Academic reading: Administration of Blood Products

I did a bunch of reading for an assignment, and one of the things that came out of me doing this assignment is that I noticed that there is noticed that overall the public fear around transfusions is largely around fear of an infection from contaminated blood. People fear getting Hepatitis or HIV or something else from transfused blood. I’m pleased to report that the potential for infection is incredibly low: about 1 in 1 million blood transfusions.

ABO and Rh Blood TypesThe biggest risk for transfusions is error in patient identification and blood group matching. Sometimes this is a computer error, but it should be picked up by the people administering the blood products, and most often it is an error at the human checking points that gets missed. This causes an acute reaction that can range from mild to severe and is in almost all cases, utterly preventable. So if you’re getting a transfusion, the moral is, make sure the ID check – your name, DOB and hospital number matches the paperwork and the labels on the blood product – is correct before the transfusion starts.

So below is a list of publicly accessible references around blood donations, transfusions and various criteria. The Red Cross Blood Transfusion Service is the authorised provider of blood and blood products in Australia. They do all the collection and testing, the storage and transportation of blood products. Consider for a moment  that there’s a lot of steps involved in the process and errors can happen at every point – there’s a lot of protocol that goes into quality checking and making sure everything is okay with the products that are collected, tested, stored and transported before they’re used on patients. Australia has an incredibly high quality standard for blood products, thanks to the work of the Red Cross Blood Transfusion Service, the National Blood Authority and the other governing bodies that contribute to the governance.

One more point, I will say that although donor deferral criteria is an important part of screening for safety of collected blood products, it’s outdated and needs improvement. This is a personal opinion and wasn’t part of the research I conducted. However, I know that in Australia men who have sex with other men – protected or not – are not able to donate blood. Neither is anyone who has sex with men who have sex with other men. That screening is specifically around HIV risk factors for sex between men. However, that’s screening the type of sex people have and not their sexual health practices, which I think leaves a large gap for potential contamination and infection in blood.

I think that it is more important to know how regularly people do sexual health screening, what safer sex practices they use and what their testing history shows as being more relevant for whether they can donate blood. I think using criteria that takes those things into account, would yield similar quality in safety standards for blood collected, but not exclude people on the basis of who they have sex with. I for one, am not willing to give up sex with my queer male partners so I can donate blood. And I sincerely resent that my good sexual health practice counts for nothing in this process.

Blood Components used in blood therapyDonated blood is precious, it is lifesaving and there is not enough of it. One donation of whole blood yields several blood products that can be used to help save someone’s life. Perhaps revising who we prevent from donating could address some of that lack? I would love to be a regular donor for blood – I’m healthy, I don’t get sick often and I would love to make a difference, but I can’t because of who my partners are.

 

Anyway, enough of that soap box, some reference links for you:

Australian and New Zealand Society of Blood Transfusions. (2011). Guidelines for the administration of blood products. Retrieved from http://www.anzsbt.org.au/publications/index.cfm.

Australian Commission on Safety and Quality in Health Care. (2014). Standard 7: Blood and Blood Products. Retrieved from http://www.safetyandquality.gov.au/publications/nsqhs-standards-fact-sheet-standard-7-blood-and-blood-products.

Australian Government, ComLaw. (2014). Therapeutic Goods Act 1989. Retrieved from http://www.comlaw.gov.au/Series/C2004A03952.

Australian Red Cross Blood Service. (2014). Acute haemolytic transfusion reaction. Retrieved from http://www.transfusion.com.au/adverse_transfusion_reactions/acute_haemolytic_reaction.

Australian Red Cross Blood Service. (2015). Classification & incidence of adverse events.  Retrieved from http://www.transfusion.com.au/adverse_transfusion_reactions/classification_and_incidence.

Australian Red Cross Blood Service. (2014). Cryodepleted plasma. Retrieved from http://www.transfusion.com.au/blood_products/components/cryodepleted_plasma.

Australian Red Cross Blood Service. (2014). Cryoprecipitate. Retrieved from http://www.transfusion.com.au/blood_products/components/cryoprecipitate.

Australian Red Cross Blood Service. (2014). Delayed haemolytic transfusion reaction. Retrieved from http://www.transfusion.com.au/adverse_transfusion_reactions/delayed_haemolytic_reaction.

Australian Red Cross Blood Service. (2014). Fresh frozen plasma. Retrieved from http://www.transfusion.com.au/blood_products/components/plasma.

Australian Red Cross Blood Service. (2014). Mild allergic reactions. Retrieved from http://www.transfusion.com.au/adverse_transfusion_reactions/mild_allergic_reaction.

Australian Red Cross Blood Service. (2014). Platelets. Retrieved from http://www.transfusion.com.au/blood_products/components/platelets.

Australian Red Cross Blood Service. (2014). Red cells. Retrieved from http://www.transfusion.com.au/blood_products/components/red_cells.

Australian Red Cross Blood Service. (2014). Severe allergic reactions. Retrieved from http://www.transfusion.com.au/adverse_transfusion_reactions/servere_allergic_reaction.

Australian Red Cross Blood Service. (2014). Transfusion related acute lunch injury (TRALI). Retrieved from http://www.transfusion.com.au/adverse_transfusion_reactions/TRALI.

Australian Red Cross Blood Service. (2014). Transfusion associated sepsis. Retrieved from http://www.transfusion.com.au/adverse_transfusion_reactions/sepsis.

Australian Red Cross Blood Service. (2014). Whole blood. Retrieved from http://www.transfusion.com.au/blood_products/components/whole_blood.

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