Collection of Blood

• Blood is to be collected only by trained

personnel working under the direction of a
qualified licensed physician.

• Blood collection must be by aseptic methods,

using a sterile closed system. If more than one
skin puncture is needed, a new container and
donor set must be used for each additional
venipuncture.

by Mohammed Abu-basha 1
 Blood Containers

• Blood must be collected into an FDA-approved container that is

pyrogen-free and sterile and contains sufficient anticoagulant for
the quantity of blood to be collected. The container label must
state the type and amount of anticoagulant and the
approximate amount of blood collected.

• Blood bags may be supplied in packages containing more than

one bag. The manufacturer’s directions should be followed for
the length of time unused bags may be stored in packages that
have been opened.

by Mohammed Abu-basha 2
• Is there anything I should do before I
donate?

• Be sure to eat well at your regular

mealtimes and drink plenty of fluids.
 Identification

• Identification is essential in each step from donor registration to

final disposition of each component.

• Before beginning the collection, the phlebotomist should:

1. Identify the donor record (at least by name) with the donor and ask the
donor to state or spell his or her name.

2. Attach numbered labels to the donor record and ensure that it matches the
blood collection container, attached bags, and tubes for donor blood
samples. Attaching the numbers at the donor chair, rather than during the
examination procedures, helps reduce the likelihood of identification errors.

3. Recheck all numbers.

by Mohammed Abu-basha 4
 Preparation of the Venipuncture Site

• Blood should be drawn from a large firm vein in an area (usually

the antecubital space) that is free of skin lesions. Both arms must
be inspected for evidence of drug use, skin disease, or scarring. A
tourniquet or a blood pressure cuff inflated to 40 to 60 mm Hg
makes the veins more prominent. Having the donor open and close
the hand a few times is also helpful. Once the vein is selected, the
pressure device should be released before the skin site is prepared.

by Mohammed Abu-basha 5
• There is no way to make the venipuncture site
completely aseptic, but surgical cleanliness can be
achieved to provide the best assurance of an
uncontaminated unit.

• Several acceptable procedures exist. After the skin has

been prepared, it must not be touched again to
repalpate the vein. The entire site preparation must be
repeated if the cleansed skin is touched.

by Mohammed Abu-basha 6
 Arm Preparation for Blood Collection (practical)

Principle
• Iodophor compounds, or other sterilizing compounds, are used to
sterilize the venipuncture site before blood collection.

Materials
1. Scrub solution: Disposable povidoneiodine scrub 0.75% or
disposable povidone-iodine swabstick 10%; available in
prepackaged single-use form.

2. Preparation solution: 10% povidoneiodine; available

prepackaged single- use form.

3. Sterile gauze.
by Mohammed Abu-basha 7
 Procedure

1. Apply tourniquet or blood pressure cuff; identify

venipuncture site, then release tourniquet or cuff.

2. Scrub area at least 4 cm (1.5 inches) in all directions

from the intended site of venipuncture (ie, 8 cm
or 3 inches in diameter) for a minimum of 30 seconds
with 0.7% aqueous solution of iodophor compound.
Excess foam may be removed, but the arm need not
be dry before the next step.

by Mohammed Abu-basha 8
4. Starting at the intended site of venipuncture
and moving outward in a concentric spiral,
apply “prep” solution; let stand for 30 seconds
or as indicated by manufacturer.

5. Cover the area with dry, sterile gauze until the

time of venipuncture. After the skin has been
prepared, it must not be touched again. Do not
repalpate the vein at the intended
venipuncture site.
by Mohammed Abu-basha 9
 Notes

1. For donors sensitive to iodine (tincture or

povidone preparations), another method (eg,
ChloraPrep 2% chlorhexidine and 70%
isopropyl alcohol) should be designated by the
blood bank physician.

2. For donors sensitive to both iodine and

chlorhexidine, a method using only isopropyl
alcohol could be considered.

by Mohammed Abu-basha 10
 Phlebotomy and Collection of Samples

• During collection, the blood should be mixed with the

anticoagulant. The amount of blood collected should
be monitored carefully so that the total, including
samples, does not exceed 10.5 mL per kilogram of
donor weight per donation.

• When the appropriate amount has been collected,

specimen tubes must be filled. The needle and any
blood-contaminated waste must be disposed of safely
in accordance with universal precaution guidelines.

by Mohammed Abu-basha 11
• The needle must not be recapped unless a safety
recapping device is used. Disposal of the needle
must be in a puncture-proof container.

• After collection, there must be verification that

the identifiers on the unit, the donor history, and
the tubes are the same.

• Gloves must be available for use during

phlebotomy and must be worn by phlebotomists
when collecting autologous blood and when
individuals are in training.
by Mohammed Abu-basha 12
 Phlebotomy and Collection of Samples for
Processing and Compatibility Tests (practical)

Principle

• Blood for transfusion and accompanying samples

is obtained from prominent veins on the donor’s
arm, usually in the area of the antecubital fossa.

by Mohammed Abu-basha 13
 Materials

1. Sterile collection bag containing

anticoagulant, with integrally attached
tubing and needle.

2. Metal clips, hand sealers, Dielectric sealer.

3. Balance system to monitor volume of

blood drawn.

4. Sterile gauze and clean instruments

(scissors, hemostats, forceps).

5. Test tubes for sample collection.

by Mohammed Abu-basha 14
 Procedure

1. Ask donor to confirm his or her identification.

2. Ensure that all labeling on blood container, processing tubes, and

donor records is correct.

3. Prepare donor’s arm as described in (previous method).

4. Inspect bag for any defects and discoloration. The anticoagulant

and additive solutions should be inspected for particulate
contaminants.

5. Position bag below the level of the donor’s arm. A hemostat

should be applied to the tubing before the needle is uncapped to
prevent air from entering the line.

by Mohammed Abu-basha 15
Remains in a
closed
system!
Tubes for
testing

Bag O’Blood
6. Reapply tourniquet or inflate blood pressure cuff. Ask the donor
to open and close hand until previously selected vein is again
prominent.

7. Uncover sterile needle and perform the venipuncture

immediately. A clean, skillful venipuncture is essential for
collection of a full, clot-free unit. When the needle position is
acceptable, tape the tubing to the donor’s arm to hold the needle
in place.

8. Release the hemostat. Open the temporary

closure between the interior of the bag and
the tubing.

9. Ask the donor to open and close hand slowly every 10 to 12

seconds during collection.
by Mohammed Abu-basha 17
10. Keep the donor under observation throughout the donation
process. The donor should never be left unattended during or
immediately after donation.

11. Mix blood and anticoagulant gently and periodically

(approximately every 45 seconds) during collection. Mixing may
be done by hand or by continuous mechanical mixing.

12. Be sure blood flow remains fairly brisk, so that coagulation

activity is not triggered.

13. Monitor volume of blood being drawn. One mL of blood weighs

at least 1.053 g. A convenient figure to use is 1.06 g/mL. For a
500-mL bag unit, this is 530g (plus the weight of the container
and anticoagulant). 63 mL anticoagulant in 450 mL bag
70 mL anticoagulant in 500 mL bag
18