Fundamentals of Blood Banking

a thorough and precise presentation, covering all the general aspects of blood banking.

1. Fundamentals of Blood Banking Khaizran Siddique Med. Lab. Technologist Blood Bank

2. What is Blood Bank ? Blood banking refers to the process of collecting, separating and storing of blood. The term “Blood Bank” typically is used for a division of a hospital laboratory where the storage of blood product occurs and proper testing of blood is performed to reduce the risk of transfusion related events . Now a days stand alone blood banks also occur and can be a Govt. holding body or a private body.

3. Requirements of blood bank The main areas requiring attention are as: Premises Personnel Quality control of Blood product Reagents Equipments Manual of SOPs Documentation

4. Premises Design and construction of blood transfusion premises are important. There must be adequate space for work. Furnishing and lighting must be adequate. Personnel There must be adequate personnel with appropriate educational qualification, training and experience.

5. Quality control of blood product PRODUCT STORAGE VOLUME STERILITY COLOR W/B 2°c-6°c 21-35 days 450ml No Growth Red P/C 2°c-6°c 21-35 days 280ml No Growth Red PLATELET 20°c-24°c 5 days >40ml No Growth Colorless FFP -25°c to -30°c 12 months 220-250ml No Growth Yellowish CP -25°c to -30°c 12 months 10-20ml No Growth White PRODUCT STORAGE VOLUME STERILITY COLOR W/B 2 ° c -6 °c 21-35 days 450ml No Growth Red P/C 2 ° c -6 °c 21-35 days 280ml No Growth Red PLATELET 20 ° c -24 °c 5 days >40ml No Growth Colorless FFP -25 ° c to - 30 °c 12 months 220-250ml No Growth Yellowish CP -25 ° c to - 30 °c 12 months 10-20ml No Growth White

6. Standard operating procedure Every blood bank should have its own SOPs. It includes detailed instruction about techniques procedures and other activities. SOPs should be available at each working area. Documentation Blood bank must have a record keeping system. It could be manual, computerized or combination of both.

7. Main functions of blood bank The Blood Bank is one of the major components of a hospital, concerned with various activities. Donor registration Collection of blood sample Blood processing (blood grouping + CBC + cross matching) Donor screening Collection of blood donation

8. Product formation Blood product storage Issuance of blood Transportation of blood Identification and analysis of blood transfusion reactions Disposal of blood and related products

9. Donor registration Donor selection criteria: Any donor, who is healthy, fit and not suffering from any transmittable diseases can donate blood. Age between 18-55 yrs Last donation should be more than three months before Pulse: 60-100 beats/min

10. Blood pressure Systolic :110-150mmHg Diastolic: 70-100mmHg Temperature ≤ 37.5°C Weight ≥50kg

11. Collection of blood samples If the donor fits into the selection criteria then take the blood sample in two vials and label it properly with the name and ID no. EDTA vial Gel vial

12. Blood processing First of all do the B lood group of donor`s sample. Blood type of a person can be determined on the basis of two major systems: ABO system Rh system There are two methods of blood grouping i -e. Forward blood grouping Reverse blood grouping

13. Now move to the next step which is CBC Hb must be ≥ 13gm/dl Hct between 38-45% The next step is Compatibility testing which is also known as Cross match. Used to demonstrate ABO in-compatibility and clinically significant antibodies to red cell antigen.

14. Donor screening This should be done to screen the donor`s sample before collection of blood donation to assure healthy and safe transfusion. Perform donor screening for HBV, HCV,HIV and syphilis through ELISA technique. Additionally, screen peripheral blood for Malarial Parasite through ICT.

15. Collection of blood donation Blood is collected from the donor as per the blood product request from the doctor treating the recipient. For this purpose ,we use different types of bags according to the product requirement. Single bag Double bag Triple bag Pediatric bag

16. Product formation After collection, blood products are made according to the requirement. Whole blood Packed cell volume Fresh frozen plasma Platelets Cryoprecipitate

17. Platelet A pheresis The term specifically refers to the method of collecting the platelets, performed by an apparatus in blood bank that separates the platelets and returns the other portions of blood to the donor circulation.

18. Blood product storage PRODUCT STORAGE W/B 2° c -6 °c 21-35 days P/C 2° c -6 °c 21-35 days PLATELET 20° c -24 °c 5 days FFP -25° c to - 30 °c 12 months CP -25° c to - 30 °c 12 months

19. Issuance of blood It is mandatory for blood bank staff to check the following before issuing of blood. Blood bag no. Blood group Cross match compatibility Blood screening results Coll. Date and Exp. Date Visual inspection of bag

20. Transportation of blood Specially designed blood transport boxes should be used to ensure the integrity of the blood product during transportation. Appropriate materials and packing arrangements are very necessary for this purpose.

21. Identification and analysis of blood transfusion reactions If any transfusion reaction gets registered to your blood bank, following should be done. Obtain pre and post transfusion specimens of recipient. Immediately perform tests of ATR investigation profile. Obtain the sign and symptoms of ATR from the hospital staff. Consult with hematologist and take advice for identification of ATR.

22. Disposal of blood and related products All those bags which meet the criteria of expired blood and the empty bags returned after successful transfusion should be considered waste and disposed off. Record the data of blood bags before disposal. Put all the waste blood bags in bio hazard waste bag (yellow bag). Seal the yellow bag. Finally dispose off to A.T waste management company.