PRBFACE

Ijazards are always present in all human activities. The severity, incidence and frequency vary with thc type of activity and prcvcntive acrions in force with rhe acrivity. Forowing s dcscribc thc type of hazards and blood bank poricics regarding preventive actions. various d.'s and don'rs are dcscribcd. Trrcsc
shourd be adhered ro.
lr4:rj<lrit-r'

.l'lltb.ritl.ty acciclcnts and inl.lcrir)r.s

occur:rs a rcsurr of-tr:c rbrtowing.

I

Altcrrliorr lo tfclail calr takc c:lrc ol.ruost ol-(hcsc.

I ltrrttitrt cl-r1)r. J)oot

tcchrritlucs and Misusc ol. cquiplncnt

I'v1;c ot'hazar<Js

Iliol.gic.r' ('rrcrnicat
Iliologicrrr rraz:u'd

rrazrrrJs' cquiprrrcnts rcratcd, Itectricar and firc

contmcting inrbction or spreading it in rhe comnrunity is of i'rportarcc in trrc rab.ratory. Iiquipnrcnr and Chemical 'itr'ticur,r' hazards though, possi blc :uc rcl:rtivc inliequcnt. G.<ld aticl salc labilrat<lr-r' practicc. il' strictry fbilor'cd, can take care of almost arr rhe lriologic.l ha:ra*ls and ttrosl ol'thc otlrcr hazards. No spcci arizedequipmenr can repracc it; trtttrosl it ca. supplartt it' Guidclincs of lhese practices afe given in the following s and Itavc tlic stalus ol'rulcs si'ce failure to obscrve them can endangerothermembers of the stafl-and contnrunity
Chcruical ltazard : Since Blood Bank hardly uses loxic chemicar this hazard is minimar. Equipr'cnt rclalcd haz-ards : these are rnainly due to faulty technique in their use. The t,attttitl gir"cs direcrions lbr the propcr use of equipment. The stafrshourd deverop and

oI

'

oev

CEETA'{JAU FOUNDATION iFg 7c-

fu,+U,

ltg '-

.-!ID-.=:.

:=_-.

_.:..

technique can save time'' However when ir wert read to accidenr or

ff

9qqlp!nQ'lt:-4!!iqre q!9 n*y fer thet {,rgkrg_shortcut in. :it invariable will l*a a ryrr.h greater craar-- loss ,^^= to much ofrime

marfuncffiilffi:

-=.--

waste disposat is of prime intportance in rhe brood bank. Ail wasre in the brood bank is bc considcred potcntially haz-ardous and -to deart accordingty. Necessary guiderines are provided in the following s.
crccrricar haz-rrds

:;::
'l'ltcrc

""t

: I)rcvc'rion tbrforv rhc gcncrar

principrcs in use anywrrerc

itrc ccrlaitt slandard practicc.s callcd .(io<ld latxrratory practiccs. Tlrcse are built in (.' prc'c'r haz:uds. 'r'hcsc arc givcn 'rcch:r'isrr 'ari<lu-s rigrrt in bcginning of the 'lhcsc sop. nccd (o bc gonc through and followc<J.

I
F.OI GEEIATIJAU

rrepared By

fOUNDATION
t>

3Un AGARWALT . -:,'Glnhtnan I faagng llsnlee

I '

ut",
J

-:<1-!'q!F.--

1-

.'+!lt!*.

LABORATORY PRACTICES
rliese guidelines are given.dorls not reflect their importance. Each
as any other is.

Afftechnical procedure should be performed in a way that mininrizcs formation of

aerosols and droPlets.

Cowns and/or protectivc coats and glovcs nrust bc worm wltcrt rvorking in thc
blood bank. Protectivc laboratory clothing shoulcl not bc slorcd irr thc suttc lrrkcr or cuptroard
as strcct clothing.

Salbty glasscs. lircc shic'lds (r'isors) or othcr protcctivc dcviccs rttrrst bc \\'onll whcrr

it is neccssary to protccl tlrc c1'cs and lircc liorn splashcs

:rnd inrpacting

objccts.

Protcctive gloves must be rvashcd whilc on thr: hands and agairr irlicr rcrtroval.
clcancd and disinfccted beforc reusc.
a

No pipefitting by mouth. Automatic sanrplers ard diluters should bc used rvhcncvcr ;xlssiblc.

ar
a

rubber bulb system or equivalcnt is usc

if a glass votunrctric pipcttc is bcing

i:iii:iii

used.
a
a

Eating drinking and snroking is not permittcrd in ttr,e laboratorl,.

Drinks and food stuffs muse bc kept only in a rcfrigcrator sct-asidc uniqucly lbr
this purpose.

:::i:::::::. ::t:ii:t:ii

a a
;

Lipsticks and cognetics should not bc applied in the laboratorl,.

Labels must not bc licked. Pencils.and pens must not bc ptacccl in rhc nroutlr.

::::-:::

Instrumcnts connected lo power and water suppties nrust not bc touchcd or rurned

offexcept by those authorizd to do so.

Speci{ic instructions for packaging and transporlation of biological nratcrials bc
ii:;
i.

strictty observed.
\

=t -E-!_ :

fI

=
-a-

L-

=a
:ii -E :Y.

= = =

# # ffi

l?iit.'::

Fi.,

E' F.' F.-

fi',

ffia,,

1_

Itg_!!:f:1fry
hand.

musr be kepr
+

lglga_t:.

of

marerial not pertincnt to

wort at

dangerous nraterial and after ar rhc er:d of the dar,.

Thc work surfaces musl be deconlanrinaterl atier any spill of'

porcnrially

going out of the taborarory.

Staff nrust wash their hands aftcr lriurdling inlcctious rnalcri:rl and

rvlrcnever

All tcchnical procedurcs nrusl bc pcrlirnncc.l

productions
o f'

acrosols.

fJ

Scc that arthropod ancl ndcnt corrtnrl pr1)r:r:t11r irr pl:rcc. (.orrsrrll lrlooct bank oll'icc.r it'1,ou llnd it is not clll.crivc. 'l'he s-vringcs and thc nccdtcs shotrltl trol l.rc rrsc ils srrbslitrrtc lirr pipcttcs litr rc.nl()\,ing in ll,ct
iou.s nratcrial.

c<lnlantinalccl ntalcrial ltrust lx. dccorrltrnrirrlrtcrl bclort. tfi.slxrsirl lilllclrv guidcfincs :rs givcn ulrdcr
rr.:rstc tlisposrrl.

All

()r

t(:usc

irccidcnts. ovcrl ()r;rolclrtilrl c\llosur.(.s to i111q.c11.,,,s lrr:rtcri:rl rrrrr.sl bc, rcptlrtcd to thc bloo<l'hank sall't)'sttPc^'is.r' irrrrrrctri;rrcr-r, rr,rr. rriiil trrkc or ()\,cr+-c all crlrrr'clivc :rrrd/or prc'cnrari'c ;rcri.'s. f lc srrrrlr *"",., ,....,,.rs .r. :r, .sucrr incidcnts.
Ba.sclinc hcalth chc.ckup and tcst. particul:rrlv ro tcst rhc irbilit-1, to rl.totult dclbnsc to infcclio's' rvill bc kcpt of all pcrso's.r

Afl spills.

rrc rc;rcirlccr. Although alt spccimcns arc trculcd i't'lctitltrs ccrrrrirr orcs ,illc Jr:rrricurarry dangcrous'

.isk. r)cri.cric;ril-r,(rri.s srurrf

I-aboratory doors of thc infcctious tlisc,sc.s r:rr.,.r'rrr.r-r. slrlrlr rclrr:ri' crrscrr cruring rvork' on15'pcrsons wlrc arc thnrilia'ii'itlr tlic litircrrri:rr r-i.sk ir'tr r*lr. r.ccr spcciric .requirenrent (lnrmunization) rvill bc pcnnittccl to g111g1-

rvrren knorvn, consurr strpc^,is.r r*rrirc rrulr<Jrilrg trrcrr.

All staff shall arake themsclves

undcnake training, as and rvhen. arr:lnsc<J.

lirr'iliar rvirrr rhc rurcs .r' r:rb.r'r.ry s,ri:ty

and

Mo",

F'

OEETA}IJAIJ

f OUN DAT ICN

'Ib V

$dFat

GtP. AGAR!'J}'L) Trsrrle

& $enaqrng

'SPBCIAL

PRECAUTIONS WITH BLOOD AND

OTHER BODY FLUIDS

to protcct thc workers

agairrst

otttlittcd rrclou'as thcsc arc dcsigncd Kinclll' lbllo$, thc prccautiorls R virus' I-[umatr Inrnlunc Dcficicncy virus' blood bornc pathogcns c.g. lrcpatitis .rra

t'c 'iruscs

artd hclnrinthcs' .l-Scprclrrhagic lclcr. irniJ by pr()lozoa

(l':lllsl)ot'l of sDccirllclr CoIlccti()n, l:tl)clitlg :lrl(l

tt..

\\/clt

ttl()\'cs lirr all llrocctltrt.cs'

lirrccps artd [1g 1s1111rrctl liortl s)'r'ingcs rvitlr trccdlc Allcr.r.,'lriltUnclrlrc ttcctllcs sltrrtrltl
pllrccd irt tcccpt:tclcs

'lirl

slr;tr 1lt' cottt:tirtittg lt-r'poclrloridc'

rliscard lo ('1rcllllr rlisclr:trgc,1,.11l1rotl irllo llrc sllccitttcrl ltrfrc ittt<l

lcccl)l:lc lc colrla
i

s1'rirtgc irrto tltc

rr irr

lt1'1'roc lt

lrrl r tlc' ott lltc spccitttclt ltlbc'

('irrcltrllr lttttl sccttrclr l)tll ll sl()l)l)cl

lirlrn.

lrtrt:rlebcl'l):tttgcrtrl'irtlc'cliorr-\\iltcrtcvcrtlcccss:tl\'otttltcspccittrcltttrllcaltdtltcrcqttcsl
irrli.a, lirr lralrsrttissiort to thc labOratory' llcqucst lrllrcc tlrc trrbc iil scll:rriltc c()!rl.ri!rcr. r,ittc

lillrtt slrotrld bc 1ll:rcctl scp;tlrtlclr

l{cccption stlrl'l'slrtltrl<l llol ()l)crl thcsc
bags.

Olrcttittg slrccilrtcn trrbcs autl s:tnrlrling contcnts (ilovcs ntttst hc worlll.

'lo prcr,cnl splashinq . tltc stol'rpcr

slrotrld bc grasped tl'rrouglr a piccc of paper'

lm*

+ouNDAl

lot{

Fd

sESrAxJALl

U"#.

No"uu,
lt*lnYllJ.t.."

SAFE LAI]OI{ATORY TECHNTQUES

iqucs for (hc safe handling of

en in tlre labora{o

'l'ltc pcrs<lttttcl ittr'<tlvcd in c<lllcctittlr <ll'spccilncrr. irr(crnirl transporl and rcccilll 9l' spccilttcn citrr'-\' ir risk ol' irrlL'clirlrr.

Ijollorr irrg prccrruri.rrs il'ohscn'cd *.rrltl rcdrrcc llrc r.isk.

rt

Sllccirrrcrr (]rnlairrcrs

I lse rolrrrsl c()ntilitrcr. rrurrlc

ol':llirss or pl:rstic.
cr.rp or.sl<11"1;rcr.

a
a a a

('lrcck tltlrt llrc crtttt:tittcr tlocs ttttt lcirk irltcr corrcctl_r applvinl llrc

No rrurrcri;rl slrtrtrltl rcrn:rirr rln rlrc otrtsidc ol'thc corrl:riltcrl. ('ot't'cctl-r l:rlrcl tlre cotrlaittcr to lircililllc idclrtitrcatirln irr llrc lirborlt.rr.. tlrc rct;trisilion tilrrtt lirlrn artlurrd rhc colrlaincr but plrrcc is scp1ralct1,. prclcrir[rl-r, irr ir pllrstic cnvckpc.
rvr':r1'r

l)o tt0(

ltt citsc sPccittlctt is srrslx'ctccl of'ctln(airrirrg p:rtlror:crrs ot'\\/il() ltisk (iroup (l!cltatiti.s ll vi1'115 cr It!V) lah,_:! t!rc cont:rilrcr.trs rr.cll as
spcci:r| "t!:rngcr tll' i rrlcction-' lahcl.

.i
:r

thc rcqucsl lrtrnr bv

'l'r:rrrsllorl to llrc l-:rlroratorl

a

'l'hc

lsc sPccial scctttltlitn' cOttt:rirtcrs. rr,lrcrevcr rrccdcd- such as tftr),s or lr,r.rcs. tltrcd rvillt ritck's l() 1l'rlrlsf L'r lltc sfrcirrrcn to Ihc laboratorl,. to avoid :rccidcntal lcakalrc or -l'lrc sPi l lrrgcsPcc i rrrc* c'lrlaincr .srrourd re-l'ai rr uprigr:tI scc<>rrrlur.,r cOrrtailrcrs

nril-\'

lrc nradc o!' rnctar or prastic b;, sh.urd

lrc

aut.cla'ablc

or- r'csislant to rhc

acrior of chenricar disinfectanrs.

?"""ufou*ot$\oN

9
Regularlydeconlan1lltq1-e_lhg_ s_ecq!!_4y
_cs1 ra

iners.

0Dcning l)ackages

a
a

Ilnprrck llrc sPccirrrcl't on lra\.s.

I lsc goorl

rnicrohirllogicirl practiccs.

ll' tltc
ollicu.

spccirrrcrr corrlaincr

is

hrrkcrr

li

orrr

bio-sirlL.t-r,

\-(
a
a

''\ rrrtrr'ilt' slr.rrltl rrlr'rr's

|)o rrol pipcltc

r'rc rrscd

u,irh rirlklrr.i'g c;rrcs-

lx

rrrotrllt.
:r lirlrrid- c.rrrlrilrirru
l'rc

a a

|). rr.r hkr* :rir trrr.rrgrr

il l)rl)('ll('.

i'tL.cri.rrs irllc,rs.

lrtlt't'li.tts ttt;rlt'l'i:tls slt0trltl ttol

ntixcrl b-r rtllcrrt:rlc strcli6rt:yr(l (.\r.rrlsr.rr tlrrorrSlr

I

l.it;trirls slrorrltl rrot hc lilr.cihl-r crpcllcd lirrrn pi;rcttcs. srl;rkctl cl<llh ttr lbsorbenl ir:rpcr slrotrkl trc plrrcctl orr tlrc rrrlrkilu srrr'l;rt't. lo ;11,yi.1 rlisllct.siott tll ' irrlc'ctirlrrs rn.rlcrill. il' is :rccitlcrrt:rl lr <lnrpPctl li.ont ;r
l)

r\ tlisirrlr-.cl:rrrls
tl)ct tc.

o o

orrtlrr.nirr:rlcd ;tipc(rcs sirtltriti irc ccrnplctcil,srrbrncrgcd

ili

lr-r,;-,o.

IS-r{

lrlor-i.le rriir!

lcli

!irr.

lrours lxtirrc disgros:ri.

purprlse,

l)o rtot rrsc sr.ringcs l'iilcd rrith slr:rrp rrccdlcs lbr thc

ol';.ripcttirrl.

cclr nir ur.s firr:ruoi<lir

cslion of infcc(iorrs nralcrials

lntl tlrcir corrt:rcl

ryil lr .skin :rrr<l ct,cs.

a
a

Il:rrtd slrorrld lx. ulrshcd trcqucptll,apd alu,lys al tftc cn4 6l.11,6r.k ,\ r,oid lorrchinq cvcs arrti nroulh.

lj..d

rrrrd

ti'ink lrust lrot rrc consur'ed/stored in thc ratrorato^,

rc @rN{urr

FouNDA'tlor\

\*,,,

f"ms*l*l\]'**

a
a

I'_ere lbqqtQ be qo 911oJing ol gqm clryryrlfe i! qt. ('osrnclics should ntll be applied in llre latror.aton
-

rj.cc a'd cyes srrourcr

bc' shiefdcd

during any procedurcs

splashing or in fbctious nralcrial.

in

the

cc lr rr i0 rrcs
t i<l

rrs

Irrli't lrrrrr nrtrl r.csrrll lirrrn Nectllc Stick" rr itlr hr ltodcr.trric rrccdlcs. ( illrss Iltttl.r'rt ,.'ilrss.

1.ri;.rt.ilt.s

l lrt.st. r.:rrr ll(. :rr,oirlcrl lrr

s-\'l'iltgcs rr rllr rrcctllcs lirr. ltiltcttr. lit;rlltcirre gLrss pipct tcs- rr hcrcvcr
115jylg
.

\ol

;lossr blc. b-t,

\r't rtlr.rtlltI irrocrrlltliorr

soli pl:rslic
orrl_r,

f);rstcrrr. l)il)eilcs.

b_r

brokcrr l.:l:r.ssrr.:rrc cirrr

(.Il('.

bc trr.oitl,..il

lrr tlrkinl

Pcr.sortirl

( iio'. t's slrorrltl lrc rr orrr.

\r'\

JJiootl ;rrrtl scr.rrrrr sltorrlrl bc Pillctrcs c:rrclirll_r,. lrttt ;.rourctl.

cl' y,.ii-.ci{c

l_'_...

iij{itil;i_
rir er-rrigrit

:;!iiiiili! l.,e c.iiii;lclcli' sribiiici'::cd iii ri-r,p.,"*h!.riic i.r. ,':j",_;

irc'rrc

l)i:;t':r'tl sJ'rccitttctt lttbcs c.ttl:tirtirt.. bltxxl cr.ts c(c. aricr rcprucirrg trrcircrrJrs. lrr' rrllrccrl irr lc;rk plror corrr:rilrcrs r<lr irutocrilving.

srrrlurcr

'\ttr spl;rslrcs o1-s11ill:rt]cs r'r hkltltl ;rrrtl scl'lll1l '('!!'r or t'r()(}(l;ll)(l s shtltrld bc lrrtlllllctl rrillr lr-r'ac6laritc s.Jrr{i,rr.

f o\llloAlloN
F

9EEIAIIJAIJ

ra^l}f\)*'" ? $t. tn
hnq^nnu,

tl
'l'cch
ucs for

aralion of scrums

('crrtrilirgcs shottld bc tlpcr:ttcd according lo tlrc rnanrrlirctrrrcs irrstrrrt:tirrrrs,

('crrtrilirgcs slttlttld

lt

placccl al

a lcvcl so llral lhc pcrsorr rrlr'kirrrl lrr

it

look

irrlo tlrc lrorrcl to pllcc trrrrrirlrrs and buckcls corrcclly.

llrrt'kels :utd lrtutiotts sltorrltl hc fxrirc{ h-r rrciglrt il1(l \\ itlt trrl,..s i: pllrt.t. l'trl
('( )l'r'('('l

lr

lr:tlttttcctl.

\lt',rlt.rl (7(1",,)sltortltl he ttsctl lot'1r',;',,,a',ru lrrrckcls lrcc:rust.slrlnrt.or. lrrpor.lrLrr.ilt.

I

soItrtiorrs lrollt corrotl(' nlclitls.

I I

( r.'tlltilir::t'tttlrt's:ttttl
tlrr'.'k rr:rlletl
r-ll:rss

sp('('i111Ctt Crtrtlititrcrs

lirl

rrsC

irt CCttlrilirr,..s rlr,rrrl,l lrr.,r:rrlt..l

or pl:rslic.

t(

I rrlr.'s :trtrl slrct'ittt('tt ('()rrlitirlcts sltotrltl irlrr:rr s bc sccrrrcl-r cirppr'tl

s|)r11'1'ol

;tl lclrst -l t:rrr. sltotrld bc lcli hcltrccrr tlrc lcr.cl ol'lltritl :ut(l tlt(.t.irrr,rl'llrc

t't'rt t li lir::es ltrllc.

ilirgcs lcchni(lucs- se'ctrrcl-r clrPPctl lrrhcs irrttl sc:rl:rlrlr.t.t.nlr.ilirrit. lrrrt.kt.ls ()ll('l il(l('(ltl:ll(' l)r()lccliott ;ttlitittsl ittlr'ctiorrs ;rclttsols ol'irrltctrrl rrr;rtt.r.i;rl:. ('t.irI ril'rrgc ol' l{isli (. rorrrr -l tt J nricroorg:rni.srrrs

( rtroll 1r'lllf

\l)('('llltr'tl stlsl)ccle(l ol'crtttlrtirtirtll lnicr(x)r'girnisttrs i1 risk (i16rrp i l,r .l slr,rrll

t't'n l ri l i r-r:ctl i rr l'rlrlcltcs scl)lrrillc lirurr ollrcr rrurtcriats.

lre

('crllri ltrtc lttl:cs:ttttl lrolllcs slxltrld lravc scrcrv c:rps arrd strorrltl lr:rrr. l):rrrgcr pl
irr

lr't'l irrlr l:rlrel.

usr..cl.

St':rl:rl'lc ccrllrilir{c huckcls nrrtsl lrc

I lrc lrrrckcts tttttst hc ltladcd. sc:alctl rrrd opcncd in

bioklgical sirltr_r c:rhirrt.l.

lic:-ltti:tr tlccottlrtlttit'uttiott rtl'lruckcls. rotors:rrtd ccntrilirgc borrcls

slr.rrll

5c t1rrc.

rrcs

lirr llrc

rrsc ot'horur

shllicrs and sonicators

(':t1.rs:tttd cttl)s
(lrsl()rli()rl.

or lrolllcs sltould t^* irr good condilion lrrtl li.e.'tirrrrr ll:rrrs 'r (':tPs s!totrld hc u'cll litting and gaskets should bc ilr t..rl c'rrtlili.'.

K,*u,

hu{A',

,trc- llrcl9_nrachincs slrould be covcrcd b1' a sl.rotrs.lritrt\l):rr'('rrt Pl;tstic -\ t1,";" pirssifrf.'. nr:rt'lin,.'i. iliiifi'itl-rc-ir citsittg.. I hcsc shoutd bc tlisinlccr"Orl'r"i;* Wlrc:q

lft

pl;rst ic c()\'crs. sltould hc o;rcralctl irr a biologic:rl sal.:t1'cabittcl

Al

llrc crril ol'tltc opcralitttt lhc cttnlaincr shtlttlcl bc opcttcd

s:r

lbl-r

errlrittct

'l'cclurirtrrcs litt' lltc c:trc :tntl ttsc tlf rcfriqcrlltlrs and frcczct's

llr.li'irlr'r'trtors. tlcc;'r li'cczct's;ttttl Pr.r'iotlit':rllr

tlrr icc cltcsts sltttttltl lrt'tlt'li,r:lt',1:ttttl r'lr';ttlr'rl irrr<l:tn-\ :lrlll)()u1,.'s lrtlrcsclc. lltltl ltlrvc lrttlkett tlttritt:'\lr',rr" lr'rlrrt\r'tl

t(

a a

l .r('(' l)nrlccliort rttttl ltcltr r -tlttlr t'tthllct' ulor t's sltottltl lr.' rr.rtttl.

\lit.r

t.lt.lrnirrrr. llrc irrrrcr srrrlirct.s ol'lltc t'lrhirrcts sltorrltl lr,.'tlisirrli', t,,i

l:r1,, 1..i

..\ll tlr.'crrrrtlrirrcrsslorctl irrtlrcrclii(ct'irl()r'ssltotrlrl l'rccicltt'lr Sciurtilic tt:ttllc

rtl-

lllc c()ttlctlts.

'

|)lrtc ol'storittg
N;trtrc ol' irrdividtr:tl trit,, skrt'crl lltcttt.

Iltrnrrrurlrlc solrrliorrs nlttsl nol hc slot'ctl

pt'(x)1.

irr:r rcli'ir:et:tlor ttttl'.'.'. rt

W:rstc l)isposul

l)rrc to tlrc lxrssibilitl'ol'U/llO risk gradc i organisnts lll tltc rr':rstc irrt'lrr,lirrr'
itttloclltvcd :tnd disclrtlcd

;,;11,,'11 ;;11ri

blttotl h:rss slurll lx' s<l:rkcd irt l7n Sodirtrtr hl,lxtcltkrritc lirrrtr lS i,' 'l lr,'rir. tlrc;i

ls

tton irrll'ctiorrs \v:rslc. 'l'hc rr:rslc slurll I'r' t:rl.r'rr .rr',

,. I'r I!..'

cot'rlract()r cnrployccl h1' thc lrospital lirr salc dis;rosal in irrciltcr:rtor.

t{clc'r'cncc :- l.ittrontttln' l}io-Salctv N4arttrirl 2"'l cdilirlrt l(){)i. prrlrli-rlr,,! i'.. \\ | |( )

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cttcvit. f OU$DAI\ON

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!l
I
I
:

t3

General
l l
I

\.

Blood Bank

Department of Transfusion Medicine

Geetanjali Medical Cotlege & Hospital,

Udaipur

,"

#tNrtrr.trou$sA1\oN

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t4

_GeetanjaliMedicalCol|ege&Hospital,Udaipur
SOI'No-2

PRETRANSUFSION TESTING

is 1o sclcct bloocl lrul.p0sc :rnd scol)c: -'l'hc ptlrposc of prctransfirsitln tu;tirlg and rvill luvc acccptablc surviv:rl colltP()ncnts tlrat rvill not causc harnr to thc recipicnl bank' r*lrc' t'utrsftrscct. 'l'hc activitics shall bc hcl<i in thc variotts scctiotls lilr thc blood
pcrtaining to this llcsll0nsibilitl,: - 'l'hc tcclurician on duty in thc various activitics
of thc rncdical officcr on dutl'' ob.jcctivc shall bc rcsponsible undcr ovcr all supcrvision

I'roccdurc
No' ircsitivc idcrrtificatiuii of iecipicnt and rccipic:lt blood sanrplc {SOl'
'1)

ABO and Rh typing of rccipient'blood sample' (SOP nNo' 3) l0) confirnrarion of Allo group of recipicnt's rcd cells. (soP Noto be nlade rvitli l1 clsc ol-carlicr transfusion(s) wifh availability of records' conrparisott
thc prcscnt findings- (SOP No. 3)

confirniation o[ rhc IUr typc of Rh-negative pcrsons (soP Nol)crfornrancc of cross match (SOP No' 13)

ll)

recipient (SOP No' 13) Sclcctiorr ol'conrponents of ABO Rh types appropriate for the

t5) lssue pf the blood/cornponents to a Proper recipient (SoP NoRcfcrcncc:

of Blood Transfusion Medicine Technical Manual American Association

roU$DA1\oN

Bank 13'r' edition 1999-

---7

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for

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l5

Blood Bank
SOP No.3

Geetanjali Medical College

& HosPital, Udaipur

PRETRANSUFSION Ttr STING

(.

irncl vcracilr' .r'sa'rplc- tr'pc .r' prrlduct. d'tc urposc :rntr sc'pc :_ Paticnt.s idc'tity. is t.'c rrlr.r'ctr .r trrc ri.rc ol'rccci'itrg ti.rc. rcasorr <l!-transrusion is docunrc'tc..'r'lris
rf

thc rctltrisition-

'l'his rvill bc done at thc rt:ccptit)l'l c()ttrllcr'

ort dtrtY:tt lhc countcr shall bc rcsponsiblc llcsporrsibility :- Thc lcchnician/clcrk/ntrrsc rcccipr rcsistcr. In casc ol'attt'dilficultl'cotrsult lirr ir. All crrtrics shalt trc madc in thc lbr propcr *'orking' in-chargc rvho will bc rcsponsiblc

rvit' t'c Mcdical offrccr

N{

atcri:rl and cquiPmcnts

ReceiPt Register

. . . .

Illood group

sera and sltcies

I;inger Pricker AntisePtics

No' I proccdurcs as mcntioned in SOP Safcty proccdure:- Follow thc safcty

Procedure

7.

l,Clrecktlrename'registrationnumberontlrefornrwitlrthebloodsanrplc. (As per & see for availability of the product(s) the blood grouping of the sample
Do
SOP No- 10)

z F(e{aredBY

Fcse,.A$lArlr**.:::. o\_*E

u,

t sr i$:$iLrl,.,ree
Mar"'

l6
lndobloodgroupoftheavai|ab|edonorforreplacement. ,t-giutnistory of previous transfusion, procure his earlier report of

componentstransfused.Passthemovertothesero|ogylabfor
r

the present findings-

the nent can bc nradc available ask rlrc patient/ relatives to complete .

rd tinrc

of recciving thc sarrrple oi tlre patient's sanrple tube.

indicating chcckcd.

r ftrrtrt atrd sctrcl thc ttortor(s) rvith it and rcquisition lilr nlcdical clreck up rlllccr prcparc a card givirrg rcccipt rcgistcr po., tlall.lc. registration no' of

,{ ,ducl

rcquirc<J arrd datc:rrrd linrc rctltrirctl scnd tltc pltlicnt's santplc

with

this iard to tlrc scrologY latr.

g.

Mcdical OlTiccr shall clrcck lltc tlotlor(s) accoruling to (S0l' No.'l) dircct thc donor with tlrc 10. Alicr nrcdical clrcck up lnrl il'lixrntl lir. rncdical olliccr shall
clonor fornr and rccluisiti0lr p:lF:r to tltc blccdittg nronr. I

l. Fill thc cScck lisr at rcccption. trltntt gnrtrpint

roonl.

lah. nlcdical cxatttination and donor's

@*,

r6

3. If not available then do blood group of the available donor for replacement. 4. In case the patient give history of previous transfusion, procure his earlier report of
tests and blood/components transfused. Pass them over to the serology lab for
comparison with the present findings5.

If blood/component can bc nradc

available ask thc patient/ relatives to complete the

payn.lcnt fornralities and nrake necessary in thc requisition register.

6. 7. 8.

Put the date and tinrc of rccciving thc sarnple

oi

the patient's sanrple tube.

Sign thc fornr indicating checkcd.

l;ill thc donor ftrrnr and scnd thc dorror(s) rvitlr it and rcquisition Itlr nrcdical check up trl prcdical olliccr prcparc a curcl giving rcccipl rcgister tlo., tlall.lc. rcgistration no. of
paticpt, protltrct rcquircd :rrrtl dltc :rrtd lintc rctltrircd scnd thc p:r(iclt('s santplc with
this card 1o thc scrology lab-

(. 9.
10.

Mcdical Otficcr shail chcck llrc tiorror(s) accordirtg io (SOP No.

i)

Alicr

nrcclical chcck up und il-lorrrrd

llt. rncdical oll'iccr sh:rll dircct lhc dtlnor with tlrc

clonor fornr attd rctltrisilitlrt p:tpcr ltl lltc blccclirtg rtloltr. I

l. l:ill

thc chcck list ut rcccJrtion, bkrod rroupirtq lub. ntcdicitl cxattlitratitllt and donor's

root't1.

"6\

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Nr4'

t7

- Blood Bnk . -Geetaojal Mcdieal colleg-e & Hospjta!,

SOP No-4

Ud4ip_111

SELECTION OF BLOOD DONOR

{r

Iturposc :trrd scrtJtc :- 'l'hc PurJlosc is lo lay down guidclincs to sclccl a suitable donor wltosc blo,rl *'ill hc s.fL' l. lhc rcci;ricrrl arrd wh. hir,scrl'slrall rrot irr any way bc harnrcd by bl<lod tlottrtliort' l'ltc c.r:trrtinaliorr shall bc colrductcd by rtrc nrcdical officer in his chaltttlcr sltorll-r' ltlirrc ti<lnarion alrtl wirlr prc-donation counscting's. I-lc shall
findilrg-^ irr

thcti.rr.r r'()()l'r.'r-his tirrr'srrail bc prcscrved forperiodof

rcconJ his

3 ycars.

ll,csJronsibilitr. :- Iicsporrsibilir_y _ Mc<jical olliccr on duly-

M:rlcrial :rnd equiJlrrrcnls

Donor lilrrns
Exaltr i rrali<llt cotrclr
B

:_

lood

prc)^sur c appitr:rl rrs

Wcighirrg nurctrinc Stclhrlscopc J-hcrnronrclcr

safcll'

:-

'rrccdurc Proccdurc

I:.il.r'

thc sarbty proccdures as nrenrioned in

sop No- r

&;,,

counseling. counseling u,i1 inctude what all the tests r'ortkj bc dorte i'cluding I-llV. would he like to know the results of his tests, lr4edical ofrlccr rvourd c'aruale rhe donor according to the foilowing criteria.

Medical

olliccr r'rll ;r..r'idc prc-<Jonation

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Criteria for selection of donor

A. B. C. D.

Age between 18 to 60 years.

Wcight not less than 90 pounds (50 Kg.) I{emoglobin should not be less then 12.5 grams or hematocrit3SYo (for procedure
sec SOP number 5)

I)lrysical Exantination

i) (ii) (iii)
(

Pulsc -50- | 00 pcr nrin.

I). l). systolic not nrorc than 180 nrml-lg I)iastolic no( nrore than 100 mml{g

Crilcri:r for'dcfcrrncnt or rcfusing for blecding

A. ll.

l'crstrr)s rvith cardiac discasc should not bc blcd.

lrrrlivicluitl sullcring or cvcn a carricr ol'transmissiblc discasc such as sl.philis. rrrrrlulil. hcpatitis or othcr infcctious discasc should bc rcjcctcd. Individuals giving
lristorl,ol'.jatrrrdicc in pasr lifc should bc rcjcctcd forevcr. llistory of nrataria strould
rrrlt lrirvc ['lccrr prcsent for last onc year.

('.

(
(

iiving history of-an1' allcrgy (Spccially Bronchialasthnra)

iivirrq lristory ol'opcrations or accidcnt during last six monllrs should not bc bled.

l:. l:

-ocllly allcctcri skin lcsions.

l)rinols shoulcl not bc bled rvithin threc rvecks aftcr vaccination against rabics and
tctilnr-ls.

C.

Shorrlrl not iravc donatcd blood in last threc montirs.

Qucstions'to bc aslicd for screening.

I. 2. l. 4. i.

l)onors is Rcplacement/Voluntary Donor Ilas tlrc donor donated before & when

llavc you bcen for any reason defened

Whcthcr he has taken breakfast or not?

to donate blood

[s thc donor unde r the influence of Alcohol and Tobacco or nav other stimulant

rourorrPtt

fd ceElNJ$

\6*tqo",

*StS$$$'"'*

l9
W_hetler

"1d"1

any medication or under treatment for

one year. Does the

nredication include
Undergoin
8.

"rpiri". g any investigarion (Like X-Ray

Chesr, ECG erc.)

Suffbred from Jaundice with in last two year

IJ

9,

istory of tuberculosis

Ilcfcrcncc :-

l. 2.

lllood rransfusion tlrcrapy volume il I)r. Il. N. Markoo 1995- 4-5.

'l'ratt.sfusion Mcdicinc'l-echnical Manual Arncrican As-soci;rtion of Illood llank. l3tl,

cdition

1999.

(.

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BfoodBank
SOP No.5

- Geetrrrjali

Mgdlcal College & Hospital, Udaipur

SELtrCTION OF BLOOD DONOR

I'urposc lnd scopc

:-'lo idcntily hcaltlrl'donors

as rcgards thcir hcntoglobin status.'fhis

slurll bc clrlrrc ilr tlrc lrlotld bank itscll'urxl bl,tltc lccllrician on duty bcforc the donors is

(.

clcclarcd fit.

llcsponsibility :- 'l'hc tcchniciiut ort duty slrall bc rcsponsiblc for it. In casc of'any'

diliicultl, consult rvitlr tlrc Mcdical Ofllcer on duty rvho will be rcslrcnsible for propcr
pcrlirnrrancc.

Mrrtcrial :rnd cquiplrrcrt{s :Sahil's nrcthod

Sahi

Cya

n nr ct

h-hcnr

globi n

Autonalyzcr
Autonalyzcr

l's hinroglobinonrctcr

colorinrclcr Drabkin's Soiution 20U I pipctle

N/10 I Icl

l0 nrl test tubes

Safctl, proccdure : Follow thc vrfcty proccdures
in SOP No.

as nrcntioned

I'roccdurcs Sahil's Mcthod

r + o

Take N/l0 I ICL in the llb tube unto the lorvest mark

Add 2 microlitre blood with pipettc

Allow to stand for 5 n'rinutes

\a*q,,

2r

t
water' equal bY adding distilled level in gn/dl Read the lowest concave

Mcthod C1':rnttrctlt l{emoglobin

r|)rcparatiorrtr|.workirrgso|utiott:diIuterthcdrabkinso|utionwitlrD.W.l:10
+srvitclro|.r|rcinslrunrcnl|5nrinutesbcforestartingtlretcst.

r r o o 1

'l'akc 5 nrl l)ratrkin's rvorking solution in a tcst tubc' of Hb pipcttc' trlottcl samplc rvith thc hclp
Aclcl 201r1

nrintttcs' N4i:i rvcll artd rvait lbr 5 Grcctt tltc absorbltllcc :ll 540 nrn or

liclrcl

liltcr'

('orlpltrc rvitlt tlrc stantlard clrart lbr the rcsult'

I

standard wcckly' Not :- ('hcck tltc valttc ol'lhc llb

l)ctcl'rtrinationofl{bbyautonr:rticanalyzcr'
a

('ollcct blood in EDIIA vialwashing' Stirrt tlrc tttachinc for priming &

I
a

Shakc thc

vill

propcrly aspiratc tlrc sample

as pcr ttre instructions of nrachinc'

t
a

Aspirittc tltc sanrPlc'

l)ctcrtuinc I lb by thc analyzrr

\
llcpor(ing rhe rcsult : Thc rcsutt
should bc recorded in the btood donor

formas well

irrrcgistcr|ilrr|rispurpose.Staptctlreanalyzeroutputs|iptothedonorfornr.

Quali(1' Control

- Scc SOP No' 31

K.L. Mukherjee, l99l-

Rcfcrcncc

vol-2 :_ Mcdicar Lab. Technorogy

-**r::;;

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:?,

z2

Uqod Bank
SOP No.6

- Ggqaqiat i lfgf icat Coilege_& H*_pirat; Udaipur

SELECTION OF BLOOD DONOR

trris Sot'] i-s t. rirrrrlrv 's pnrccdurc to brccd and in arr ascptic n.l:ln11cr. rvillroul ulr-\, clrancc ol- clotlring. in oplinturn :lntounl and taking carc of tlrc d.rr.r truri'g urtr prstr.natiolr. I).n.r sharr rrc brced in iirc ci<tnor'.s roolrr oni1,.
:_

l)urposc and scopc

Purposc

o'

approvcd donor

I cchnician/Nursc olr dur1, shall oc rcs;nnsiblc filr lhc proccdtrrc and in of dilficulry, shall inlbrrn tlie r.ircciicrit rtllrcci i)il duty rvhr> is rcsponsiblc tbr snroorh rvorking.
:

Ilcsponsibilitr,

casc

S:rfc(y lrroccdurc : Follorv thc safl,ty proccdurcs as nrcntioned in SOl, No.

I)ocurucntation anrJ preplralion of bag I)roccdurc

l' on receiving lhc donor rvith dthc

idcntity of trrc donor witrr thc dolror

2"

tbrnr.

donor fornr rr<rnr rhc ! nrccJicar rrrrvrLdr office, ottrcc, ci crrcck trre

n,rrc. addrcss. agc, se.r. donor type and atlotting rhe unit No- Scrcct appropriate bag. lnspect bag (sr an_x {c\er\s an\ \rsco\orairon- App\y pressurc ro check for leaks. Thc anricoaguranr and additive solutions shoutd be inspectcd, for appropnat. r,rs\r,rrrc- gs\sr ar.\ rs.l\r{rr_:sur\:\r:\*rr\u1,r:rNr-ss-rsr\e-\sr.s.r\s\:\sr-

lvlake flcessary enrries'in thc <J.nor rcgistcr c.g- donor-s

sa(\e-.orNr-

\ - \rrter \srrsr reg.\s-$rirr\\s\

an\ \ate o\ \snairsrr-5rNe. donor qand-

4@uo*"

tsr SEE)

\sNsr
*hl',l?HS),"'*

': t

23
date of bleeding and Unit No'' Blood grouP' identity, donor with PrePare bag label

4.
5.

put,"

nttlY

on the bag'

and the bag to the phlebotomist' Pass on the donor

PreParation ARM

Material

l.

Savlon solulion

2. "l)rep' solutiolt : lletadinc 3. Sterile gauzc'

Safctl' I'roccdurc
:

solttlitln

I its trlctttiotrcd in SOI'No' Irollorv tlrc salcty procctJttrcs

-(

ltroccdurc
i

.i -! - L--., nr! a i! scll | ibr*r pur a'ti i-rrrr. trag .,..,i rirc d.nor's itic*tity witir iirc rccircck siraii i)irici.roto'rist
artd sigtt-

2.

and rclca-". cu|.l: iclcnti|y r,crripurrcturc sitc lrltltlt| trr |)rcssurc Appll,totlrlriquct tourniquct/cuil
'

S.scarc|rarca'iltlcast4crlr(l..5irrchcs)inatltlircctions|iorrrtlrcintcndcdsitctrl vcnipunctttrc(ic.Scttror.iirrchcsindiarl.tctcr)|.or30sccondsrvitl.r0.7/" nccd not [*t--l:-xccss |oatrr trraY irqucottsstl|ttriotr o|.sar,|trtl.

tr.c

rctuovcrJ' but tlrc aml

dry bcfolc thc ncxt

4.

, --- -, ^^^-a otttrvard in a conccntnc nroving iil'td 0l-vcnipuuctrrrc Starting at thc intendccl sitc lct sta:rd lirr 30 scconds' spiral' appl;- "l'rcp" soiuticn;
skinlrasbcc:lpl.cparcd.itll}tlsttrolbcttluclrc<llgaitr.Dorrotrcpalpatctlrcvcinal
thc intended vcnipurtcttrrc sitc'

stcp'

5.Covcrtlrcarearvitlrdry.stcrilcgauT-,cu'rtillhctirrrcolvcnipuncturc.Aftcrthc

'6.Rcapplytlretourniqucr.Pcr|brnrthcvcnipunctttrc.oncetlrcbcvelhaspenetrated
is not gloved finger' providcd thc nccdlc
at stcP 2' site must be repeated' slafting

rvith nccdlc scm nlay bc pcrformed thc ahovc skirr tlrc of thc skin, palpation

touchcd'

of the

T,lftlreneedleisrt,itlrdrarvnandvenipunctureisattenrptcdagairr'preparatlon

21

No!e:: l] v'!' :

;ffi:*j::'rm:::fffi*:::,:Iil
Green

Pvp)' ano-Fimellrod-(egail"tur" oi ph;siciaru

donors'

Exidire

*uO t'

widely use for iodine-sensitive acceptable and

PHLEBOTOMY
fronr lrrinciplc sanrplc's obtaincd --^a6\,in{r satnplc's' accon"lpanying and fossaBlood for trirtlslusion arca of thc atltccubital thc in ann. usually on thc donor.s
pronri11g111

rcilr

IVl:rtcrial Stcrile collcction l.

an<i a
1

bag

attachcJ rrrbir .ning anticoagulant. *'ith intcgralls contat

hand sealcrs Mctal cliPs and ^. i drarvu' volumc of blood nronitor to systclu Balancc

needlc'

J.

6.

forccps) (Scissors' hcnrostats' itr$rumcnts clcan Stcrilc giuzc and samPle collection' Tcst tubcs for blood in tubing' Dcvicc for stripping

Dielectric sealer'

Sufctv I'roccdurc

Follorv

in as nrentioncd procedurcs safety the

SOI' No' t

Itroccdurc

: :::::il:TJff.:"JT:''::'::::".,,iiJ:';'trJT:J:'
particulate contaminants' volume' color and

Theanticoagulantandadditivesolutionslrould.beinspcctcdforapprt
is rever and adjus'led

*::::::*::"j:::J:J:""":"illance clips and Unless nretal

to be drawn' amount of blood
Hang trre bag knot in tubingoverhand loss a very

are usc a hand sealer

thrc and route tubing

ffir,

r""N

..^uto$\Qn

Dfi

25
near the needle before thc pinch clamp. A ctamp should be applied to the tubing is uncapped to prevent air from entering the line' needle
5. 6.

of blood drawn' If balance system is not used, bc sure to monitor the volume Have donor open and close Reapply tourniquet or inflate blood pressure cuff.
hand until previously selccted vcin is again pronrincrtt'
and ret'l"lovc thc clamp- A Uncover sterite needle and do vcnipuncture inrnrcdiately a full' clot-frec until' Tape clean, skilful venipuncturc is essential forcollection of

tftc tubing to the donor's arn'l lo hold needle in placc

gau7r.
ti. 9.

attcl

ctlvcr sitc rvilft stcrilc

bitg antl tlrc tubing' Opcn f hc tenrporary closurc bclrvcctt tltc itttcriol ol'tlrc l0- 12 scctlllcls dtt|ittu collccliott' I Iavc donor opcn and clOsC lrand slorvll, cvcu

I0.

'l'ltc tionor Kcep thc donor undcr obscrvation tltroughotrt thc donatiotl Pll)ccss-l'n' to ;rlicr donatiortsl.rou!d :te.,,e!' bc !c!i u:rattcn,-lcd dulipg o1 i111111g:tlilttcly ol'his cor'crsc wittr the donor about lris lil'c. lt rclaxcs tltc dtlttor arttl lllkcs
fronr any apprehcnsions of blood donation'
nrirrd

ll

(a1-'proxirltalclv cvcrY J5 N4ir: thc btood and anticoagulant gcntly and pcriodically
11' placing bas on e scconds) during collcction. Mixirlg ntal' bc clonc b1' ltartcl or

nrcchanical agitator.

t2

i-s nrt lJc sure blood flow rcrnains lirirly brisk, so that coagtrlati6tr aclivitv

agitation' rigid triggered. If tftcrc is conlinuous, adcquatc btood florv attcl cotlstlnt tirlc linrits are not neccssary. llowcvcr. units rcquiring ntorc thart l5 tttilltltcs io
ciraiv niay noi bc suitabic iorprcparation of piaiclcis, ircsir

i"'"'"tr f iastiia(Fl'i')'or

by indicaiiorr cryoprecipitatc. Tire timc rcquired for coilection urn bc tttt'lrtiit'rt'cti 15 the time of phlebotonry or the nraximal allou'ablc tinrc (start timc plus
minutes) on the bag labcl13.

Monitor volume of blood being drawn.

I[a

auto-balancc is trscd, thc dcvicc

uill

of blood interrupt blood flow aftcr the proper amount has bcen collectcd' On nrl for weighs at lest 1.0539, indicated by the minimunr allowablc spccific gravity
donors. convenient figure to use is 1.06 giml; a unit corttaining 405-495 trl should weigh 429-525 g plus the iveigh of the container rvith its anticoagulart '

Note the total weiglrt on the bag-

fo.GEry '-*llsl5ii'*"='

FouNoAlgr.

26 t-enpqqfy Clamp tubing near venipuncture using a knot, melal "!iP, o1 9th9r, -4"*. Release blood pressure cufytourniquet to 20 mm Hg or less and fill the

14.

pilot tube(s) for blood

processing sample(s)

by a

method that prevents

contamination of the contents of the bag. This can be done is several ways.

a.

If the blood collection bag contains an n-linc ncedlc, make an additional seal with a prepared henrostat. prctal ctip, hand sealcr. or a light knol rttadc t}om prcviously
loose knot.lust distal ro,thc inlinc necdlc. Opcn thc contrcclor by separating lhe
needlcs. Inscrt

t[c

hcnrosrat, altow lhc tubc 1o

lrll

and reclatnp ltrbing- Donor needle

is now rcady lirr rcnloval.

tr.

1'tlrc bloott ctlllcctiorr

trag cotrtains alr inlirrc proccssing trtbc. lrc ccrtain that thc

processing tu6c. or pouch. is full rvhcn tlrc collcclion is conrplctc and the original

cla1lp is ptaccd iicar'tlre donor rrcctlic.'i'itc crtlirc itssctnirll'lllity rlow tlc rcnroved lionr thc donor.
c.

straigfit-tubilrg asscrnbly sct isstrcd. (lrc lirllorving proccdurc should bc used. placc a lrcrlostat on thc rtrtring alltlrving ;rbotrt lirtrr sc8,n'lcn(s bctrvccn tttc ltctt'tostat

ll'a

ald t5e nectJlc. Pull tighr thc toosc

ovcrltantl ktto( rtladc in stcp 3. relcasc the

I

hcmostat ancl strip a lggntcn! of tlrc rubirrg lj'cc ol' ltlttod lrgtrvccn thc knot and thc n""dle (about I inch in lcngth). Rcappll, lhc hcrttttstat and cut thc tubing in the

strippcd arca bctrvccn ttrc knot and thc hcrnoslat. Fill tlrc rcquircd tubc(s) b1' rcteasing thc hcn'roslat anct thc rcclamp lltc tubirts with thc hcmostat- Sincc this
systcnl is opcn, trio-safety prccautions shoultl bc lbllorvcd. Dcflate cuft' ald rentovc lourniqucl- Ilcnt<lvc nccdlc fronr arm;

t5.

if not alrcady

rcnroved- Apply prcssure ovcr gauzc ancl lravc clonor taisc an:r (elbow straight) and ask the donor fo trold gauzJ firmly ovcr phlcbolortty sitc rvith thc otlrer hand-

t6.

Discard needlc asscmbly into biohazarcl c<tnlaincr dcsigned to prevent accidental injury to and contamination of pcrsonncl-

17.

Strip donor tulring as comptetel-v as possiblc in thc bag. Starting at seal- Worli quickly, to prcvcnt bloocl litrnr clottinq in lltc tubing. Invert bag several times to mix tSoroughly; rvhen allon'tubing to rcljll rvith anticoagulated blood from the bagRepeat this procedure a second time-

,"r*ffi
*}:"ffi\l+'ir?

h*:\,,

27 bag into segments leaving a segment Seal the tubing attached to the collection a unit identification number to one number clearly urrJ.o-pt"tely readable. Attach
.)

18.

Knots, metal clips or a dielectric sealer segment to be stored as a retention segment'

testing' It must be possible may be used to make segments suitable for conlpatibility

loseparatesegnrentsfortheunitrvitlroutbrcakingstcriIityofthebag.Ifadie|ectric lront tfte distal end of the tube sealer is used, tl-re knot or clip sfiotrlcl bc renrovcd
aftcr a double scal is nlaclc'

19. Ilcirrspccl the containcr lirr dcfccts' 20. Ilcclrcck 'ur'5crs gn l1c c<lrrt:rinr:r,
Il.

proccssing tubcs' donation rccord, and

rctcntitllt scgnrcntarc to bc rcnrOved rvholc l)lacc ltl<locl :tl ltllplollllrllc lclll[)cl'ilttll'c' LJnlcss plalclcts in the designated blood sh.uld bc 1>lacctl al l-60 ('irnnrccliatcly alicr collcction

if Jri:iicicis:ii'e i<i !ic !i:il-i'csici!, liltiiiii sliiiii!<! noi bc chillcd' b-'it 20'240 C until sh.uld llc storcd irr:r rr:rn'cr irtc.dcd l' rcach a lcntpcr:riurcof ttrttst bc scpar:rtcd rvithin 8 hours after Jrlarclcrs :trc scl)al'atctl. I'tlttlcls
i.ci'rigci.iiitii. collection of ihc until of n'holc lil<iotl'

22. llantj ovcr pilot tubcs to llrrnsrrrissiblc C:t rc of ttottor :tftcr pltlcbolttrtty l. 2. -l . 4. il. b. c. d. c. t-.
bitritlagc
I

clisclsc and scr<llogy laboratory'

of necdleAp'11, lirtrt prcsstrrc rvirlt slcrilc grltrT.c ovcr thc point o[entry iilicr lllccclirlg
stops'

Apll'

obscrvation' lavc dop6r- rcnlrirr r-cclirrin:l irr ircti tilr l'crv tuintttcs undcr undCr ObServatiOn and Allrtr..,r!on<,.r to sil rrll .[ rr''llk to tltc rclicSlrnlCnt arCa scrvc rc ll'csll lllcllts
-

(iivc dtltttlr itlstrtlclirlrls ltbottt post phlctrotomy care' Ilat ancl drirrk s0ntcrlrirrg lrclilrc Icaving thc donor sitDo tlot lcavc trrttil rclcascd b1'a stall'n'lembcr'

Drink ttlorc {ltri<ls thritr itsual irt tltc ncxt 4 hours'

Avoid consrrrtrinq alcohtll trntil sotttcthing has bccn eatenDtl ttot sttrokc lilr l() lllit)ttlcs'

If thcrc
thc site.

rs blccdirr!.

litlril lhc Phleboromy sile, raise arm and apply

pressure to

ffiou,

For GEETANJAU FOUNIFfrI-ON (J.P. A6ARIJAL)

\$4",

Cldnoac & Lla;:x3rtg lrr''lae

T
g.
h.

rhe had down or sit with lie either occurs' If fainting or dizziness
knees.

bctna fu

lfanysymptomspersist,eithertelephoneorreturntothebloodbarrkasgel

doctor.
Resunre

if all nomral activities

I worli -rr^ T-l^n^r who asymptonratic' Donor

in certain

occupatio|ls(eS.Constructionworkers,opcratorsofnrachinery)orpefsol|s
workirrgatheiglrtsshouldbccautionedtlratdizzinessoffaintnessmightoccrrrif giving blood' inrmcdiatcly alicr thcy rcturn lo rvork

Mailr(iri'

aftcr a l-crv htxtrs' Rcnrovc bandage blood Yolttnrcscvcral da;'s to rcstorc high fltrid int:rkc lirr
-Ii:rrl.s/ir-sior

Ilcfcrcncc :-

AS'sociatiOn ofBM t Mcdicittc !'cclntical Mitrtuitl Antcrictttt

iJrrrrk i3'f'cdiiioi-,

i999-

no'

7i4'

ou|\o!9\{

29

Blood Banl<
SOP No.7

& Hospital, UdaiPur

STORAGEANDTRANSPORTATIONoF BLOOD AND COMPONENTS

Irtrr-''sc a.tr sco'e :-

cc, is urairrtainctr a...raxi.rar cfricicrcy.r'ctlur'o'c.ts

cottsiclcritt

ru'cri.. til't'c rcd .l-'c obiccti'c ot'trrc SOr) is t'at trrc 'irrllility. and is prcscrvccl' Illcnct clotti.g

l'lrcorctical storagc' Drtlccssitt,: attd trilnsrxrrl' dtrring is 1'lrcvctrtcd tlitcter.ial pl'olili-:ratiotl

ioll arc cxplainccl'

lbr thc prrrc-ctltrrc atrd in on dtttl',shall trc rcsponsitrlc :-'l-cchrriciatrA"lttrsc llcsponsibilitl, rcspondiblc rirr s.rootlr r.cdicar ofricer on duty rvho is t'c i'rbr'r c^sc or.dir.'ctrlt1,srra,
rvorking-

Storagc of l]lood
l\'I

l{crial
[r'i gc ra to

Iic

rs

rv't

tlt

tc tn ;lc ritt lt

rc rcco rdcrs

S:rfctyi'rocctlurc:-liollclwthcsafetyprocedurcsasiricntioncdinSOPNc'!
Itrocctl u rc

arc: I\{:rin objcctivc of stor:rgc of blood l. 'l'o ruairttain rcd cell viability and function

2. 3.

1'o Prevcnt coagulation

To nrinimize bacterial proliferation

'r-he

metaboric energy for their n-retabolisrnRed ccrs are living ceils rcquiring nret rvithout the body these requirenrenF are ln products' waste of production to lead

processes

\sbo,,

30

difficulty. Any system of storage should meet this requirement. APart from adding energy providing ingredients to the anticoagulant solution blood is stored at low temperature of
20 to 80C to slow down the metabolism and also prevent bacterial multiplication.

Ncvcr frcczethc blood solid, as it would causc hemolysis of the rcd cclls'
'l'1cic are various typcs of anricoagulanl solutions designed for this purpose. These are
givcrr bclow.

l. Acid citratc dcl(rosc (Acl)) blood lo bc usc lr'ithin 2l days. 2. (litr:rtc l)ho.sphatc t)crtrOsc (CPD) lllood to usc rvithin 28 days. 3. (-'itr:rtc l,hosphatc l)crlrosc rvith Adcninc (CI'D-A) lllood to bc uscd rvithin 35
ti it1's.

-1. llcplrip-

Illoocl to trc uscd rvithin 24 ht'lurs. This is nrainly rcquired for exchangc

l11lslirsio1 to lrcrvt'rorrr intants as citratc nray causc toxicity leading to cardiac

i;r'cgularitics antl dcath. Kcrb's cyclc and liver of ncrvborn infants nlay !'lot bc ablc
t() copc

witlt cxccss citratc.

Sorlirrnr lrcparin 2250 trnits in 30 ml of buffbrcd saline are good enough for 500 nrl llItlttd.

of

Ingrcdicrtl
(i lucosc( Dcxtrosc)

ACT)
24.6 gnr nonc 8.00 gm 8.00 gm none
1000 ml

CPD
25.50 gm
none

l)isotl. Clitratc
-l'isocl. (litr:rtc

26.30 gnt
3.27 gm 2.28 gm 1000 ml

Citric Acid
Monosod. Phclsphate

Dist. Watcr

\6ttsr,

3l
CPD-A has the same ingredients as CPD wirh addirion of adeline

Ratio of anticoagulant

15

ml

l4 ml

To 100 ml of Blood
Pcrcentage of anticoagulant

Dcxlrosc-

This is source of energy for thc RBC to keep renr arive in storagc.

Citralc-

Acts as anticoagulant by trinding thc ionic calciunr. which is csscntial for

coagulation.

(-'itric

Acid-

lts function is to kccp sorncu,h:r( lorv pl l. lt hclps to slow down tlrc rcd ccll
rrral nhnl ic-.

l)ltosJtlta(c- It is addcd to ntaintain thc conccntration of 2. 3 diglyccroplrospSatcs irr tlrc rcd cells. If its lcvcl is rcduccd hcntoglobin dcvclops high aliiniti, for
oxygen and tltus fails ro relcasc oxygen in the tissucs.

Transpor(ation of l]lood Matcrials

-i'ircrnrocoi boxcs ior single bag

iceboxes for nrultiple bags

safc(1' proccdurc: Follow the safety procedurc as nrentioncd Sop No- |

I)roccdurc

f)uring lransport, the temperature of blood nrust be kept belorv 100C. Sturdy well insulated containers with adequate cooling material are suitable for this purpose. Broken
picces

of u'et commercial ice are best suited for it- Ice should preferably be above

the

blood to take advantage of cool air moving dou'nwards. Blood containers and ice should

ffi,,

32

be in plastic wraps.

ur"

i". ilt

If the blood is to be taken long distance or-weather is unusr'rally oT ieb; p*iar in beiwcen and be-row ahe brood conrarner- TFe-anr.unt

ho['

of blood' should roughly be equal to the amount

Thc box should have a not' lssuc c:rch unit in thc assigncd thcrmocol box.

Notc

:- l. 2.

or used with in The Btood slrould bc kept in fhe refrigerator at 4-60C I

hours-

bc takcn back Illood and/or conrponct'tt issrrcd outsidc hospital u'ill not

for rcusc'

ti

1995 No' l9 llcfcrc'cc:- lJl.od tr:rnslitsi.n t6crapl'r'.lttrtrc-ll.ll.N. Marktxr.c4iti.tr-1"

llttea',

33

Blood Bank
SOP No.8

- Geetanjali Medical College & Hospital,

Udaipur

PREPARATION OF CELL SUSPENSION

Iturp<lsc and sc<lpc:- Ilcd cell suspcrrsion in variotts cottccrttratiot) arc rcqrrircd lilr 'l'hc proccdttrc basically ittvolvcs ccll various tcsts and preparali<;n ot' reagcnt cclls.

rt

-l'his SOl'] is washing and suspcnsion tll'rvasltcd cclls in salirtc irr dclincd cotrccttlratiorl. -l'lrc rvork rvill bc pcrlorntcd irr tlrc scr<llosical scclion for guidancc in such prcparations-

of thc trlood bank.

llcsp6nsibility :-'l'cclrniciarr orr dutl'shall bc rcsponsitrlc lttr thc proccdttrc atrd irr casc tlf .dit'ficulty shall'infbrnr thc Mcdical Ofliccr ort duly rvho is rcsponsiblc lirr srtrootlt
working.

Matcri:rl
Test tubes 75 mnt x lOmnr

Pastcur and nrcasuring pipettcs

Ccntrifuge Norntal salinc

Ccll rvashing

Safcty Proccdure :- Follorv tlre safety proccdurcs as mcntioned in SOI' No. I

Procedurc

Take on tube and put two drops of rvholc blood and fill rvith 0.857o Nacl.

ffi.,

v
o Nl i x

we'

a
e

Tj^ mi: Again PutNAC'

times' RePeat three

:Tll,;ii ::#::"ff
of suspcnsion

:":Tfi:perna'lan'l

ce's

preparation are rcady for

Prcparation

of red ccll suspension

Sirlincsuspcrrdedcellsarcthriccrvashedirlsaline'torcrrlovccontanrination supra, "*o fi'allv 'u'*no"o '" '^l"lt-t"-:-::":lil;;.*T"*' prorcius (vidc .,,,"n'" ":: "
2.

"t
"

dF(

:"'*':"1,:^T,l:::::l':l s'spcrrsi.r'r il:],:'.J::";j ;,:, r-*irkc ir l07o owrl scruln tt-l

of patic.ls g tutrc ana dr.ps

::"":"*

::: irr pzttictrt-s rrwn

.

scftllll' l.
Altcrnativcly-Wholc

rs"' situations' ccrtaitr irr Llr r ^ ^'l hc useo used ur nray bc '*rV blood
r

No' 86 Markoo' 1994' R'N' Dr' grotrp serology Ilasic blood llcfcrcnccs :-

fouNDAl\o!''

hia*

35

Bloq{Bank
SOP No.9

- Geetaq[ali Msdical College & Hosplta! U_dqrpur

PRBPARATION OF REAGBNT CELLS

l)urposc :tttd scopc :- l-ltc SOP dcals rvith thc prcparatiolr ol'rcd ccll suspcnsions lbr
ccrtain of thc tcst and quality conlnrl.
-l'his

slrall lrc scrology laborator_r ol'thc blffxl bankol-

llcsponsillilitl' :-'l'cchnician ott tluty sh:tll bc rcsponsiblc lirr tlrc proccdurc and in casc

{'

dilficulty shall inftrrnr thc lr4cdical Olficcr on dut-1,rvho is rcsprnsiblc l-or smooth
working.

Mntcrial
l'est tubcs 75 nrnr x l0 mnr
Centrifuge
Pastcur and ntcasuring pipcttes

Normal.saline

And D

serun'r

Coomb's serunl

Ilrcparation of ABO ccn(rol cclls

Safctl' l'r<lccdurc :- Follorv thc safctl' proccdurcs as rncrrtioncd in SOI> No. I

Procedure

Collect blood in plain of EDTA vial fronr 3 to 5 donors of knorvn A,B (ignorc Rh typc)
and O Rh positive donors-

Collect cells and wash them .3 to 5 u'ith salinc (SOP No. 8). Afler llnal rvash pool rhen
according to their group. Prepare 3 to 5o/o suspension in saline for tube test and lOTo
suspension

in saline for side test. Check rvith knorvn antisera. Store in small aliquots-

r*s'sry{);:i'"
*Jf..ff*f\)'"*

36 on the serum grouping and as control for checking Store at 4C. The cells are used for group antiseia cells are used for checking on the blood antisera being used' O Rh positive
and also for antibodY screening'

J'hcse cclls shotrld bc prepared daily'

Prcpara(i'n
.l-'csc

,f

I'}ositive) Coornb's conlrol cclls or scnsiiizcd cclls (O Rh

ccrs arc rrsc tirr crrccki.g

.r

llre. rcucli'i11,

.r'c.o.rb's sc^*r

supplied by the

rtritttttlitctttt'cr as lltc lcst is bcirru pcrltlnttcd' as lo cause p<lsitivc cclls. Scnsitiz.atitlrr is brotrglrt in as rvay so
ur':l
i

'l'trcsc arc scnsitiz.ctl O

llh

coaiitrg ol'iiic cclls iii' liiiii I)

l;r:t!';

""'i

!lorrt lgg!

rr{ i rtat

tln'

\A/aslr 0.5

fthe .l-'.ckccl () lih -r, cclls I ro 5 tirncs rvith salinc (SOP No. 8) aftcr 'rl t'cstrspclicl ili I iril i;l's:tlirlc' rvaslt llrtli ltttcl rtlix- ()trscr'c aggiuti.atio'' It sliould n (td 2 t. 3 rlr-.1ts .l'4il.tctl ..\'ti l) sc'tlrll ot'Anti D' l+ agglutination rtttlrc thlttt 1-r. ll'ln()rc rcl)cill rvith lirrtltcr clilution Irot lrc
:r turbid baCkgrOUnd' lncans a l'cs,cltut't1ts rr,illt rrr:rr' ll'cc rcd cclls irrrcl

Orrcc t5c

lhc 1-.rocctlurc. Aftcradding thediluted anti cclls to bc well coated' D, incubatcd rhc cclls at l7')(' lirr l5 trtittttlcs ltlr tlre 0'l nrl ol'packed cells to l)rcp.rc a 47u strs'ctrsion t;i'tltc scnsitiz-cd cclls by adding

ililtrti..s

iir-c cs(:iblislrctl lcpcul

2.4 ntlol'salirrc.

'fakc

tirtlp rll- tlrcsc cclls iil

rcacl thc

aggltrtinltiott t-crtcliorr.

lcsl ltrl'rc itncl c'tlorub's scrut'tl' Mix and centrifuge and lt slrotrltl bc 4-l i-c' onc solid aggregate rvith clear

background

of tfiese sensitized ceels' NOt: ln an1, Cttrlpttr's tcsl. il-rtcqittivc- lrtltl a clrop

t[c aptiglobulin serum iS reactive' There sfiould bc irggltrtirrlttitlrt irttliclrtirrg t[lir

Ilcfcrcncc :- Basic [rloocl grotrP sclologv

I)r lt. N' Markoo' 1994 No' 86'

FOUNDATION

,6r,

fd

ogtAYALt

obNfu'

!-#ffif\l'"'o'

37

Blood Bank - Geetanjali Medieal Colhge & Hospital, Udaipur

SOP No.I0

ABO AND RH GROUPING

l'urltosc :urd scopc :- 'l'lrc SOI' rlcals rvith thc various nrethods of ABO and Rh typing of tltc pltticnls :tntl dorrrlrs. 'l hc trrsk slurll bc donc in llrc scrtllogl' laboratory of tlrc blood
llank.

llcslltxrsilrilit-'r' :-.1'ccltrticirtrr/Nrrrsc orr cluly shall lrc rcsponsitrlc fior the procedurc and in
c:tsc

ol'tlil'llctrltv sh:rll irrlirrrtr thc nrcdical ofliccr on duty u,ho is responsible for snrooth

rvork ing.

l\'l:r (c ri:i

lJlrlocl uroupinq scnr

viz i\rrti-A Anti-li.

Arrti-O, Anti-,rits. Anti-Ai

Microsiirics
ADtrlic;riors sticks

l'cst

tLrbcs 75 ntrn :<

I0 nrrl

l)ltstcur 1tiltcttc.s
l-itlrttraior '. ccrriri iiirrcs

S:rfcl-r' Itroccdrrrc

:- l:ol l<ln, lltc slfcty proccdures

as nrentioned in SOP

No.

l,-onvard Grouping

Slidc N'lcthorl
Itl-ocedur-c

I:()llrltvltianrrlilclLll.cr s instruction. if anv.

-,.--2

.A'/ PrSpa?ed By

FOUtiDa"'

Nts"S,,

38

o r r o t r o . ' t r + +

Take two slides and divide each into three parts by drawing a line in the middle by a glass marking pencil.

Label the parts A (croup), B(Group), C (conrrol). sinrilarly divide rhe scco'd slide into lrvo parts and label as DA and BA.

If

trre brood group comes oul to be

done.

"A" or ..A8,, thcn further sub_grouping shal

be

l)ut .nc crro;r o'palicnt's rvrrorc brood in cach co'rparl'rc'rr. lr4ix u,cll with stick. llotrrtc thc slidcs rvith lrand. {ilr lcw sccon<J.s. l-ook lirr agglutination rvithin ? nrts-

sera.A'in conrparllncnt A..8, in B; One drop n<lrntal salinc in 'c"' ottc drop Anti D sera irt 'l)'and onc tlrop of 22%"llovinc albur'i' in IIA

Put onc drop of Anti

ll'[r1..<l l]r'ot'rp is "A" or "AIJ" lurthcr sub-groupirg rvill 6c <jonc:rs lirll.rving labcl thc slitlc as A I on thc slidc.
l)rr( or:c drop

of-Anti A l.

N4i.r u.cll rvitlr stick.

Iiorarc rhc slidcs rvith hand. fbr lc.w scconds. l,ook lor agglutirration wirhin 2 mts.

I'rrllc nrc(h<ld

A 5% rcd ccll suspensior

tltc
2

10o/o

suspcnsion of

is rcquircd. rt nray bc preparcd by doubrc dirurion ofcclls dcscribcd abovc-

lakc fir'c 75xr0 nrnr tubcs and n:ark thenr A, B,.AB, D and IlA. .Add o'c drop cach of a'ti. A, anti B, a.ti AB, anti D antisra in thc respecti'c rubesonc drop 22%o bovine albumin be place in BA.

J.

Add t'vo drops of

5%o red

speed ( I 500 rpnr) for onc mt.

a.

ceil suspension in each tube- ce.trifuge at row or incubate for one hour al room rcmperature.

Obsen,e for agglutina{ion and report the result.

a,

t outtoj'"

ssF

N$aur

o**

hs"q,,

39-

Report
Agglutination in 'A'-CrouP A Agglutination

o o
a a

in'Al'
'B'

-GrouP

Al

No Agglutination in Agglutination in

'A'

-GrouP A2

-GrouP B

i
a

No Agglutination in Agglutinaliort

'A' & 'B' -Group O '&'l)'-Group AI) in both'n

I
+

Agglutination in

Al ol'AI] -Group AllS A2l) No Agglutinatiort in Al ol'AIl -Group

Agglutinatitln in '11' -l{11+vc .I.|rcrcs|rotrldbcrr<raggltrtinatitlttin.C's|idctcst0rl}Attrtrc.

.(

a
a

Alt lth ncgarivc b1' slidc or tubc tcsl strould

bc chcckcd

firr l)u ,tttig"t

Ilcversc GrouPing
Slidc N{cthod- Ilcversc grouplng

A l0% suspcttsiotr is ttsc. Talic a slllc tjsc A. B an O rcagctrt cells dcscribcd bclbrcIl and O' Ancl onc droP ol'rcfcrcncc cdls dividc it into thrcc portions and labcl A'
and

A. B and O in thc rcsPcctivc

arcas-

and rnix with a sick or toothPidk' Add two drops of resr scruln on the ccll suspcnsion forth for complctc nrixing. Sprcad in a 2 cm circlc' Tilt back and

Obscrvc agglutinatioli and rccord' variation nray be scen in different Note:- Agglutination are usually smaller- Considcrablc in their sera' pcrsorls dePcnding on the titer of the antibodies

fd

-iw
.^h.I\Ct\

hns$b,

.rs*t

Tube Method

celrs in A, B and o reference of each two droPs O and add and orrv B E :s A' tubes l. Label three _-_.r for 1 mt or low speed for at tubes' centrifuge tube. Centrifug the respective .ach tube' to each serurn test of for 2. Add two drops for one hour' ' taken as positive be temperature to ; ts room l{aerlolysis incubate at and record' oggft"inotlon 3. Observe fo'
r

- Reverse

grouping

agglutination'
tcst. thc agglutilratiotr utrdcr slidc As trrctrtitltrcd at 100 nragniltcatitltl' tttrcicr trticrtlscopc
scc

rn ca: <..xsc of doubt ^rr ln snrall. bc to arc likcly

{'

tulre by sli.e or grcuping rcvci"sc or groriiiiiig oi' forrvarri up si(rr:riions, put N.rc:- irr rrri in tut. .troutd bc 'aving-patient's ,tio.-o, This is trcatcd :r co.tror arry'o"tt'"'"' arldition of 'rctrrod, i' tircsc' tn ccllsrvithotrt aggrutination rcfcrcucc s'ould bc 'o tcst tcst.T'crc t'c .s results of tlre wil), .,," o.u s:rr*c trrc auto agglr,ti,'^tion
cilse occu|.s

it rclrrcscnts

wotrld bc irrvatid'
at roorn tenrpcrature' irrc to bc <lorre

All proccdtlrcs llcsult :-

i-ook for agglutination

GrouP B

Agglutirration Agglutinatiorr

in A cells
in B cells

GrouP B GrouP O GrouP

B cells in both A & ni"*'ut'n"'ion B cells irr both A and Agglutination No

AB

Qualiq' Control

-16,"

- of reagents

see SOP

No' 3l '

\dsfr