WHO Guidelines on Drawing Blood: Best Practices in Phlebotomy

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A closed collection system with a sterile blood collection bag containing anticoagulant,
and with an integrally attached tube and needle should be used. Some bags include
diversion pouches to sequester the first 20 ml of blood collected, to minimize
contamination from skin flora and the skin core (50). If blood for haemoglobin testing is
gathered with a capillary stick, a single-use sterile lancet should be used and then placed
immediately in a safety box.
• Location:
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Premises should be of sufficient size for efficient operations, with separate areas for
clean and dirty processes, clean running water, and surfaces cleanable by disinfectants.
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Floors should not be carpeted.
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Waiting areas should be outside the collection area, to minimize the risk of respiratory
pathogens for workers.
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All fixed and mobile blood donation sites should be safe, clean, hygienic and tidy, and
should meet defined standards of environmental safety.
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The donation sites should be organized in a way that ensures the safety of blood donors,
staff and donated blood units, and avoids errors in the blood donation process.
4.1.2 Before a blood donation
<strong>WHO</strong> has developed a set of basic requirements for blood transfusion services, which cover the
steps to take before donation (51). Blood donation should be voluntary; it should not involve
duress, coercion or remuneration. Also, potential blood donors should be selected carefully,
according to the national criteria for donor selection.
Before a person donates blood (52):
• the potential donor should be given pre-donation information, advice and counselling
about the process of blood donation;
• a relevant history of the donor should be taken, covering health and high-risk behaviour,
and including
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history of mastectomy (blood should be taken from the arm opposite the site of surgery)
(48, 53);
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current and recent medications or chronic infections;
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history of prolonged bleeding or a past diagnosis of bleeding disorders;
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history of previous donations, to ensure the waiting period is respected;
• a preliminary physical check-up of the donor should be done, including weight, blood
pressure, signs of infection or scarring at potential sites;
• the donor should be offered fluids, to help reduce the risk of fainting after blood donation
(54);
• the person should provide informed written consent, based on the national requirements.
26 <strong>WHO</strong> guidelines on drawing blood: best practices in phlebotomy