Topics Covered :

Donor care
Donor room Procedure
Blood Drive Management

Donor Care

A well equipped blood bank with sophisticated up-to-the-minute equipments, blood bags, kits, blood collection vans, ample doctors and phlebotomist won’t be of any help for the ailing patients if the blood in the shelves is not adequate.

Arrangement of blood donation camps with every possible campaign strategies applied will take a back seat without donor turnout.

Voluntary blood donors are microscopic minorities even today. So we need a constant supply of donors.

Blood donor motivators, Camp Organisers and Blood collection team are the front liners. Donors’ impression depends on the attribute of these individuals. Inkling about the organisation in the peoples mind visiting the blood drive is created from the teams’ savour which is an everlasting one. There cannot be a single blood donation drive without the blood donors and so proper care is to be taken to fulfil the minute needs of the blood donors. Peoples responsible for the reception of donors to their departure are the key contributors. Bad impression created at any point of time will discourage the donors from future involvements. Specific teams with team leaders should be engaged who will not leave their respective positions under any circumstances.

Role of Blood Donor Motivators & Camp Organisers regarding Donor Care:

Reception of donors: Reception of donors is very important. Donors should feel that they are wanted. Dedicated volunteers should be deployed for the reception of donors.
Escorts: Well educated volunteers on Blood donation should escort blood donors to the bleeding area and accompany them back to the refreshment area with a smiling face. Queries coming from the donors end before donation must be answered in a positive manner satisfying the donor completely. This in turn boosts the donor. It’s the duty of the escort to vigil that the donor has taken plenty of fluid before donation .this will reduce possibility of vasovagal reaction and the donor is not empty stomach . Clear and simple post donation advice must be delivered . Such as

Standing rest of the day should be avoided.
NO strenuous physical exercise within 24 hours.
NO tampering with the venepuncture dressing and it is to be kept the rest of the day.
Plenty of fluid should be taken.
Avoid driving, diving & smoking for the next one hour.
Heavy weight should not be lifted with the venepuncture hand.
If the donor feels like fainting he or she should quickly lay down and raise his/her legs or sit

Down and lower his/her head.

Bed side Volunteer: Fear complex is the main obstacle to blood donation. Bed side volunteers helps to eliminate fear complex by interacting with the donors about various other issues distracting the donor while the phlebotomist carries on with his job. Giving company, talking to the donor, satisfying donor’s curiosities and a confidence given to the donor is a part of donor care.
Punctuality: Today time is precious. Time is important to the donor .Unnecessary waiting will irritate the donor and the donor may leave - not to return for ever. Donors should be well informed about the start & end time of the camp and punctuality must be maintained by the organisers.
Donor screening: Donor organisers and motivators present should keep a strict vigil that the screening is carried out properly according to the guideline.
Refreshment for donors: Arrangement of Proper Refreshments for the donors is an important episode of donor care. Carbonated & caffeinated drinks must be avoided. The donors should be offered juice sandwich etc., as refreshment. Volunteers must keep a strict eye on donors so that they remain seated and relax for at least half an hour before leaving the donation venue to avoid post donation complications.
Ambience of donation site: It’s a part of donor care on behalf of organisers to see that the donation site is properly ventilated with proper sanitation facilities. Privacy of Donor in screening area is to be maintained as this is a vital sect ion of donor care. Overcrowding in the donation area is to be managed. Decoration of the camp with IEC materials like fliers, banners, posters and hoardings encourages the donors.
Behaviour: The appearance & dress of the organisers must meet with the donors, so that they feel comfortable with the organisers. The team members must show respect to themselves and the donors. Donors should not witness personal conversations between the team members. Team members must listen to donors emphatically. Cheerful and energetic body language of the organisers and Medical team with a genuine ready smile will comfort the donors.

Handling Complaints: The complaints of the donors should be handled with equanimity keeping aside the emotions. The donor’s version is to be listened with compassion without any disagreement or squabble. Information provided by the donors is to be clarified and take necessary actions. Expressing regret to the donors will ease the situation.
Waving Good Bye: After completion of the total donation procedure time comes to bid adieu. A THANK YOU with a hearty smile will ensure the donor for the next drive. Donor undergone vasovagal reactions should be taken special care and escorted to their home if needed. A phone call in the evening or the next day enquiring the donors’ physical status will strengthen the relation between the organisers and the donors.

As stated earlier it’s the duty of the whole team comprising volunteers, motivators, organisers, doctors and phlebotomists to keep in mind about the CARE of the donor while carrying out the donation procedure. We never should forget that the health condition of a voluntary donor is as much important as the ailing patient who is waiting for the gift of life from the voluntary donor. Thank you.

Blood Donation Camp

Voluntary blood donation programmes - recruitment and retention are about people and community, about understanding them, capturing their interest and influencing their behaviour. The main communicating task for both blood donor recruitment and retention should be geared towards getting public understanding about the importance and triggering a response for action. Once a blood donor motivator raises awareness, he or she must motivate and persuade people to donate blood. One key secret of successful blood donor recruitment is to take the beds to the donors as close as possible on their convenient date and time rather than expecting the donors to come to the blood bank. The closer the bed to the potential donor, the stronger is the likelihood of success. This is possible only through outdoor blood donation camps. If the camps are held in a relaxed manner, it can be an enjoyable pleasant experience for all concerned. All over the world, most blood from voluntary blood donors is collected from outdoor camps in rural and urban areas.

In Indian context camps can be organised on holidays or in the evening in residential area or locality based socio-cultural organisations not only in cities or towns, but also in suburbs and villages. The people of all ages assemble either on holidays or at the end of day’s or week’s work and the example of adults donating blood would be a strong teaching and demonstration effect for the children. Even diehard determined non-donors may be expected to donate blood someday if the camps become a regular activity in a particular venue.

Camps can be organised in educational institutions, industrial and commercial houses throughout the week. Only all these combined efforts would ensure steady flow of blood in the blood banks. A few blood banks have well equipped mobile blood collection vans fitted with everything including beds, doctor’s chair, wash basin, storage refrigerator and even a small refreshment corner with own power generating unit. These vans are quite costly and cannot negotiate through the roads in suburban areas and villages and are not suitable for mass blood donation camps even in camps with 200 donors. Besides, festive mood of the environment and demonstration effect would not be there.

So in Indian context, best method is outdoor camps by carrying blood bank personnel and equipment in a vehicle and pitching the camp in a prefixed well ventilated place. The outdoor camps in India are and will be organised in places far away from blood banks. So a checklist of blood collection equipment and instruments should be maintained and carefully checked before the departure of the vehicle from the blood bank. Most of the blood collection items cannot be organised locally. Any omission to carry even a small item may frustrate the noble effort of the donor organisers and the donors.

Advantages of collection of blood from camps:

Intending donors get opportunity to donate according to their convenience.
Familiar faces and known atmosphere help in the shedding of fear complex by the first time donors.
Community participation.
Recruits new donors.
Health status and habits of intending blood donors are known to organisers, quality blood is assured due to self-exclusion.
Demonstration effect.
Convert non-donor to donor.
Help in donor retention.

In camp management and organisation, local organisers have scope of using their imagination to convert the area to a festive mood with decoration, light music rather than the silence inside a hospital blood bank.

The motivator should identify a key person amongst the group. In consultation with the key person, motivation session and the date and time of the camp should be fixed up according to the convenience of the donor group.

The proposed camp site should be inspected well in advance with due importance to the following points:

Adequacy of the space for anticipated number of donors and on-lookers
Lighting and ventilation
Electrical outfits
Availability of water
Toilet facilities
Waiting space
Donors’ screening space
Furniture (tables and chairs)
Refreshment space not far away from the donors’ beds
Cleanliness of the site.

Movement of the donor in the camp should be as far as possible unidirectional. Flow diagram of donor may be as hereunder;

On the day of the camp, the chief motivators and the team of volunteers and the blood bank team should reach in time. The donors should be warmly received and guided and escorted through different stages. Presentation of memento, badge, certificate with courtesy and sincerity and answering all queries of donor should be considered as part of donor motivation. The refreshment corner should be well managed and donors should be handled with personal human touch. This being the last point of the camp, it leaves a permanent impression in the mind of the donors. Talking with the donor throughout all the stages is extremely important, as it helps donors to feel wanted and also helps the first time donors to shed their fear. The donors should be advised to remain in refreshment room for at least 15 minutes and should be advised to increase their water consumption during the day and refrain from smoking for half an hour. A hearty good-bye with a request to donate again after three months is destined to inspire a donor to become a regular repeat donor.

Signs of minor reaction like the following should be handled with tender loving care and compassion :

Restlessness
Perspiration on forehead
Pale colour
Lack of willingness to communicate

Intending Reception

Filling in Registration card
Checking Body weight
Haemoglobin
Medical Check up
Medical Questionnaire
Blood donation Refreshment
Recognition of donor by badge

When reaction occurs to a donor, motivator or medico-social work should remain calm and try not to get other donors upset and call in the medical officer-in-charge of the blood collection team, but ensuring the prevention of the donor from falling down. Placing the donor in the bed or floor with a pillow under the feet, helps in subsiding minor reactions. But doctors should check up the donor in all such cases. In case of bleeding from the seal of vein puncture, finger pressure with cotton wool, folding the arm with a cotton wool pad in between and raising the folded hand a little upward helps in stopping such bleeding. Once the bleeding stops, the vein puncture site may be sealed again. The best motivational efforts may go in vain, in spite of best possible donor recruitment and retention strategies, if the camps are not organised in an efficient manner with active involvement of blood bank team, local organiser and motivators. At every stage, care should be taken so that the donor can leave the area with a good impression with a resolution to come back again. Donors’ blood cards should be made available to the donors in time directly or through their local organisers. Refreshment should be offered neatly with a friendly gesture and hospitality. The motivators should understand the significance of serving refreshment to keep the donor engaged under the watchful eyes of socio medical volunteers or the medical officer. The donor should be made to understand that refreshment has nothing to do with immediate recuperation of blood loss due to donation. A piping hot or cold drink and light refreshment are offered to compel the donor to spend some time in a relaxed mood. Whatever be the items of refreshment, they should be served neatly and nicely with a smile. A well organised camp inspires many onlookers around to become blood donors.

Blood Donation Camp Premises

The premises used for outdoor donor sessions may often be the only local venue available, but they must be of sufficient size, suitable construction and in an appropriate location to allow proper operation. They must be clean and maintained in accordance with accepted rules of hygiene.

Space Requirement

The space required will obviously depend on the number of staff anddonors and the rate at which donors arrive. The following activities shouldbe kept in mind when accepting a venue.

Registration of donors and all other necessary informationprocessing. Wherever possible, there should be easy access to a telephone, preferably within the venue.
Pre-donation counselling, the medical history and the health check-up to determine donors’ fitness to donate blood. Facilities should be available for confidential discussions between donors and social workers or the medical officer.
Withdrawal of blood from donors without risk of contamination or errors. Visitors and onlookers should not be allowed to come too close to the bleeding area.
The social and medical care of donors, including those who suffer adverse reactions. Sufficient seating arrangements should be provided for donors and staff, with allowance made for possible queues during busy periods.
Storage of equipment, reagents and disposable.

Health and Safety

Health and safety factors should be taken into account when selecting venues for outdoor camps. In particular, the following points should be kept in mind:

The venue should be as close as possible to the centre of population being served. It should be possible for the vehicle to park close to the access doors in order to facilitate the unloading of equipment. The ground to be covered by staff carrying equipment into the building should be even and well-lit, if possible, the space to be used should not require the carrying of equipment on stairs. A similar safe approach to the building should be ensured for donors. Notices should be displayed directing donors to the appropriate entrance to the building and to the room being used.
The place should be free from dust as far as practicable. Cement floor with appropriate matting would be helpful.
The furniture and equipment should be arranged within the available space to minimise crowding (for avoiding possibility of mistakes or accidents), enabling privacy and adequate supervision to be maintained and ensuring a smooth and logical work-flow.
There should be adequate lighting for all the required activities. Wherever possible, there should be provision for the use of emergency lighting in the event of a power-cut. The blood collection team should always carry a hunter’s torch.
It may not be possible for the collection team to control the temperature, but every effort should be made to ensure that the space does not become too hot. too cold or stuffy and must be comfortable. There should be arrangement for fans in summer.
Facilities for providing refreshments for donors and staff should be separate from other activities, wherever possible. Every effort should be made to ensure that equipment used in this area does
not pose a safety hazard.
Toilet facilities for male and female donors and staff should be available. Separate washing facilities are desirable for staff.
Adequate facilities should be available for .the safe disposal of waste. Sharp and solid waste should be collected in suitable containers for return to the blood transfusion centre or blood bank and for subsequent safe disposal.
The premises should be free from vermin.
Proper arrangements should be made for cold chain maintenance.

Mass Blood Donation Camp

In industrial or commercial houses and educational institutions, facilities for holding blood donation camps may be extended once in a year by suspending their normal activities. If smaller blood banks opt to collect blood according to their need or capacity many willing donors have to be refused. This may send a wrong signal to the community and would certainly make the task of the donor organisers a difficult one. as they would not be able to make such make-shift arrangement for camps again at successive intervals. The organisations may not like to suspend their normal work for the camp in the same year once again. Camps at such a place organised by massive awareness campaign, particularly when the camp is organised at a central place where donors come individually by availing themselves of public transport, should be planned in a different way as refusal to accept from such donors on account of logistics may affect the blood donation movement to a considerable

extent. Besides large scale awareness campaign through electronic or print media is not possible for smaller camps of 20/50 blood donors. The solution lies in bringing in a number of blood bank teams to work side by side under the same roof, each collecting blood according to its respective capacity.

Donor screening, registration and donors refreshment corner may be arranged for centrally so also the campaign.

There have been such successful mass blood donation camps in the cities like Delhi. Calcutta, Mumbai. Chennai, Surat, Bangalore, and Pune. Some such camps have become regular fixed day camps of over twenty years’ standing. Many donors of these mass donation camps have subsequently become organisers of smaller camps in their place of work or in their locality. There are three main advantages derived from a mass donation camp. First the resources available with any voluntary agency in India are just not sufficient to sustain a mass awareness campaign round the year .However, a specific campaign can start about three weeks before a mass donation camp and can gradually build up into a crescendo through postering, outdoor hoardings, radio talks, TV. exposures and through the free coverage in the newspapers. The publicity generated leads to increased awareness in general. Secondly, mass camps have a demonstration effect. When one sees

so many fellow human beings donating blood, he feels inadequate unless he also donates himself. This is the demonstration effect of peer pressure. The third benefit is that a number of big and’ small blood banks working side by side act as a technical workshop and activate the less active blood banks. This, of course, needs a competent technical supervision. Mass blood donation camps call for very well coordinated organised efforts between the organisers, the collecting agency and above all, the donors. A well managed mass blood donation camp can motivate the non donors and a reminder to repeat the act may also become instrumental in ensuring better participation on subsequent occasions. Mass blood donation camps also open up opportunities to involve more blood bank personnel, social organisations and volunteers with the blood donation movement. Such camps may be organised in educational institutions, factories, big offices, banks, social clubs or at central convenient places where donors being motivated through campaign may come individually.

Precaution should always be taken so that quality is not sacrificed for the sake of quantity. All technical procedures should be strictly adhered to. In mass blood donation camp poor turnout due to natural calamity or situation beyond the control of the organisers may frustrate the elaborate

arrangement. So the organisers should be pragmatic and not over ambitious while planning such camps.

Donor Recognition

In the four principles of voluntary donor recruitment strategies, recognition of donor comes in line with the other three — Education, Motivation and Donation. Human beings value positive recognition — that precious moment when someone important expresses some real appreciation for what he/she has contributed. When one person knows that he/she has worked hard and has done something, should he/she not expect to be recognised for it? If it is not forthcoming from the team leader or colleagues in the team everybody tends to feel unhonoured, unvalued and unrecognised. The motivation drops, energy level falls and spirit evaporates. Therefore, recognition has a big role in motivation.

Milton wrote:

“Fame is the spur that the clear spirit doth raise to scorn delights and Hue laborious days”.

Where does recognition come from? It can have a variety of sources. In the case of a famous person, it is a matter of public esteem. Fame comes from the Latin word ‘fama’ meaning report. So fame is how people talk about a person which adds up to his/her personal reputation. A person who is much talked about favourably is a reputed person. Reputation based upon significant achievements make people famous. Of course, in our society, individuals can more easily achieve a kind of spurious fame by gaining the attention of many people for diverse reasons. A footballer, cricketer, television interviewer, pop singer can easily become famous in our society with the favour of media.

Although, such fame carries positive overtones, it can simply suggest popularity or general recognition rather than discriminating approval or general recognition of inherent excellence. The media can, to a large extent, make or break this form of popularity or recognition. The vast majority of people, however, are not destined to become famous in the real sense of the word. Therefore, for most, recognition will be particular rather than general. Recognition for common people needs to come both formally and informally. There should be formal occasions when you recognise the quality or value of a particular contribution; be it of an individual or team effort.

There will also be plenty of informal opportunities for expressing appreciations. But recognition in both forms should have the following characteristics:

Giving recognition should be on the principle of treating everyone in a fair and equal way.
It should reward real achievement or contribution to the common good, not self-seeking gain.
It should serve to inspire and encourage all concerned.
Wherever possible, it should be given in a public way in front of the working group or organisation.
Remember to treat recognition informally as well as formally.
Above all, it must be genuine and sincere or in a word, real.

The last point is crucial. People dislike in sincerity.

In the hierarchy of human needs, recognition plays an important role in donor recruitment and retention. Recognition of the donors and enticement to recruit donors are not the same thing. In some developed countries attempts were made to entice donors with free hamburger or steak of McDonald or such other renowned outlets. Donors felt insulted as they thought their gift of love was being equated with hamburgers. Complaints were received over phone from some regular donors deploring attitude of persons needing such incentive. Paying health insurance premium for the donors is a monetary form of incentive and therefore, is not recommended. Recognition of voluntary blood donor means honour without any monetary value. Recognition of donors helps as:

Automatic incentive
Paramount impression
Social prestige
Motivation to panel donors
Healthy spirit of competition
Spurs donors to greater participation
Feeling appreciated and honoured
Forms stronger commitment
Help in retention of donors.

Forms of Donor Recognition may be in the following form:

Letter of appreciation
Greetings cards / Thank you letters
Certificate
Badge

Certificates play a big role in Donor Recognition

Memento
Souvenir
Annual felicitation by way of convocation
Donors card
Special award for 10/25/50/100 time donation
Donors' get-together

Honouring at a public function.

10/25/50/100 donation award or badge at a public ceremony is a part of donor recognition. Recognition of donor organisations in the form of letters of appreciation, greetings cards for special occasions and by giving award/'souvenir/memento, etc. through public function is highly recommended. Although a voluntary donor does not expect anything in lieu of gift of love, yet a metal badge bearing the national emblem and marked voluntary donor and a certificate presented in the camp just after the donation in recognition of the donation help a long way in motivating people to donate blood. Blood group-cum-donors cards also help in the promotion of the blood donation movement. Special awards for multiple donations draw the attention of the society to this social cause and should be instituted for donors. Outstanding social workers, doctors, camp organisers may also be honoured and recognised.

Inter organisation challenge trophies can build up a healthy competition among various groups. Within the state, a three-tier system of awards is recommended, i. e., local, district and state. There should be recognition of the services of the blood banks and donor motivating organisations by the appropriate authorities at all three levels. It is desirable that the performance of the state blood transfusion service should be evaluated against a predetermined norm and meritorious service may be acknowledged by National Awards. Recognition and awards act as an incentive to existing donors/institutions and motivate potential donors to become regular voluntary donors. A very effective motivational tool is an annual prize distribution function which could be held at the local, district or state level. This affords the voluntary organisation an opportunity to publicise its activities in the community and project its positive image. It can outline its goal and spell out the targets it hopes to achieve. Involving a respected person of the community as its Chief Guest, enhances the image of such programme. Efforts should be made to I give maximum possible publicity through mass media

Another method is to organise an "At Home" for repeat donors/group motivators at Raj Bhawan, if possible, or at, any important place involving a V. l. P This makes donors feel appreciated and important. Again, at Republic or Independence Day Functions, outstanding donors/motivators could be honoured by requesting the local authority organising the function to do so. Public recognition makes their commitment even stronger and donors become a part of the movement. Membership of imaginary 5 litre or 10 litre clubs with a presentation of appropriate memento is another way of donor recognition. Printing of photographs of donors in house magazine may boost up morale of the donors and help in recruitment of new donors in subsequent blood collection drive. It will be interesting to have a look at the method of donor recognition in different countries.

Awards given in some countries:

Germany;

A bronze badge for 3 blood donations
A silver badge for 6 blood donations.
A gold badge for 10 or more blood donations.

Austria;

A badge in the form of a drop of blood at the first donation.
A silver badge for 5 donations.
A gold badge for 10 donations.

Belgium:

A special certificate for those who have distinguished themselves as blood donors or as voluntary blood donor recruiter.
A certificate at the first donation (giving them the right to anequal amount of blood and plasma for themselves or their next relations for one year).
Certificate after 10 donations.
Small bronze "Pelican" plaque after 25 donations:
Certificate with bronze medal for 40 donations.
Gold medal for 80 donations.

U. S. A.:

After first donation a badge in the form of a drop of blood.
For all following donations the same badge in gold with a figure marked corresponding to the number of donations.

Greece:

Ordinary badge for upto three donations.
For 5 to 9 donations, a badge with one star,
For 10 to 14 donations, the same with two stars.
For 15 to 19 donations, the same with three stars.
Silver medal and certificate for 20 to 21 donations.
Gold medal and certificate for 50 donations.

Turkey:

Amongst other genera! recognitions, the Turkish Red Crescent gives women donors a pair of earrings in the form of a drop of blood.

In India, recognition of a donor with a badge and a certificate at the time of each donation are very common in most of the states. Special award after multiple donations like ten/twentyfive/fifty donations are also in vogue in some states. In states like Gujarat and Jharkhand donors donating blood for hundred times are specially honoured and they are called "Centurion Blood Donor".

Donor Room Procedure

Pre- Donation Checks of Equipment and Materials for blood drive :

All equipment and materials must be -
• Correct.
• Clean.
• Calibrated.
• Checked for performance.
• Ready for use.
- Blood collection mixer – Needle destroyer.
- Tube sealer - Alcohol Swabs.
- Stripper - Spirit & iodine.
- BP instrument - Multiple Blood Bags.

Blood pressure apparatus
• Mercury sphygmomanometers are considered to be the gold standard for measuring blood pressure.
• However, Aneroid sphygmomanometers (mechanical types with a dial) are considered safer than mercury based sphygmomanometers.
• Aneroid sphygmomanometers require calibration checks.

Donor Identification

Correct identification of the donor
- At reception
- Immediately before venipuncture
Cross- check the donor with available records
Name, address, date of birth
Re-check the donor’s identity

Phlebotomy

To be performed by a trained person
Usually cubital fossa is chosen as the vein is palpable and required volume of blood can be easily drawn from this vein
Examination of the area chosen for the venipuncture
Should have no local infections

Phlebotomy Site Examination and precautions

Check the site, as professional donors/drug abusers may have multiple punctures
Collection is a sterile process so surgical environment should be maintained
Phlebotomist should follow the hand washing procedures

Use of Gloves.

Routine use of gloves is not mandatory for phlebotomy of blood donors.
Gloves should be made available for those who want to use them.

Reference: AABB technical manual, page 53.

Gloves are required when:

An employee has cuts, scratches, or breaks in skin.
When there is a likelihood that contamination will occur.
While an employee is drawing autologous units.
While an employee is performing therapeutic procedures.
During training in phlebotomy.

Reference:AABB Technical Manual page 53

Hand Hygiene

In most situations, thorough washing of hands with ordinary soap and water is sufficient to decontaminate them.
Wash hands with soap and water when visibly dirty.
Alcohol-based hand-rubs may be used to decontaminate lightly soiled hands when hand-washing is not available.
Soap and alcohol based hand rub should not be used concomitantly.

Preparation of the area

BP cuff should be tied and pressure maintained at 40-60 mm Hg
Tourniquet should be used carefully, as the pressure applied cannot be gauged.
No local anaesthetic drug need to be administered Donor Arm Cleaning
Important to minimise risk of bacterial contamination during vein puncture
Follow the SOP for Methodology and selection of cleansing agent
Trained staff
Assessment of Compliance and effectiveness Cleaning the area
Deflate the cuff and clean the area selected
Spirit /alcohol swab and iodine should be used to do this
Savlon etc. is not recommended.
Clean 4-5cms area in a concentric centrifugal pattern
Do not touch the cleaned area after preparation.

Preparation of the bag before puncture

Inspection of the bag for the clear anticoagulant solution
Inspect for any leak or damage or particulate matter
Identify the donor record with the donor and all items associated with donor include:
- collecting and processing institution,
- phlebotomist,
- Date, time, expiration,
- component type, volume, storage temperature,
- special requirements.
Bag should be placed in the blood collection monitor
Remove the needle cap just before the venipuncture to maintain closed system

Labels

Identify each donor with donor record
Label specimens collection container and all satellite bags for components.
Attach labels at the time of collection to all future processed materials.
Perform a recheck for all numbers and labels.
Record type of donation and any processing of unit.

Labeling

Positioning of needle for donor phlebotomy
Blood Collection
Utmost Care During Blood Collection is the Key To Good Quality of Blood / Components
Confirm Donor identity with labeling of blood pack and sampling tubes
Ensure Adequate vene puncture Site disinfection Procedure
The procedure takes about 5-10minutes
Donor should not be left unattended
Bag should be periodically mixed so that uniform mixing of anticoagulant with blood occurs
1ml of blood =1.05gm
350ml = 367gms +weight of the bag

Monitoring Blood Collection

Constant monitoring during donation
Smooth Blood flow
Gentle mixing of blood
Collection time - 5-10 min
Appropriate Volume collected = ± 10 % of desired volume
Sample collection
- Identity checks
- Correct handling
- Labeling

After the procedure

Deflate the cuff once the procedure is over
Clamp the tubing
Place the sterile swab and withdraw the needle
Apply pressure and let the donor lie down for 5mintes
Do not recap the needle
Stripping should be done to mix the blood in tubing with anticoagulated blood in the bag
Collect Pilot samples for serology & grouping
Seal tube at least 5 segments

Pre Centrifugation Storage

Critical elements – Time and storage conditions prior to component separation
Store upright for 30-60min ( preferably in Laminar Flow Hood)
Maintain Temperature Between 20 and 24 Degrees for Platelet preparation
Maintain Temperature at 4 Degrees for Red Cell preparation/whole blood collection
Mix Each Unit Well for Consistent Separation.

Donor room procedure and management :

Adverse Donor Reaction:

Teaching Aims

You will learn all about adverse donor reaction and prevention of certain reactions.
You will learn to define, identify/diagnose and handle all the reactions.

Adverse Donor Reactions

Definition: Untoward feeling by blood donor before, during or after blood donation.

There is a psychological element to most reactions so a friendly cheerful atmosphere can reduce donor anxiety and perhaps prevent any adverse reactions

Majority have VASOVAGAL Reactions

Usually mild and harmless

Personnel should be trained to recognize and give initial treatment, including CPR.
Emergency equipment -must be available including an emesis basin, towels, oropharyngeal airway, oxygen and mask, and emergency drugs as determined by the blood bank physician.
Immediate action - remove tourniquet and needle, move donor to private area, notify donor’s physician if donor does not recover rapidly after initial care.

Emergency Drugs for a blood drive :

Regular Checks for expiry
Syringe /Needles
IV set, IV fluid- NS, 25%dextrose
IV Steroids
Antiemetic
Calcium Gluconate
Adrenaline/Noradrenaline
Aromatic Ammonium
Ambu bag and oxygen cylinder

Types of Adverse Donor Reactions :

Vasovagal reaction
Sudden fainting due to hypotension
Neurophysiological response
Apprehension, first time donor, female
Emotional stress
Sight of blood

Prevention

Donor screening
Psychological support through positive donor-staff relationship and reassurance
Physical comfort like temperature and surrounding environment

Classification of Adverse Donor Reaction :

MILD - pallor ,sweating, dizziness and nausea
MODERATE - vomiting ,Loss of consciousness of transient or short duration, Bradycardia , Shallow respiration, hypotension (systolic as low as 60mm Hg), Slow pulse. Also include tetany, vomiting and hyperventilation.
SEVERE - Prolonged loss of consciousness, convulsionsfocal or generalized with or without incontinence of urine or faeces, cardiac events.

Management of Adverse donor reactions:

General Principles (1)

Reassurance/Distraction
Loosen tight clothing
Ensure adequate airway Raise legs above the level of donor head
Check for vitals
Donor to spend extra time at BTS/Leave only after final check up

Guidance on future donations

General Principles (2)

Discontinue donation
Talk to donor to assure that it is nothing serious and he/she will be alright
The donor should NEVER be left alone. He/she should feel that there is someone who is concerned and is committed for his care.
Remove donor if possible from general donor area to another room or use a screen to prevent sympathetic fainting of other donors.

Moderate Reactions – Management

In addition to treatment as in mild reaction, administration of 95% O2 and 5% CO2 may be helpful in case of fainting with hyperventilation. If possible, remove the donor from the general area to another room or use a screen to prevent sympathetic fainting. In case facility for monitored administration of 95% O2 and 5% CO2 is not available, re breathing into a paper bag is helpful.

Severe Reactions-Management

Observation is very essential. Keep donor under observation If need be, assistance should be provided to accompany the donor to his place to avoid any injury or accident. Must prevent injury to donor, Put a padded tongue blade between teeth if convulsions are prolonged. If there is no improvement within 30 minutes, shift the donor to emergency medical care unit and administer 300-500 ml normal saline with or without dextrose.
After recovery post donation instruction must be given to the donor and some additional instructions depending upon severity of the reaction. Record of such reactions must be mentioned on donor card/donor register and should be explained to donor and call donor next morning or evening for follow up and for the reassurance.

Mechanism of Tetany :

Hyperventilation : Increased inspiration and expiration either rate or depth
Results in excessive loss of CO2
Severe cases can result into hypocalcaemia (tetany) or convulsions.
calcium gluconate can be given for hypocalcaemia.

Usually associated with anxiety

Prevention and treatment

Reassure the donor

Ask the donor to cough to interrupt the pattern of breathing

Instruct the donor to re-breathe expelled air into a small paper bag

Hematomas

Usually results from the puncture of a blood vessel
Prevention is by effective collection technique
Should be taken care by local Pressure, Application of Ice, Thrombophob ointment application and Pain killers
Inform the donor that there will be color changes over a period of a week and it will resolve without leaving any mark.
Majority Resolve spontaneously

Arterial puncture
Bright coloured blood spurts with pressure

Management:

Stop the procedure
Apply hard pressure on puncture site for at least 15 minutes
Raise limb above the heart
Reassurance and Documentation

How to Minimise Donor Reactions ?

Donor education before and after donation
Volume of blood drawn – 8-9ml /Kg of donor body weight
Audiovisual entertainment
Hydration : a glass of water, 30 minutes before donation
AMT-applied muscle tension-repeated rhythmic contraction of muscles of arms and legs.
Learning Outcome

Enabled to prevent adverse donor reactions and identity, classify and handle all types of donor adverse reactions.

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