2 English reference blood collection [WS/T 203-2001common terms in blood transfusion medicine]
3 Overview Blood collection is the process of collecting blood from donors into blood containers [1].
Preparation before blood collection is of great significance to improve work efficiency, ensure blood quality and the safety of blood donors, and carry out blood collection smoothly.
4. 1 preparation of blood donors 1. Repeat the necessary items: heart, lung, liver, spleen, blood type, blood pressure, weight and various blood test results, and donate blood after being approved and signed by the doctor.
2. Eat a low-fat light diet 1d before and on the day of blood collection to avoid excessive fatigue.
3. Understand the common sense of blood donation and relieve mental stress.
4. If possible, take a bath the night before blood collection, especially the elbow.
4.2 Disinfection of blood collection room 1. Wipe and clean all appliances and floors with 0.2% peracetic acid or 0. 1% chlorine-containing disinfectant.
2. Ultraviolet lamp irradiation for 3060 minutes.
3. If blood collection lasts more than 4 hours, blood collection should be suspended and disinfected again.
4. Clean and disinfect every week 1 time, then expose to nutrient agar plate or blood agar plate 15min, or use LWC 1 sampler for 0.5min, and the number of colonies is less than 200 /m3. If pathogenic bacteria are found, they must be thoroughly cleaned and wiped, and then disinfected with 36% formalin steam.
4.3 The work requirement of blood collection room is 1. Before blood collection, we should enthusiastically publicize the significance of blood donation, introduce blood donation knowledge, reduce the mental burden, and make blood donation go smoothly.
2. Check whether the photos on the blood donor and the blood donation card are consistent, and fill in the blood donation card carefully.
3. Urge blood donors to wash their arms with soap and then enter the blood collection room.
4. In the process of blood collection, pay attention to the blood donors.
5. First-aid drugs and equipment should be available indoors, and doctors should be able to implement first-aid techniques such as air embolism and syncope.
Medicine: white sugar; 25% ~ 50% glucose solution; 10% calcium gluconate solution; Normal saline; Low molecular dextran; Aromatic amino lipids; Sedatives such as dizzy haining; Nitrate preparation; Atropine and epinephrine for injection; Respiratory central stimulant.
Equipment: sphygmomanometer, stethoscope and thermometer; Sterile bloodletting bag; Tongue depressor; Oxygen bag or oxygen bottle, mask; Sterile gauze, cotton ball, adhesive tape; Disposable infusion sets, syringes and all kinds of disinfection needles; Acupuncture needle; Towels and spittoons, etc.
4.4 Preparation of blood collector 1. Prepare blood collection equipment: wipe the plastic bag of blood bag with a towel soaked in 0.2% ~ 0.4% peracetic acid solution or 0. 1% bromogeramine solution, and check its production and expiration date. There should be no leakage, discoloration, mildew and other phenomena. In the bag.
2. Blood collection personnel should change shoes, wear masks and hats according to the operating room routine, and wear disinfection clothes before entering the blood collection room.
5 Blood collection methods Blood collection shall be undertaken by medical personnel and personnel specially trained in blood collection techniques, and they shall not be employed without special training; The proficiency of blood collection technology is directly related to the quality of blood and the health of blood donors, so every blood collector is required to master blood collection technology skillfully.
1. Check the electronic blood collection instrument (blood collection scale), and check the quality of blood collection bag again (whether there is any breakage, water leakage, mildew, liquid storage, etc. ), and check whether the blood donors and the full set of cards are consistent with the labels of blood collection bags and test tubes.
2. Put the donor's arm flat, tie a tourniquet or sphygmomanometer about 5cm above the cubital fossa, and keep the pressure at 5.3 ~ 8.0 kPa (40 ~ 60 mmHg). Choose the thick, full, elastic and hard-to-slip middle elbow vein, followed by the expensive vein; Because the cephalic vein is easy to slide, it is only used when the former is not easy to touch.
3. Disinfect the venipuncture point and surrounding skin with 2.5% tincture of iodine, the range is about 8 ~ 10 cm2. After the tincture of iodine is dried, the iodine is removed with 75% ethanol.
4. Place the blood collection bag at the forearm of the blood donor, clamp the blood collection catheter with hemostatic forceps, remove the needle protection cap of the blood collection needle, puncture, and loosen the hemostatic forceps when there is blood return; Cover the needle holes with sterile cotton balls and fix them with adhesive tape.
5. When the blood flows into the blood bag, put the blood bag on the automatic shaking blood sampler lower than the arm to fully mix the blood with the preservation solution to prevent blood coagulation; Ask the blood donors to relax and clench their fists, and the blood collectors will sign and label the blood bags.
6. When the blood volume reaches, ask the blood donor to loosen his fist, hold the blood collection catheter about 23cm away from the needle tail with hemostatic forceps, and pull out the needle; Blood donors are required to press the needle eye with three fingers for about 3 to 5 minutes to avoid hematoma or purple spots caused by subcutaneous blood flow.
7. Heat-seal the blood collection catheter about 5cm away from the blood bag, and then heat-seal multiple sections every 10cm or according to the original printed words on the catheter, and conduct multiple blood matching, re-examination and blood collection.
8. classify each type according to the amount of blood stored, recheck the blood type correctly, and store it in the refrigerator at 2 ~ 6℃ after verification; Clean the blood collection room, clean the blood collection equipment, check whether the blood storage register is complete, and then enter it into the computer.
9. Blood collection volume: When using plastic bags to collect blood, the total weight and blood volume of plastic bags should be calculated. According to the specific gravity of human whole blood 1.050, the total blood collection amount = the number of milliliters of blood collected x the specific gravity of blood+the weight of plastic bags and preservation solution. For example, taking 200ml of blood, the total weight after blood collection is: (200×1.050)+70 = 280 g.
10. In the field, blood can be collected by blood collection vehicles or tents, but the blood should be kept at 2 ~ 6℃ as far as possible.
6 Precautions (1) Strictly disinfect the skin, and the disinfection range is 8 ~ 10 cm2. After disinfection, fingers are not allowed to touch the puncture site. During blood collection, blood collectors must wipe their hands with commonly used alcohol cotton balls or towels soaked in 0.2% peracetic acid solution, and try to keep their fingers sterile.
(2) The causes of poor blood flow during blood collection should be found out: ① the needle is improperly positioned in the vein, and the inclined plane of the needle is blocked by the vein wall or valve; ② The puncture is too deep or the inclined plane of the needle does not completely enter the vein; ③ Blood collection catheter is squeezed, stuck or bent; ④ Insufficient or too high tourniquet pressure leads to superficial venous insufficiency or deep venous obstruction; ⑤ Blood donors are nervous and have a blood donation reaction, which leads to venous spasm or collapse. In view of the above reasons, it should be treated in time to keep the blood flow unobstructed.
(3) Carefully check whether the number, name and blood type on the bag label and the tube label are consistent. If the label falls off, blood samples must be taken from the blood bag for liver function and blood type re-examination, and the results are consistent before they can be issued.
Nursing care of blood donors 1. After blood donation, the cotton balls and adhesive tapes covered on the eye of the needle must be kept for more than 4 hours to avoid infection of the eye of the needle.
2. Check the puncture site for bleeding or bleeding. If there is bleeding, raise your arm and continue to compress the local area.
3. After donating blood, you should rest in place for a proper time, then slowly pick up the donor (not suddenly, in case of dizziness caused by transient cerebral ischemia) and leave without abnormal reaction.
4. If blood donors are found to have dizziness, dizziness, pallor, sweating and other symptoms, they should be treated immediately.
5. If you feel thirsty after blood donation, you should replenish water in time, which will help the recovery of blood volume.
6. Restore blood volume 8 ~ 24h after blood donation, and instruct blood donors to avoid strenuous activities during this period to prevent accidents.
7. Ask blood donors to eat high-protein and digestible food after blood donation, so as to facilitate the recovery of blood.
8. Some people feel very tired after donating blood, and ask blood donors to keep cheerful, emotionally stable and get enough sleep.
9. Patients with complications (cerebral embolism, hemorrhagic anemia, etc.). After donating blood, you should be sent to the hospital for treatment in time.
8. Selection of blood donors Blood donors must undergo a health examination. Those who meet the following conditions will be issued with blood donation cards with the approval of blood transfusion doctors to protect the health of blood donors and the safety of blood recipients.
1. Age? Male 18 ~ 55 years old, female 18 ~ 50 years old. Above this age, both men and women are willing, the unit agrees, the medical examination is qualified, and the doctor approves, and the age can be relaxed by 5 years.
2. Good health, without the following medical history? Viral hepatitis (hepatitis A is cured in 65,438+0 years, and those who are negative in three tests can donate blood), malaria (those who have no symptoms of malaria for three years after stopping treatment can donate blood), schistosomiasis (those who had schistosomiasis before 65,438+0 years, have recovered, have no hepatosplenomegaly and have no clinical symptoms can donate blood), tuberculosis (those who have been cured and have been inactive for two years can donate blood), Sexual history or syphilis antibody positive, AIDS history or HIV antibody positive, malignant tumor, severe allergic disease, mental disorder, frequent headache or syncope, cardiovascular and cerebrovascular diseases, liver and kidney, blood, endocrine and metabolic diseases, and major organ resection treatment.
3. Blood donation history? The number of blood donations and the last time of blood donation, the interval between two blood donations should be more than 6 months; There was no unqualified examination before blood donation.
4. Normal nutrition and development? Body temperature, pulse, respiration, blood pressure and weight are normal, but there is no obvious abnormality in head, neck, heart, lung, liver, spleen, superficial lymph nodes and external genitalia; If necessary, do chest X-ray, and the specialist examination proves that there is no important disease.
5. check? ABO blood group (positive and negative) typing, Hb and ALT are normal, HBsAg, anti -HCV, anti -HIV and RPR are negative.
6. Women? Stop donating blood within 9 months after delivery, 6 months after abortion, pregnancy, breastfeeding and menstrual disorders.
7. Blood donation should be suspended in the following circumstances? Within 4-5 days before and after menstruation, if you have flu, influenza or other diseases, you have just pulled out your teeth or been vaccinated (such as measles, mumps, yellow fever or rabies vaccine, and adult oral polio vaccine), you can donate blood after 2 weeks; After the last injection of rubella vaccine, you can donate blood after 4 weeks; You can also donate blood 2 weeks after injecting animal serum products).
8. Anyone who meets Article 1 in the following clauses shall be postponed for at least 6 months.
(1) Persons who receive blood, blood components and blood products (such as coagulation factors VII and II, VII, VII and X complexes) and participate in blood immunization.
(2) people who are in close contact with patients with viral hepatitis (except those contacted by hospital staff in their daily work); The staff of hemodialysis units are particularly exposed to patients' blood.
(3) Having received skin grafting, tattooing, ear piercing and acupuncture.