blood bank part1 lecture for MBBS students.

Blood bank lecture for MBBS students

1. BLOOD BANK Dr. Sushma chourasia

2. What Is Blood  BANK blood bank is a center where blood gathered as a result of blood donation is stored and preserved for later use in blood transfusion. The term "blood bank" typically refers to a division of a hospital where the storage of blood product occurs and where proper testing is performed.

3. However, it sometimes refers to a collection center , and some hospitals also perform collection. Blood banking includes tasks related to 1. Blood Collection 2. Processing 3. Testing 4. Separation 5. Storage

4. What is blood  ? Red color liquid that run throughout our whole body. Blood circulates through our body and delivers essential substances like oxygen and nutrients to the body’s cells.It also transports metabolic waste products. There is no substitute for blood. It cannot be made or manufactured. Generous blood donors are the only source of blood for patients in need of a blood transfusion .

5. BLOOD COMPONENTS There are F our basic components that comprise of human blood: 1. Plasma 2. Red Blood Cells 3. White Blood Cells 4. Platelets.

6. Red blood  cells These cells carry oxygen to the tissues in the body and are commonly used in the treatment of anemia . Red blood cells represent 40%-45% of your blood volume. They are generated from the bone marrow at a rate of four to five billion per hour. They have a lifecycle of about 120 days in the body.

7. Plasma Plasma is the liquid portion of the blood. Plasma is yellowish in color and is made up mostly of water, it also contains proteins, sugars, hormones and salts. It transports water and nutrients to the body’s tissues .

8. Platelets Platelets are the smallest of our blood cells and literally look like small plates in their non-active form. Platelets control bleeding. Wherever a wound occurs, the blood vessel will send out a signal.

9. Platelets Platelets receive that signal and travel to the area and transform into their “active” formation, growing long tentacles to make contact with the vessel and form clusters to plug the wound until it heals. They help the blood to clot and are used in the treatment of leukemia and other forms of cancer

10.  White blood cells These cells help to fight infection, and aid in the immune process. White blood cells are essential for good health and protection against illness and disease. Like red blood cells, they are constantly being generated from the bone marrow. They flow through the bloodstream and attack foreign bodies, like viruses and bacteria. They can even leave the bloodstream to extend the fight into tissue.

11. TYPES OF BLOOD gROUPS O Rh-positive O Rh – Negative A Rh-positive A Rh-negative B Rh-positive B Rh-negative AB Rh-positive AB Rh-negative

12. INVENTION Karl Landsteiner,  an Austrian scientist discovered the ABO blood group system AND he was awarded WITH the Nobel Prize. In his experiments, he mixed different blood types and noted that the plasma from certain blood type produced agglutinates or formed clusters which were caused by the absence of molecules on red blood cells and resulting in antibodies to defeat that molecule. He then made a note of the agglutination and divided the blood types into 4 different groups.

13. Our immune system recognizes another blood type as foreign and attacks it if introduced in the body causing a transfusion reaction. Any inappropriate match with the Rh and ABO blood types, causes the most serious and life- threatening transfusion reactions. Therefore, before blood transfusion, it is suggested to have a blood group checke d

14. Blood group system RH blood group  system ABO Blood group system

15.   ABO blood  Group system The basis of ABO grouping is of two antigens- Antigen A and Antigen B. The ABO grouping system is classified into four types based on the presence or absence of antigens on the red blood cells surface and plasma antibodies. 1. Group A – contains antigen A and antibody B. 2. Group B –contains antigen B and antibody A. 3. Group AB –contains both A and B antigen and no antibodies (neither A nor B). 4. Group O – contains neither A nor B antigen and both antibodies A and B.

16. The ABO group system is important during blood donation or blood transfusion as mismatching of blood group can lead to clumping of red blood cells with various disorders. It is important for the blood cells to match while transfusing i.e. donor-recipient compatibility is necessary. For example, a person of blood group A can receive blood either from group A or O as there are no antibodies for A and O in blood group A.

17. Rh Blood  Group System In addition to the ABO blood grouping system, the other prominent one is the Rh blood group system. About two-thirds of the population contains the third antigen on the surface of their red blood cells known as Rh factor or Rh antigen; This decides whether the blood group is positive or negative. If the Rh factor is present, an individual is rhesus positive ( Rh+ve ); if an Rh factor is absent individual is rhesus negative (Rh- ve ) as they produce Rh antibodies. Therefore, compatibility between donor and individual is crucial in this case as well.

18. FUNCTIONS OF BLOOD BANKING Blood donor selection Donor pre counselling Donor Blood collection Donor post counselling Blood tests Blood storage Blood transfusion

19.   BLOOD DONOR SELECTION The  purpose of donor selection is to assess the suitability of an individual to be a blood donor so that blood donation is safe for the donor and the blood products derived from this donation are safe for the recipients. The donor selection process should be carried out in accordance with written standard operating procedures. 1. WELL BEING The Donor s hall be in good health, mentally alert and physically fit and shall not be inmates of jail or any other confinement

20. 2. AGE • Minimum  age 18 years • Maximum age 65 years • First time donor shall not be above 60 years of age • For Repeat donor upper limit is 65 years • For aphaeresis donors 18-60 years

21. 3. WEIGHT • 350 ml – 45 kg • 350 ml – 45 kg • Apheresis – 50 kg 4. DONATION INTERVAL • For whole blood donation, once in three months (90 days) for males and four months (120 days) for females

22. 5. BLOOD PRESSURE 100-140mm   Hg systolic 60-90mm Hg diastolic with or without medications 6. PULSE 60-100 beats per minute 7. TEMPERATURE Afebrile; 37°C/98.4°F 8. HAEMOGLOBIN It should be above 12.5g/Dl

23. 9. MEAL The donor shall not be fasting before the blood donation or observing fast during the period of blood donation and last meal should have been taken at least 4 hours prior to donation 10. ALCOHOL Donor shall not have consumed alcohol and show signs of intoxication before the blood donation. The donor shall not be a person having regular heavy alcohol intake

24. 11. PREGNANCY AND  RECENT DELIVERY Defer for 12 months after delivery 12. ABORTION - Defer for 6 months after abortion 13. BREAST FEEDING - Defer for total period of lactation 14. MENSTURATION Defer for the period of menstruation 15. NON SPECIFIC ILLNESS 16. SURGERY 17. RESPIRATORY INFECTIONS 18. CARDIOVASCULAR SYSTEM

25. DONOR PRE COUNSELLING Explain about   donation process and benefits of blood donation. Ensure volunteer blood donation Encourage HIV test Develop safe donor pool.

26. DONOR BLOOD COLLECTION DONOR BLOOD COLLECTION  - PROCESS Blood donation is carried out under the supervision of trained, skilled technicians. The entire procedure, from start to finish, does not take more than 45 minutes. The blood is usually drawn from the median cubital vein, from the inside of the elbow. An antiseptic such as iodine is ued to clean the skin above this vein.

27. This helps to prevent bacterial infection at the site of puncture and also helps to prevent the blood drawn from being infected. A tourniquet may be used to elevate the blood pressure in the veins of the arm. This helps to ease and speed up the process. Sometimes the donor is given an object to squeeze repeatedly in order to increase blood flow to the targeted vein. Invariably a needle with a larger guage is used inorder to minimise the shearing forces that can cause damage to the RBCs.

28. DONOR POST COUNSELLING Tell about  donor blood details (test results ) Explain about healthy lifestyle. Explain about to take nutrition. Encourage HIV test. Encourage AIDS test

29.   BLOOD TESTS BLOOD TESTS All donations  must be tested for the following infectious diseases and found to be Negative for antibodies to: • human immunodeficiency virus (anti-HIV-1/2), • hepatitis C virus (anti-HCV), • human T- lymphotropic virus (anti-HTLV-I/II), •hepatitis B core antigen (anti- HBc ), • Trypanosoma cruzi either on the current donation or at least one previous donation.

30. • Nonreactive for hepatitis B surface antigen ( HBsAg ).Nonreactive when tested using licensed nucleic acid tests (NAT) for: • hepatitis B virus (HBV) deoxyribonucleic acid (DNA), • HCV ribonucleic acid (RNA), • HIV-1 (RNA), • West Nile virus (WNV) RNA, • Zika virus (RNA ),

31. DONOR BLOOD STORAGE BLOOD STORAGE Donated blood  was stored in 5 different ways 1. Whole blood 2. Packed RBC 3. Fresh frozen plasma 4. Platelet rich plasma 5. Cryoprecipitate

32. WHOLE BLOOD Blood  is collecged into CPDA-1 anticoagulant containing bags. 350 ml blood collected 73 ml of anticoagulant in collection bag. Anticoagulant CPD – Citrate Phosphate Dextrose Stored at 26*C Shelf life -21 Days. .

33. PACKED RBC Red cells with 1/3 of the original plasma. 45g of hemoglobin per unit. 250 ml blood stored. It contains mostly rbc , wbc and less amount of plasma. Stored at 2 to 6* c. Shelf life -21 to 35 days

34. FRESH FROZEN PLASMA Plasma removed from rbc within 6 to 8 hours of collection is rapidly frozen to below 30*C. Before transfusion is necessary to thaw at 37*C. Dose – 10 to 12 ml be weight. Stored at < -30* C Shelf life – 12 months.

35. PLATELET RICH PLASMA GENTLE centrifugation of whole blood Supernatant transferred to the 2 nd bag Volume – 300 ml Stored at 20 to 40 *C Shelf life – 5 days

36. CRYOPRECIPITATE Volume –  15 ml Stored at <25*C Shelf life – up to 1 year.

37. BLOOD TRANSFUSION A blood  transfusion provides blood or blood components when someone had lost blood due to an injury, during surgery or have certain medical conditions that affect blood or its components. The blood typically comes from donors. Blood banks and healthcare providers ensure transfusions are a safe, low risk treatment. A blood transfusion is a common procedure in which donated blood or blood components are given to you through an intravenous line (IV).

38. A blood transfusion is given to replace blood and blood components that may be too low. A blood transfusion can save your life. You may need a blood transfusion in certain medical conditions such as: : • Anemia • Certain cancers • Hemophilia • Sickle cell disease

39. How does a  blood transfusion work? The donated blood or blood components are stored in special medical bags until they are needed. Your healthcare provider connects the needed bag of blood to an intravenous line made of tubing. A needle at the end of the tubing is inserted into one of your veins and the blood or blood components begins to be delivered into your circulatory system. What can I expect during the transfusion? Before your transfusion, your nurse will:

40. • Check your blood pressure, pulse and temperature. • Make sure the donor blood type is a match for your blood type. • Make sure that the supplied blood is the product ordered by your doctor and is labelled with your name. During your transfusion, your nurse will: • Recheck your blood pressure and pulse after 15 minutes. • Recheck your blood pressure and pulse at the end of the transfusion

41. How long does  a blood transfusion take? How long a blood transfusion takes depends on many factors, including how much blood and/or blood component you need. Most transfusions take between one and three hours. Talk to your healthcare provider for more specifics about your needs.

42. What kind of reactions can happen from a blood transfusion? People can react in various ways to blood transfusions. Reactions people experience may include: • Breathing troubles. • Fevers, chills or rashes. • Hemolytic transfusion reaction (your immune system tries to destroy transfused red blood cells).