Anemic blood donor !

[azizka71]

Hi every body

 

After physical examination the doctor gave a donor approval to donate blood , after  completion of the donation the nurse who take blood did hemoglobin test by take a sample from the whole blood unit,  hemoglobin test shows that the donor has anemia (Hb = 8.0 mg / dl) then the doctor  call the donor and describe him some medicine and advised him to visit a specialist doctor. Unit of blood were donated separated into red blood cells and plasma. The question is  the unit of red blood cells  considered a therapeutic unit, is it possible to transfuse it to an anemic patient for example, or for surgery?

please give your opinion about this unit can be used or not?

Edited October 10, 2014 by azizka71

[SMW]

In my opinon, the only individual that should be transfused with this unit is the donor!  In the USA (and I'm certain some other countries who can chime in), a Hgb or Hct is required to be perforrmed on the donor and must meet pre-determined acceptability criteria BEFORE a collection is even initiated.  

[azizka71]

Thank you SMW

Yes, you're right. Even in my country we use these criteria but the doctor made ​​a mistake when this was not being done (hemoglobin test)
Maybe because he relied on the visual examination of the donor and he doesn"t appear it pallor and the donor also hid from the doctor that he suffered hemorrhoids and ulcers thinking that it would not affect the process of donation, but certainly the doctor is responsible in this case, he should make sure of hemoglobin before giving approval to donate blood.
the question Is: is the red blood cells unit will be useful if intensive spent for any other patient will raise the proportion of hemoglobin as the unit which taken from the donor meets the criteria for the rate of hemoglobin, which must be higher than 13g %

??

I am responsible in the Department of quality control and this is the first time that it come across such a case, I have no idea about how to behave in this unit of blood, i put this question on this site to benefit from the expertise of the members in this forum. Thank you

[SMW]

In my opinion, all components from this donation should be considered non-conforming and discarded. The donor has demonstrated that they are an unreliable historian and who knows what other questions were not answered truthfully!  For this reason, the donor should also be permanently deferred and any prior donations from this individual recalled. More significantly, since it appears there was willful disregard to follow required policies and procedures when approving individuals for donation, ALL products from all donors qualified by this doctor should also be recalled/withdrawn.  Willful disregard to followed required policies and procedures would generally be considered grounds for termination.  

[Malcolm Needs ☆]

Totally agree SMW - although I have more sympathy with the donor (who may have been mistaken, or not understood the rules) than the doctor.

[azizka71]

Thanks SMW, thanks Malcolm Needs

I also agree with you.

Could you please tell me the best method to chek hemoglobine ( of course befor donation ) , for example in your country do you chek the hemoglobine or Hct and by which machine CBC caulter or another method.

[SMW]

In the USA, the Hgb/Hct determination is generally performed using a sample from a finger-stick puncture and generally includes either a screening test utilizing Copper Sulfate or quantitative tests such as a spun microhematocrit or a Hemocue assay.  

[aafrin]

I agree completely with SMW and Malcolm on this. This doctor needs intensive training and should be reprimanded for not following protocol. You cannot just look at donor to certify him fit to donate, Hb has to be done and should be more than 12.5 gms/dl. plus other physical exams.

There are many disadvantages in copper sulphate method which makes it unsuitable especially in a camp or multi-donor settings. We also do Hb by Hemocue method.

[lewisda]

Hi,

I do not know what country you are in, but the Hemocue is widely available and used by many hospitals in Saudi Arabia and in the Middle East.

[Auntie-D]

The other thing to consider is the resulting low volume of cells in the unit would mean that the haemoglobin of the person receieving the unit may not rise sufficiently, thus inceasing the number of donor exposures. In all the labs I have worked at we always give multiply transfused patients the 'fattest' units to try and limit the number of donor exposures a bit.