Guidelines for Setting Up Blood Storage Centres - NRHM Tripura

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(D) In Rh hemolytic disease of new born Rh (D) Negative blood of the same ABO group as that of the baby is used if it is same as that of the mother or if it is compatible with mother’s blood. Once the baby’s ABO group is not compatible with mothers ABO Group, then O Rh (D) negative blood is selected and matched with the mother’s serum. TABLE 1a : CHOICE OF ALTERNATIVE BLOOD Alternative Blood Group Patient Blood Group First Choice Second Choice (Given as Packed Cells) (Given as Packed Cells) O None None A O None A 2with anti A1 O None B O None A1B A or B O A2B A or B O A 2with anti A1 A 2or B O In group AB, patients A group Blood as an alternate CROSS-MATCH TECHNIQUES source is preferred over B group blood, as anti B in Group A is weaker than anti A in B group. It is • Immediate spin technique advisable not to change form group A to group B • Saline room temperature technique blood or vice versa, when more than one unit is • Indirect anti-globulin technique given in a continuous transfusion. The decision to change back to group specific blood, IMMEDIATE SPIN TECHNIQUE/SALINE ROOM would be based on the presence or absence of anti A/ TEMPERATURE TECHNIQUE anti B in subsequent sample of patient. Immediate spin technique or saline room CROSS-MATCHING temperature techniques are enough to rule out any The terms compatibility test and cross-matching are ABO grouping error but are inadequate for detection sometimes used interchangeably, however they of clinically significant IgG type of antibodies. should be clearly differentiated. A cross-match is only part of compatibility test & its functions are: CROSS-MATCHING METHOD • It is the final check of ABO compatibility 1. Set up a row of two test tubes in test tube rack & between the donor and patents. label them 1 & 2. • It may detect the presence of an antibody in the 2. Put two drops of patient's serum in test tube no. patient’s serum that will react with an antigen on 1 & 2. donor red cells, which was not detected in antibody screening because of the absence of 3. Add 1 drop of 2-4% donor red cell suspension corresponding antigens in screening cells. in tube no. 1 & 2. 21
STANDARD OPERATING PROCEDURES 4. Mix the contents of the tubes and incubate tube • Ward No. no. 1 at room temperature for 5-10 minutes • Bed No. (immediate spin method) or for 45-60 minutes for saline room temperature technique. • ABO & Rh Blood Group 5. Incubate tube no. 2 at 37ºC for 45 minutes DONOR UNIT NUMBER (indirect antiglobulin technique). • Donor ABO & Rh Blood Group 6. Centrifuge the tube no. 1 at 1000 rpm for 1 • Expiry Date minute (immediate spin technique) while in • Date of Cross-match saline room temperature technique • Initials of the Technician cross matching the centrifugation is optional. blood. 7. Examine the tube no. 1 for haemolysis or The satellite blood centre should maintain the record agglutination. If haemolysis or agglutination is of each unit of blood issued in a proper Register. present, cross-match is incompatible. If no • Name of Patients haemolysis or agglutination is seen, wait till the incubation of tube no. 2 is complete. • Hospital registration No. 8. Examine the tube no. 2 for any haemolysis or • Ward agglutination; if negative wash the contents of • Bed the tube no. 2 three times with saline and • Blood Group decant the last wash completely. • Donor unit No. Issued 9. Add 1 drop of anti-human globulin (AHG) • Blood group of donor unit / component reagent and centrifuge at 1000 rpm for 1 minute • Date & time of issue and look for haemolysis or aggluatination • Name & Signature of person who has issued the macroscopically & microscopically. blood 10. Record the results. • Name & signature of person who has collected NOTE : Run Auto Control i.e., patient’s serum & the blood from the blood bank. patient’s washed red cells (3-4%). It is advisable to check each & every unit before issue for any change in colour or haemolysis, leaks, etc., & also issue a cross-match report along with the blood unit. INTERPRETATION : No haemolysis or agglutination indicates compatible cross-match, while haemolysis or The clinician in charge of the patient should be agglutination indicates incompatible cross-match. advised to send the reaction form completely filled, in case of any reaction for evaluation. LABELING & ISSUE OF BLOOD INVESTIGATION OF A TRANSFUSION REACTION Before issuing a unit of blood for any patient for In case of a suspected transfusion reaction the transfusion, it should be properly labeled. following things are to be done : The label should have the following information. Things to be done in the ward by the sister • Name of the patient immediately. • Hospital Registration No. (I.D. No.) • Stop the transfusion 22
Page 1 and 2: Guidelines For Setting Up Blood Sto
Page 4 and 5: Foreword It is estimated that for e
Page 6 and 7: Acknowledgements The publication of
Page 8: Contents TOPIC PAGE Guidelines Intr
Page 12 and 13: INTRODUCTION There has been a signi
Page 14 and 15: (v) Consumables : There should be a
Page 16 and 17: 6. DOCUMENTATION & RECORDS The Cent
Page 18 and 19: (5) The First Referral Unit, Commun
Page 20 and 21: 9. The Blood Banks who intend to su
Page 22 and 23: ANNEXURE -II SPECIFICATIONS BLOOD B
Page 24: STANDARD OPERATING PROCEDURES
Page 27 and 28: STANDARD OPERATING PROCEDURES INTER
Page 29: STANDARD OPERATING PROCEDURES • C
Page 33 and 34: STANDARD OPERATING PROCEDURES INTER
Page 36 and 37: INTRODUCTION The Department of Fami
Page 38 and 39: Collecting Blood/Blood Components p
Page 40 and 41: DISPOSABLE EQUIPMENT For blood admi
Page 42 and 43: • Alternative blood group can be
Page 44 and 45: TIME LIMITS FOR INFUSION Blood Comp
Page 46 and 47: DEXTRAN 60 & DEXTRAN 70 • HES is
Page 48: compounds in which all hydrogen ato

Guidelines for Setting Up Blood Storage Centres - NRHM Tripura

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