14. The preservative have been mentioned in the foregoing
15. Store the donated blood at 4–6oC (37–42oF) in a
refrigerator that should solely be used for keeping the
blood transfusion bottles only. If this blood is kept
constantly at the required temperature—a duration of
21 days may be allowed to lapse between collection
and transfusion of the blood. If storage conditions are
less ideal, then it is best to shorten the storage time
to about 14 days (after this duration it should not be
Blood Banking (Immunohematology) 365
Occasionally, venipuncture is unsuccessful or the vein
may develop spasm after venipuncture so that blood flow
1. Do not try to probe around in the vein, as this can result
in a hematoma and discomfort for the donor.
2. Remove the needle and discard the pack as it will be
3. Never resite the needle in the same arm.
4. Reassure the donor, giving a full explanation for the
unsuccessful venipuncture in order to retain their
If the donor consents, a further venipuncture on the
other arm may be attempted, if a suitable vein is located.
No more than a total of 350/450 mL of blood should be
If there is a failure to maintain a blood flow during the
collection, the person who has performed the venipuncture
should be informed immediately. Slowing of the flow rate
¾ Reduced cuff pressure: Check that cuff pressure has
¾ Occlusion of the lumen of the needle by the vein wall:
¾ Positioning of the lumen of the needle on a valve within
the vein: Try to re-establish the flow by withdrawing the
needle gently or even by slight rotation of the needle.
Before doing any of these things:
1. Explain that there is a problem with the blood flow and
ask whether the donor is experiencing any discomfort.
2. Remove the swab and check that there is no hematoma
3. If there are no other apparent problems, proceed with
4. Avoid excessive manipulation of the needle or
squeezing the donor tubing as small clots may form
which will then be released into the circulation.
A failure to reestablish a blood flow will result in a partial
collection. This should be marked on the donor’s record
form and the donor should be given an explanation and
apology, if the collection is too slow, the donation should
be discontinued. This should be recorded on the donor’s
Hematoma can be prevented by good venipuncture
technique and application of adequate pressure following
2. Apply firm pressure until the venipuncture site stops
3. Apply an anti-inflammatory cream in a circular motion
over the area and cover it with a small; plaster or swab
dressing, then apply a pressure bandage.
4. Reassure the donor, explaining what has happened
and the reason for the bruise, and then apologize.
5. Ask the donor to keep the plaster on for 24 hours and
the bandage on for 2 to 4 hours. If they feel that it is
too tight and stopping their circulation, it should be
6. Tell the donor that they can use their arm normally, but
should not lift any heavy objects. Also, tell them that
they can take painkillers for moderate discomfort, but
that if the area becomes unduly painful, they should
contact the transfusion center or their own doctor.
7. Record details of the hematoma on the donor’s record
Accidental Puncture of the Artery
This is an uncommon complication of blood donation,
and one should be able to recognize it immediately by a
very fast flow of bright red blood.
If accidental puncture of the artery occurs:
1. Discontinue the donation immediately and apply hard
pressure to the puncture site immediately after the
withdrawal of the needle. Raise the limb above heart
2. Maintain pressure for a minimum of 15 minutes.
3. When the bleeding has stopped, apply a pressure
bandage and tell the donor to keep this on for 4 to 6
4. Reassure the donor, giving a full explanation of what
5. Record the appropriate information on the donor’s
6 Do not allow the donor to leave until they are feeling
well and after the most senior member of the donor
clinic staff has discharged them.
7. If you suspect that tissue bleeding may still be
continuing, refer the donor to the nearest hospital or
health center. If the donor lives near the donor clinic,
ask him to come back for assessment the following day.
Mild, Moderate or Severe Reactions
Most people can tolerate the withdrawal of 350 or 450
mL of blood without any ill effects. Others experience
reactions ranging in severity from a feeling of uneasiness’ to
convulsions. These reactions can occur at any time—
during the donor selection process, during donation, in
the resting or refreshment area or even hours following a
There is a psychological element to most reactions, so
a friendly, cheerful atmosphere at the session can often
reduce donor anxiety and perhaps prevent any adverse
reactions. Donor reactions do sometimes occur, however,
and can be categorized as follows:
Mild: Vasovagal symptoms without loss of consciousness.
Moderate : A progression of symptoms associated with a
mild donor reaction resulting in unconsciousness.
Severe : Any of the above, accompanied by convulsions
The signs of mild donor reactions include:
¾ Dizziness/continuous yawning
When mild donor reactions occur:
2. Raise both of the donor’s legs and lower the head
to improve the blood supply. If a donor is vomiting,
turn him on one side to avoid accidental inhaling of
3. Loosen or remove tight clothing.
4. Keep the donor cool by opening windows or switching
5. Have a suitable receptacle available at the bedside in
6. Allow a sufficient rest period.
8. Once the donor has recovered, assist him from the
bed to the refreshment area where another cold drink
9. Reassure and talk to the donor throughout all these
stages. Explain that this type of reaction is common
and does not mean that they are now physically
10. Record the reaction on the donor’s record form.
11 Advise the donor that, if symptoms persist, they should
report to the blood bank or consult a doctor.
12. Ensure that the donor is fully recovered before leaving
the session and has been seen by a trained member of
The signs of moderate donor reactions include:
¾ Loss of consciousness (fainting)
¾ Repeated periods of unconsciousness
¾ A slow pulse which may be difficult to feel because of
When moderate donor reactions occur:
2. Raise both of the donor’s legs and lower the head.
3. Ensure that a medical officer or a senior nurse
4. Loosen or remove tight clothing.
5. Keep the donor cool by opening windows or switching
6. Have a suitable receptacle available at the bedside in
7. Check the pulse rate regularly. The appearance of
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