PRE & RUN SUMMERY FOR APHERESIS ( TRIMA Accel)

1. Donor Name : _________________________________________________ Age ______ Year Gender ____________

Height ________ Pre Count __________ 103 Hct _______%

Weight ______ kg

2. Donor No

________________________________

3. Date of Collection

_______________________

4. Collect component

: Platelet ________________ Plasma ___________

5. Total A/C used

_______ ml

6. Start of Run Time

_______ am / pm

7. End of Run Time

_______ am / pm

8. Length of Run

_______ min

9. Post Platelet Count

_______ 103 /l

10. Post HCT

_______ %

11. Actual AC to Donor

_______ml

Blood Group ___________

RBCs ______________

12. Blood Volume Processed : _______ml

13. Total Saline Used

: ________ml

14. Leucocytes Reduction labels :

A . Platelet Product

: Label LRS Platelet Product Yes / No

B. Plasma product

: Label Plasma Product Yes / No

1011 Vol. of AC in Platelets ________ml

15. Platelet Product : Platelet Volume _______ml

Yield Platelets________

16. Platelet Product : Plasma Volume _______ml

Vol. of AC in Plasma ____________ml

17. RBC Product

Vol. of AC in RBC _____________ml

: RBC Volume_________ ml

QC RESULT
Time Required
min

Platelet Count

103

Product Yield

1011

Technician Name and Sign :

Medical Officer :