Contingency Blood Collections

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Contingency Blood Collections

• MSgt Rick Berg
• TSgt Magdalena Trujillo
• Lackland Air Force Base Blood Donor Center

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Contingency Blood Collections

• Getting started
• Collection of Acceptable Unit of blood

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Getting started

• What do I need to do, how do I begin!

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Getting Started

• What else will I need to begin a blood drive?

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Conducting the drive!

• Donor Prep
• Prescreen, DD 572
• Vitals
• Interview
• Whole Blood collection
• Processing
• Infectious Disease Testing

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Donor Prep

• Use your list!

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Pre-screen, DD 572

• Quick Pre-screen

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Vitals

• WEIGHT
• gt 110 lbs, (50Kg)
• APPEARANCE
• Generally healthy
• ARM INSPECTION
• No skin lesions at site of venipuncture
  (Leishmaniasis)
• Small Pox
• TEMP lt 37.5 C
• (lt 99.50 F)

• PULSE 50-100 BPM
• 40-49 If athletic
• BP
• lt 180 mm Hg systolic
• lt 100 mm Hg diastolic
• Know Manual B/P
• HGB gt12.5 g/dL .
• HCT gt38

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Interview

• Private Interview
• Ensure all questions are properly
  answered/documented to ensure donor is eligible

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Whole Blood Collection Arm Prep

• ARM PREP
• Place tourniquet or BP cuff on arm inflate to
  40-60 mmHg
• Select a vein
• Donor is allergic to iodine Choraprep
• Scrub site vigorously 30 seconds

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Whole Blood Collection Arm Prep

• Second iodine prep
• Begin in center of phlebotomy site
• Move outward in a circular manner
• Never overlap
• Allow to stand for at least 30 seconds prior to
  phlebotomy
• Do not retouch area, if so, MUST repeat arm prep

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Whole Blood Collection - Venipuncture

• Hemostat the tubing near the needle or use clamp
  on auto scale
• Perform venipuncture
• Once the needle is in the arm remove the hemostat
  or clamp
• Blood should flow freely

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Whole Blood Collection

• Inadequate blood flow
• Gently reposition needle
• If unable to establish adequate blood flow,
  discontinue
• Adequate blood flow
• Once blood flow is established, secure
• Tape needle down at the hub
• Tape tubing to arm

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Whole Blood Collection

• Collect pilot tubes
• Strip the tubing at donor bed
• Take unit to Lab
• Confirm Blood type
• Major Minor Crossmatch
• HEP/HIV/RPR screening tests

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Unit Collection

• Monitor blood volume
• 450 45 ml
• Max collection-20 min
• Correct amount reached, place hemostat on line
  after the Y-connection
• Use metal clamp to seal line (to stop flow into
  bag)

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Unit Collection

• Collect pilot tubes
• Strip the tubing at donor bed
• Take unit to Laboratory
• Confirm Blood type
• Major Minor Crossmatch
• HEP/HIV screening tests
• Complete paperwork to issue unit to OR/ER

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Post Donation Care

• Record
• There is always time for documentation
• Monitor the donor for any delayed reactions
• Recovery

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Unit Processing

• Blood can be kept at room temperature for up to 8
  hours from time of collection
• - NOTE Do NOT use ice if whole blood is to be
  used in emergency situation during contingency
  operations. Ice will destroy platelets.
• - If unit is not used within 8 hours- Keep
  unit in fridge for 24 hrs until it expires

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Unit Testing

• Test each unit for
• - ABO / Rh
• Pilot tube or Unit Segment
• Infectious Disease Testing
• - Normally, screening tests MUST be done prior
  to issuing the blood
• - Refrigerate serum or plasma ship to FDA
  licensed testing facility/Lackland Blood Donor
  Center

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QUESTIONS?
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Sample submission requirements for sending
samples to Lackland BDC
Administrative requirements for
shipping Collecting sample requirements for
testing per CENTCOM
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Sample submission requirements

• For each blood/platelet donor, submit 3 bar-code
  labeled plastic transfer tubes, capped, then
  Para-filmed, containing
• 3 ml plasma
• 3 ml plasma
• 3 ml serum
• Attach a small ISBT barcode label to each
  transfer tube. Place lengthwise near the top of
  the tube.
• Label each transfer tube as serum or plasma.

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Sample submission requirements

• Storage requirements
• All samples must be shipped frozen
• Plasma/serum must be removed from the cells
  within 3 days of collection
• Samples may be stored at 1-10 C for up to 8 days
  before freezing
• Samples must be frozen within 8 days of
  collection
• Do not freeze PPT/SST tubes. When freezing
  samples, freeze the serum/plasma portion only
  and only after centrifugation and separation

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Sample submission requirements

• Shipping requirements
• Ship in a Collins box
• Ship on fresh dry ice - using as much dry ice as
  will fit in the box, leaving as little air in the
  box as possible. Frozen samples should arrive at
  lt-20 C
• Follow up with your shipping company to make sure
  the shipment has left the terminal

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Sample submission requirements

• Notification
• E-mail and fax notification of shipments to LBDC
  the day of the shipment departure
• Attach the shipping invoice listing each sample
  number to the e-mail, as per current practice

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Sample submission requirements
Tracking
                       
Facility Id/ Year SAMPLE ID DATE COLLECTED Specimens Frozen? Date Frozen COMMENTS Facility Id/ Year SAMPLE ID DATE COLLECTED Specimens Frozen? Date Frozen COMMENTS
                       
                       
                       
                       
                       
                       
                       
                       
                       
                       
                       
                       
                       
                       
                       
     
______________________________________ ______________________________________ ______________________________________ ______________________________________     ______________________________________ _________________ ______________________________________ _________________ ______________________________________ _________________ ______________________________________ _________________ ______________________________________ _________________ ______________________________________ _________________
SIGNATURE OF SHIPPING OFFICIAL SIGNATURE OF SHIPPING OFFICIAL SIGNATURE OF SHIPPING OFFICIAL SIGNATURE OF SHIPPING OFFICIAL SHIPPING DATE SHIPPING DATE SIGNATURE OF RECEIVING OFFICIAL RECEIVED DATE SIGNATURE OF RECEIVING OFFICIAL RECEIVED DATE SIGNATURE OF RECEIVING OFFICIAL RECEIVED DATE SIGNATURE OF RECEIVING OFFICIAL RECEIVED DATE SIGNATURE OF RECEIVING OFFICIAL RECEIVED DATE SIGNATURE OF RECEIVING OFFICIAL RECEIVED DATE
______________________________________ ______________________________________ ______________________________________  
SIGNATURE OF 2ND VERIFIER SIGNATURE OF 2ND VERIFIER SIGNATURE OF 2ND VERIFIER  
No action required if specimens were not frozen prior to shipping. No action required if specimens were not frozen prior to shipping. No action required if specimens were not frozen prior to shipping. No action required if specimens were not frozen prior to shipping. No action required if specimens were not frozen prior to shipping. RECEIVING TEMPERATURE_____________C RECEIVING TEMPERATURE_____________C RECEIVING TEMPERATURE_____________C RECEIVING TEMPERATURE_____________C RECEIVING TEMPERATURE_____________C
If specimens were frozen within 8 days of collection, circle 'Yes'. If specimens were frozen within 8 days of collection, circle 'Yes'. If specimens were frozen within 8 days of collection, circle 'Yes'. If specimens were frozen within 8 days of collection, circle 'Yes'. If specimens were frozen within 8 days of collection, circle 'Yes'.
If specimens were frozen gt 8 days of collection, circle 'Yes' and annotate If specimens were frozen gt 8 days of collection, circle 'Yes' and annotate If specimens were frozen gt 8 days of collection, circle 'Yes' and annotate If specimens were frozen gt 8 days of collection, circle 'Yes' and annotate If specimens were frozen gt 8 days of collection, circle 'Yes' and annotate If specimens were frozen gt 8 days of collection, circle 'Yes' and annotate Total of Samples/Specimens Shipped Total of Samples/Specimens Shipped Total of Samples/Specimens Shipped Total of Samples/Specimens Shipped
in comment section 'gt 8 days'. in comment section 'gt 8 days'. in comment section 'gt 8 days'.
Provide additional comments as necessary to communicate integrity of specimens. Provide additional comments as necessary to communicate integrity of specimens. Provide additional comments as necessary to communicate integrity of specimens. Provide additional comments as necessary to communicate integrity of specimens. Provide additional comments as necessary to communicate integrity of specimens. Provide additional comments as necessary to communicate integrity of specimens.
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Sample submission requirements

• Rejection Criteria
• If less than 3 tubes submitted, or less than 3 ml
  submitted per tube, the sample will be rejected
  for all testing
• Non-frozen samples gt8 days old will be rejected
  for NAT testing. All other tests will be
  performed
• Non-frozen samples gt14 days old will be rejected
  for all testing

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Sample submission requirements

• Rejection criteria
• Frozen samples gt60 days old will be rejected for
  all testing
• Samples must have been separated from cells
  within 3 days of collection and frozen within 8
  days of collection and remained frozen throughout
  transit and arrive frozen
• If samples are shipped via Landstuhl Regional
  Medical Center (LRMC), LRMC should denote sample
  acceptability on arrival at their facility and
  relay that information to LBDC

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Sample submission requirements

• Rejection criteria
• Grossly hemolyzed, contaminated or broken samples
  will be rejected
• Samples in glass will be rejected. PPT/SST tubes
  will be rejected

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Sample submission requirements

• Shipment arrival

• Taking temperature

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Sample submission requirements

• Specimen shipment

• Sorting out tubes

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Sample submission requirements

• Waiting for testing

• Putting specimens in order

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Sample submission requirements

• Shipment Paperwork

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Sample submission requirements

• Rejection criteria
• Responsibility
• LBDC will notify submitting site of rejected
  samples via e-mail within one duty day of receipt
  of samples. The COLLECTION SITE is responsible
  to re-collect the donors ASAP and re-submit
  proper samples to LBDC

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Testing requirements for CENTCOM regulations

• No ABO/Rh and CMV will be completed
• Antibody screens performed on Galileo
• HBsAg, HBcAb, HTLV 1/2, HIV 1/2, and HCV on Prism
• WNV and Ultrio (HIV, HCV, HBV) done on Tigris
• RPR performed on Olympus (PK 7300)

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LBDC Testing area

• Olympus

• Galileo

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LBDC Testing area

• Prism

• Tigris

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332 EMDG

• Aerial View of 332 EMDG

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332 EMDG

• Trauma Bay

• Blood Bank/Trauma Bay

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332 EMDG

• Aphaeresis Collection

• Blood Bank

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332 EMDG

• Chemistry

• Microbiology

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332 EMDG

• Main Lab

• Main Lab

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332 EMDG

• Emergency Room

• Shipping Department

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QUESTIONS?