What is needed for donor hx for homologous (allogenic) blood donation?
1. Full name
2. Home/work address
3. Date of birth/age
4. Date of last donation
5. Reasons for previous deferral
How long do you defer someone with viral hepatitis after 11th bday?
How long do you defer someone with high risk AIDS behavior?
How long do you defer someone with + serology for HBc, HIV, HCV, or HTLV?
How long do you defer someone who receives money for sex?
How long do you defer someone with IVDU?
How long do you defer someone with babesiosis or chagas?
How long do you defer someone with leukemia/lymphoma?
How long do you defer someone who received clotting fx (hemophiliac)?
How long do you defer someone with dura mater graft?
How long do you defer someone who had bovine insulin?
How long do you defer someone with GH from human pre-1985?
How long do you defer someone male who had sex with men after 1977?
How long do you defer someone with tegison use?
How long do you defer someone with non-hematologic malig?
indefinitely until 5y dz free
How long do you defer someone with BCC or SCC?
How long do you defer someone with hx of malaria?
How long do you defer someone who lived (5 consecutive yrs) in endemic malaria area?
How long do you defer someone with soriataine (acitretin)?
How long do you defer someone with needle stick or blood contact?
How long do you defer someone who was a rape victim?
How long do you defer someone who paid for sex?
How long do you defer someone who had sex with someone who was IVDU?
How long do you defer someone who had gonorrhea or syphillis?
How long do you defer someone who was incarcerated >72hr
How long do you defer someone with tattoos?
How long do you defer someone with travel to malaria endemic area?
How long do you defer someone with travel to Iraq?
How long do you defer someone with HbIg?
How long do you defer someone with non prophylactic rabies vaccination?
How long do you defer someone who had sex with someone who had HIV or hepatitis?
How long do you defer someone who lives with a person with active hepatitis?
How long do you defer someone who received allogenic tissue (organ/skin/bone)?
How long do you defer someone with allogenic blood tx/non-hemophiliac clotting fx?
How long do you defer a pregnant woman?
through 6 weeks post partum (except if baby needs blood)
How long do you defer someone with non-routine dental work?
How long do you defer someone who lives in certain countries in Africa where there is HIV O?
How long do you defer someone with CJD risk (Europe>3mo from 1980-now, family hx CJD or vCJD)
How long do you defer someone with measles vaccine?
How long do you defer someone with mumps vaccine?
How long do you defer someone with oral polio vaccine?
How long do you defer someone with oral typhoid vaccine?
How long do you defer someone with yellow fever vaccine?
How long do you defer someone with rubella vaccine?
4 weeks (MMR is 4 week deferral)
How long do you defer someone with varicella vaccine?
How long do you defer someone with killed, toxoid or recombinant vaccines?
(only defer with live attenuate vaccines)
How long do you defer someone with smallpox vaccination without complications?
after scab falls off or 21 days, whichever longer
How long do you defer someone with smallpox vaccination with complications?
14 days AFTER sxs resolve.
What are the 5 teratogens deferred for blood donation?
Finasteride (Proscar, Propecia)
How long do you defer someone with tegison (etretinate)?
How long do you defer someone with soriatane (acitretin)?
How long do you defer someone with avodart (duasteride)?
How long do you defer someone with finasteride (proscar, propecia)?
How long do you defer someone with isoretinoin (accutane)?
How long do you defer someone with WNV?
28 days from sxs onset OR
14 days after sxs resolve (whichever later)
What are the donor screening physical criteria?
1. gen appearance
2. arm check--both arms for IVDU and venous access
3. physical requirements
What is the wt requirement for blood donation?
>= 110lb (50kg)
What is the temp req for blood donation?
<= 99.5F (37.5C)
What is the BP req for blood donation?
What is the pulse req for blood donation?
50-100 bpm (unless atheletes, then less)
What is the hb/hct req for blood donation?
>= 12.5 g/dL or 38%
What is the amt of blood drawn during donation?
450 +/- 45 mL OR 500 +/- 50 mL
What is the max amt of blood that can be drawn during donation?
What is the term that describes the process of sep blood into different components all at one time?
What is the most common method of apheresis?
Centrifugation, sep based on density
What is the method of apheresis used for ITP and LDL removal in familial hyperchol?
Adsorption (blood passed through column of material that attracts desired substance)
What are the 3 methods of apheresis?
What are the 4 targets of apheresis?
What is the most common reason for apheresis?
from donation and ET
What is plasma pheresis used for?
Myasthenia gravis/ Guillian-Barre
What is WBC pheresis used for?
What is RBC pheresis used for?
Sickle cell complications
What products can you collect during one pheresis?
1 RBC, 1 plasma
1 RBC, 1 plt
1 RBC, 1 plt, 1 plasma
What is the hb/hct for plt donation?
>= 12.5g/dL and 38%
What are the donation intervals for plt donation?
48h between donations
no more than 2 donations/week
no more than 24 donations/yr
at least 8 wk between whole blood donation or if lost>100mL blood
What is the aspirin interval in plt donation?
no aspirin/aspirin-like meds in past 36 hrs
What is the plt count if less than 4 weeks between donations?
What is the max plasma loss allowed during plt donation?
no more than 600mL (700mL if >175 lb)
What is the requirement for plasma donation if you are occasional donor (donate less freq than q 4wk)?
same as whole blood (8 weeks)
What is the requirements for serial plasma donation?
Total prot and SPEP q 4 months
no more than 2 donations/week
no more than 24 donations/yr
<25 ml of red cell loss/week
What is the donation interval for double RBC donors?
What is the citrate effect during apheresis?
citrate anticoag binds free Ca:
- tetany and arrhythmias uncommon
- give oral Ca (TUMS)
-slow rate of infusion
What is the hypersensitivity rxn in apheresis of WBC?
Hetastarch, causes rouleaux for better sep, can get anaphylaxis
What is the donation interval for allogenic blood?
What is the donation interval for autologous blood?
What is the hb/hct req for allogeneic blood donation?
>= 12.5g/dL or 38%
What is the hb/hct req for autologous blood donation?
>= 11g/dL or 33%
What is the age req for allogeneic blood donor?
What is the age req for autologous donor?
What is the weight req for allogeneic donors?
>= 110lb (50kg)
What is the wt req for autologus donors?
Is infectious dz scrn required in autologous or allogeneic blood donor?
only need in autologous donor if blood being shipped out
Do you accept autologous or allogeneic blood from a donor with a hx of dz or + test for dz?
Never accept in allogeneic donation
May accept in autologous donation
Who do you notifiy if autologous blood tests + for dz?
Physician AND patient
What is the highest risk of contamination in autologous blood donation?
What is the primary goal of isovolemic (normovolemic) hemodilution?
reduce blood vol before surgery
How much blood can you remove in isovolemic hemodilution prior to surgery?
up to 1 L
For every 1 mL of blood removed during normovol (isovol) hemodilution what do you replace it with?
3 mL or saline (or crystalloid)
When putting blood back into body from normovol(isovol) dilution what is the order?
Last blood out is first blood in
What are the 4 criteria for isovol hemodilution?
>10% chance need transfusion
Hb at least 12.5 g/dL
no serious med conds
no infxn or bacteremia
what is the shelf life of isovol/normovol hemodilution?
8h in OR
24h in blood bank
What are the possible probs with intraop blood salvage (cell saver)?
1. air embolus
2. hemolysis due to excessive suction
3. coag fx activation
What is the shelf life for intra op blood salvage?
24h in blood bank
What is post op blood salvage?
blood from JP drains, etc reinfused, nasty!
What is the shelf life of post op blood salvage?
6h RT (OR)
What is the #1 cause of fatal HTR?
clerical errors--ID is CRITICAL!!!
What types of tubes for serum and plasma do you get for testing blood?
red top (serum)
lavender top (plasma)-preferred for nontube tests
How often do you need a new pt speciment if the pt has been tx or preg in last 3 months?
every 3 days (day collected is day 0, then next day is 1, 2, midnight day 3 (really 4th day), expired)
How long do you hold pt blood sample in lab after tx?
What tests do you do for a type and hold?
hold sample not blood pdcts
What tests do you do for a type and screen?
ABO (forward and reverse)
What do you do a records check for?
see if any hx of tx complications or prev Ab, compare, but don't use in place of, current sample
Do you do the weak D test in a pt if D-?
no EXCEPT in preg patients do the weak D test (IAT)
What is the purpose of the Ab screen on blood testing?
Find unexpected Ab
What ABO type of cells are used for Ab scrn?
Group O only
What are the cells used in Ab Scrn?
Cell I: R1R1
What type of testing is req for the Ab scrn?
Only IAT (not IS or 37C), if IAT is + go on to Ab ID
What tests are performed for Type and Cross?
Same as type and screen:
What is a major crossmatch?
1.Recipient SERUM + donor RBCs (need to make sure RBC viable)
2. final ABO check
3. don't need to do IAT if Ab scrn -
4. REQUIRED if >= 2mL RBC in pdct (PRBC, contam plt, GCF)
What is a minor crossmatch?
recipient RBC+donor SERUM
What are the reasons for a +Ab in a + major crossmatch?
3. reagent Ab
4. rouleaux or other false +
What are the reasons for a + major crossmatch when the Ab is -?
1. ABO incompat
2. Ab or Ag low incidence
3. + DAT in donor
How do make a T&S into a T&C?
just ABO check (if Ab scrn-) then
immed spin (IS) crossmatch OR computer crossmatch
What is the MSBOS?
maximum surgical blood ordering schedule
gives surgeons and blood bankers idea of how many RBC units to Xmatch for given procedure