School of Allied Health Science

SHARDA UNIVERSITY, GREATER NOIDA

AN INTERNSHIP REPORT
ON
BLOOD BANK
Submitted in partial fulfillment for the award of the degree of
Bachelor of Science
In
Medical Laboratory Technology (Techniques)
Submitted by
LOVE KUMAR
ROLL NO.: 210564012
SYSTEM ID: 2021003539
Under the Supervision of
DR. RAHUL SAXENA

UNDERTAKING

I hereby declare that the Internship Report titled "INTERNSHIP REPORT ON BLOOD

BANKS" is an original work carried out by me for the award of degree of Bachelor of Science in

Medical Laboratory Technology (Techniques) at Sharda School of Allied Health Sciences,

Sharda University, Greater Noida, U.P. It is further certified that as of my knowledge and

attesting to the originality of the work, and that there is no plagiarism and the work has not been

submitted for the award of any other degree/diploma of the same Institution where the work was
carried out, or to any other Institution.

Student Signature

LOVE KUMAR ROLL NO.: 210564012

SYSTEM ID: 2021003539
Sharda School of Allied Health Sciences
Sharda University
BMLT (2021-2025)

CERTIFICATE OF INTERNSHIP

This is to certify that the project titled “INTERNSHIP REPORT ON BLOOD BANKS” is

submitted by LOVE KUMAR to the Sharda University for the degree of BACHELOR OF

SCIENCE IN MEDICAL LABORATORY TECHNOLOGY (TECHNIQUES). It is a novel

piece of work carried out by the student under the supervision of DR. RAHUL SAXENA

SUPERVISOR . And there is no plagiarism. It is further certified that the student has fulfilled all

the requisite conditions/ requirements laid down by the University. Accordingly, this internship

report is eloquently fit for the award of the degree of Bachelor of Science in Medical

Laboratory Technology (Techniques)

Name: Dr. Rahul saxena Name: Dr. Ankur Vashishtha

Designation: Assistant Professor Designation: Assistant Professor
Department: Medical Lab Technology Department: Medical Lab
Technology
School of Allied Health Sciences School of Allied Health Sciences

Signature of Program coordinator

Name: Dr. Gaurav Kaushik
Designation: Professor
Department: Medical Lab Technology
School of Allied Health Sciences

CERTIFICATE OF INTERNSHIP REPORT

This is to certify that the project titled "INTERNSHIP REPORT ON BLOOD BANKS" is

submitted by LOVE KUMAR to the Sharda School of Allied Health Sciences, Sharda

University for the degree of Bachelor of Science in Medical Laboratory Technology

(Techniques). The student has fulfilled all the requisite conditions/ requirements laid down by

the University. Accordingly, this internship report is eloquently fit for the award of the degree of

Bachelor of Science in Medical Laboratory Technology (Techniques).

Signature of Dean
Dr. KARUNA SINGH
Professor & Dean
Sharda School of Allied Health Sciences
Sharda University
 Acknowledgement

This report has been compiled as part of the internship undertaken at Sharda Hospital, Sharda

University. The purpose of the internship was to gain hands-on experience in applying theoretical

knowledge in a practical setting, fulfilling the requirements of the Bachelor of Science in

Medical Laboratory Technology (Techniques) program. I am deeply grateful to DR. Karuna

Singh (Professor and Dean) of the Sharda School of Allied Health Sciences, Sharda University,

for providing me with the opportunity to undertake this internship. I would also like to extend

my heartfelt thanks to the esteemed faculty members of the Department of Medical Laboratory

Technology, including DR. Gaurav Kaushik (Professor Head), DR. Ankur Vashishtha

(Internship coordinator and Supervisor) DR. Ajit Pal Sing (Assistant Professor), and DR. Rahul

Saxena (Professor), for their valuable guidance and support throughout this study. I feel

privileged to have mentors and educators of such high caliber.

LOVE KUMAR
Contents
THE SUPERVISION OF 01
UNDERTAKING FORM 02

INTERNSHIP CERTIFICATE 03
INTERNSHIP REPORT CERTIFICATE 04
ACKNOWLEDGEMENT REPORT 05
 Intruduction 07

Blood banks significance 08

Blood storage and preservation 15
Blood donation 19
The need for blood transfusion 32

Objective regulatory 31
Abbrevation list 33
Combined medicine 35
44
Regulations and Accreditation/Licensing
ABO blood grouping 51

Diseases from blood transfer 55

Methodology 59
Conclusion
Reference 62

CHAPTER 1:
INTRODUCTION:

India is the sixth largest country in the world, with an

incredible estimated population of more than 1.4 billion as of July 2023. The Blood Transfer
Services (BTS) in India are comprised of a vast countrywide network of more than 4000 blood
centres. The bulk of these are hospital-affiliated blood facilities (77%) and comprise government
(44%) and independently (33 percent) operated facilities, which is consistent with the diverse
management environment. The remaining twenty-three percent are classified as private
philanthropic. organisations The General Directorate of Medical Services (DteGHS), which is in
charge of BTS, is under the jurisdiction of the Ministry of Family Welfare and Health
(MOHFW). The Drug Control Officer of India (DCGI) and the Blood Cell of the National
Healthcare Mission coordinate its numerous responsibilities. As of July 2023, India had an
astounding audience of over 1.4 billion people, making it the seventh biggest country in the
world. The extensive nationwide network of over 4000 blood centres makes up India's The blood
Transfer Services (BTS) [1]. In keeping with the varied management environment, the majority
of these are hospital-affiliated the blood centres (77%) and comprise governmental (44%) and
privately operated institutions (33%). The remaining 23% are private nonprofit organisationsm.
The Ministry of Family Welfare and Health (MOHFW) has authority over the General
Directorate of Healthcare Services (DteGHS), which oversees BTS. Its many duties are
coordinated by the National Health Mission's Blood Cell and Drug Control Officer of India
(DCGI). The State Blood Transfusion Committee (SBTC) and the State's AIDS Management
coordinate all BTS and blood-related security initiatives at the state level (Fig. 1). The State
Drugs Controller (DC, State) and the DCGI oversee these organisations' management of blood
centres and associated satellite (blood storage) facilities. This intricate regulatory framework
safeguards the health and well-being of India's substantial population by ensuring the honesty,
security and availability of transfusion services across the nation.
Chapter 2:

Blood Banks' Significance The hospital blood bank's functionThe hospital blood centre or its
equivalent must adhere to quality transfusion practices as they are essential to guaranteeing that
the patient receives the appropriate blood component.

Every EU country does the laboratory part of the transfusion process in a different way. In
certain cases, the local hospitals blood bank manages the clinical transfusions testing facilities &
the blood component inventories. In other places, the blood centre provides appropriate blood
directly to hospitals.

Hospital
blood banks are required by EU Directives to put in place a system for managing quality.
Monitoring the operation of reagents, equipment, methods, and processes is crucial to
maintaining a high standard performance in the laboratory. The use of laboratory worksheets and
standard operating procedures, proper documentation and record keeping, and adherence to
safety regulations all contribute to higher performance quality.

Among the duties of the hospital's blood bank are: Quick responsiveness to urgent blood
component requests Verifying pre-transfusion requests and samples Evaluating the donor and
patient's immunological compatibility Choosing the appropriate blood component for every
clinical situation Safe transportation and management of blood components Management of
stocks and inventory engagements with the blood foundation. Requests That Are Urgent The
laboratory should be contacted by phone for any sudden demands for blood products and

components. In order to plan the work and give requests the proper priority, blood bank
employees must be offered as much warning as possible. Clear and regular contact with the
blood components requirements with the hospital's blood bank facilitates the handling of every
unforeseen circumstance. After the patient's sample and request are received, a complete
crossmatch will take around forty to forty-five minutes. The period might be shortened to 20
minutes in really critical situations. This makes it possible for testing to rule out ABO
incompatibility. In most cases, non-crossmatched blood from group O should be kept available
for use right away in cases of extreme urgency if blood is required in a matter of twenty minutes
or less. If the patient's RhD type is unknown, group O Rh D negative red blood cell should be
given to females of reproductive age.

Clerical checking and blood samples

In pre-transfusion testing, inspection is essential. Accurately identifying and tagging blood

specimens from the right patient is essential to providing safe transfusion-grade blood. When a
sample is brought to the blood bank, a staff member must confirm that the information on the
label & the transfusion request match. Additionally, the results of the current and previous tests
must be compared, and the patient's transfusion & serological history must be reviewed. Any
discrepancies must be resolved prior to the release of any blood components for transfusion.

Testing before to transfusion

This procedure, also known as "a group and screen" and "type and screen," involves analysing
the blood of the possible recipient to determine their RhD type, ABO group, and any antibodies
to red cells that may be clinically significant. If the first screening test is positive, further testing
to identify red cell antibodies might be necessary to choose suitable donor units. Prior to the
transfusion of Erythrocyte components, thepatient's serum is immediately examined at blood
bank to see if it is compatible with the red blood cell donors (crossmatch). As the blood is
transfused, several nations additionally need a second blood group testing.
Problem with electronics (computer crossmatch) ABO and Rh D compatible red cell units can be
promptly released for a patient based on data in the blood bank's information system without the
need for additional testing, as long as protocols are in place to guarantee that: The patient's ABO
and RhD types have either been determined to be type O in the very first place, tested again on
the initial specimen, or tested and verified on a second sample. There are no abnormal red cell
antibodies in the patient. The blood units are grouped in a completely trustworthy manner. The
patient's identity and sample are completely trustworthy. It is
possibl
e to accurately identify and get the patient's prior findings. Electronic problems can be resolved
in as little as ten minutes. Any appropriate national criteria must be followed by hospitals that
use electronic issues.

Choosing a blood component

The hospital's blood bank will choose and label the appropriate component of blood for the
patient based on the test findings and the details on the request form. Safe transportation and
management of blood components At this point in the clinical transfusion process, mistakes are a
major cause of unfavourable outcomes and responses. A protocol should be in place at hospitals
to guarantee that the right units are removed from the storage area. Only approved blood storage
freezers with temperature tracking charts and alarm systems are permitted to hold blood.The
ability to trace Directives 2005/61/the EC & 2002/98/ European Commission stipulate that
blood and blood components must be completely traceable from producer to recipient and back.
A system that enables the identification of each blood element sample and its intended use must
be in place at hospitals and blood facilities. In the UK, the so- called "bag and tag" labelling
method has shown to be effective. Every time a batch of components of blood is produced for a
patient, a paper tag is printed by the laboratory's programmed system. This includes patient
identifying information and two traceability labels that include the donor
number.

Until a sample of blood element is used (or sent to the lab if unused), the tag is affixed to it. A
single labelled with the tag is sent back to the hospital donation laboratory and the other is
included in the patient's records if the patient receives a transfusion. The automated system that
keeps track of each component's destiny receives data from the returning labels. We keep an eye
out for cases of nonreturned labels and take appropriate action. With this technology, several
hospitals record traceability of 95% or higher.

Management of stocks and inventory

The administration of the hospital's blood supply is within the purview of the blood bank. This
entails keeping track of the quantity of blood that expires or isn't utilised for other purposes,
maintaining an inventory for every blood type, and guaranteeing a typical age of blood at the
time of issuance. To prevent overstocking and waste, stock levels must be determined in relation
to weekly consumption and activity. An IT system that facilitates The blood inventory
management and offers a comprehensive audit trail of every blood stock electronically imported
onto the system should be installed whenever feasible.
In order to address blood shortages, the hospital blood bank and its Blood Establishment
provider should create a joint working agreement.

Schedule for Maximum Surgical Blood Orders (MSBOS)

A hospital transfusion committee, physicians, and the blood bank have agreed on an overall
surgical blood order schedule. It outlines how many blood units should typically be cross-
matched for scheduled surgical operations. It considers the likelihood of requiring a transfusion
as well as the time it takes to get blood after a request. By preventing needless crossmatching, an
MSBOS may save the effort of blood banks and help with stock management and waste
reduction. The hospital transfusion committee, doctors, and the blood bank discuss to reach an
agreement. The MSBOS is not required for procedures that employ electronic issues.

CHAPTER 3:

BLOOD STORAGE AND PRESERVATION

Keeping of blood is a crucial procedure in the blood-related banking sector as it preserves the
blood's purity and therapeutic efficacy. Although there are other techniques to preserve blood,
chilling is the most often used technique. Donors are the source of both blood and its
components for blood banks. Both & plasma, the liquid component of blood utilised in
transfusions, must be separated from donor blood during processing. The remaining platelets and
white blood cells are frozen at temperatures lower than -80°C and kept in a cryopreservation
solution. The procedure maintains the cells' viability until transfusion is required. It is essential
to keep and retain blood at the proper temperature as soon as it is drawn from a donor in order to
maintain its essential cells, proteins, and chemicals. Blood purity is guaranteed via blood bank
storage. Because it enables blood banks to provide a steady supply of secure blood that can be
kept for decades without losing its function, blood product storage is crucial. Additionally,
hospitals can make sure they have sufficient blood on available to satisfy patients' requirements
when they require it most thanks to the storage procedure.

The cold chain method of blood bank storage guarantees that blood conditions for storage are at
a suitable temperature and that the blood samples are kept at that temperature from the time of
collection until they arrive attheir destination. Any breakdown in the refrigeration system may
lead to blood degradation and increase the danger to the recipient's life. During transfusion,
blood contamination from inadequate storage may be fatal.

Blast Freezer for Blood Storage

Because
Froilabo's Blast Freezer can reach 30°C within less than 90 minutes, it may be utilised to quickly
freeze blood bags. Read the Application Note for further details regarding how our burst freezers
may be utilised to store blood bags. After the bag of blood has been blast frozen, it can be moved
to a Froilabo ULT for long-term storage.

Utilising ULT Freezers for Blood Product

Storage Froilabo's low temperature freazers enable the storage and preservation of blood. Our -
86C ultra-low freezers, which come in chest and upright variants, ensure that blood products are
always stored and protected to the highest standard. With capacities from 174 L to 1000 L, our
wide variety offers a solution for any laboratory.The significance of blood contributions, blood
grouping, and the creation of blood groups for transfusions: When ABO blood types were
discovered by Karl Landsteiner at the start of the twentieth century, blood typing was only
starting to become a widely accepted process. Transfusions now only occur after many quality
checks, compatibility tests, and screening tests. Before drawing blood from a donor, blood banks
must get a licence, according to the Drugs
Control Board of India.
 DONATION OF BLOOD:
India has the biggest blood shortage in the world, with each state together grappling with a
crippling 41 million unit deficiency. India is heavily dependent on transfusions due to the
prevalence of blood-borne infections and pregnancy complications in the nation. Every year,
more than 60 million trauma-induced
surgeries are performed in the US. It sees around 1,200
traffic accidents every day. Ten million pregnancy issues, 331 million cancer treatments,
including chemotherapy, and 230 million major operations all need blood transfusions. Official
figures show that 34 out of 1,000 eligible people must donate blood once annually to satisfy the
anticipated clinical requirement. The foundation of a sufficient and safe supply of blood and its
components is voluntary blood donors. Every year, the need for blood and its components has
increased substantially. Sadly, the demand for blood is far higher than the supply.
Three lives may be saved with a single blood donation. The donated blood unit may be given to
three distinct patients after being centrifuged to separate the red blood cells, platelets, and
plasma. Three lives can be saved and hope can be restored with only one hour of blood donation.
The process of donation:
The significance of blood grouping The four
primary blood types—A, B, AB, and O—indicate the presence of different antigens in red blood
cells. If you have a type of blood B, you have the B antigen; if you have a blood group A, you
have the A antigen. Blood type O red blood cells lack both A and B antigens on the outside,
while blood type AB red blood cells do. Rh D negative people have red blood cells than do not
carry the D antigen, whereas Rh D positive people have red blood cells with do.

When receiving a blood transfusion, it is crucial that the blood be accurately grouped. Giving a
patient blood that is incompatible might result in serious transfusion responses.
One crucial step in the blood
donation procedure is completing a blood donation form. In addition to ensuring the recipient's
safety and your own, the form assists the blood bank in determining your eligibility to donate.
Here's how to correctly complete the form:

1. Individual Data

• Full Name: Include your last name, middle name, and first name, if any.

• Age/Date of Birth: Donors must normally be between the ages of 18 and 65, however national
age restrictions may differ. Enter your birthday as precisely as you can.

• Gender: Indicate if you are male or female.

• Address: Enter your current address, which is often your home or permanent address.

• Contact Details: If required, provide a contact line as well as email address for follow-up.

2. Medical History and Health

This part determines whether you are in good enough health to give blood and if you have any
health issues that could interfere with the donation.

• Do you currently suffer from any illnesses? Provide an honest response on any current medical
conditions

• Do you use any prescription drugs? Enumerate all of the drugs you are now taking. Your
eligibility to give blood may be impacted by certain drugs.

• Allergy History: Find out whether you're suffering from any known allergies.

• Vaccination History: If illnesses like malaria are a concern, you can be questioned about recent
immunisations or travels to certain areas.

• Previous Medical problems: State if you have ever had any significant medical problems, such
as cancer, heart disease, or surgery.

3. History of Blood Donations • Previous Donations: Please provide information about your
prior blood donations, including dates, if you have done so. There are certain waiting times
between donations at some blood banks (56 days before whole blood donations, for example).

• Piercings and Tattoos: Your eligibility may be impacted if you have received a piercing or
tattoo within the last six months.

• Travel History: Many blood banks enquire about recent trips, particularly to areas where there
is a greater chance of contracting infectious diseases like Zika, malaria, or other illnesses.

4. Verification of Eligibility

• Weight: A minimum weight of 50 kg or 110 lbs is typically required by the majority of blood
banks. This guarantees that the blood donation won't have any negative consequences on your
health.

• Haemoglobin Levels: Your haemoglobin levels may be checked on-site via a blood test since
low haemoglobin might be a sign of anaemia and exclude you from donating.

• General Health Assessment: On the day of donation, blood banks often enquire about your
general health, including if you have a temperature, illnesses, or cold symptoms. You could be
requested to postpone your gift if you're feeling ill.

5. Permission to Contribute

• Informed Consent: You recognise the procedure and consent to give blood by signing the form.
Blood banks guarantee that donations are private and voluntary.

• Risks: You can be asked to attest to your knowledge of the possible dangers of giving blood,
such as dizziness or fainting. A brief period of rest after donation and adequate hydration may
help reduce these risks, which are negligible.

6. Type of Blood (Optional)

• You could sometimes be questioned about your blood type, if you know it. A blood bank will
often test your blood throughout the donation procedure if you are unsure about your blood type.

7. Contact Details for Emergencies

• Give someone's contact information in the event of a crisis. This individual should be easily
accessible and know that you are giving blood.

8. Date and Signature

• Signature: To attest to the accuracy of all the data you have supplied and your comprehension
of the blood donation procedure, sign the form.

• Date: When completing the form, enter the current date.

Advice on Completing the Application for Blood Donation Form:

• Provide truthful answers: It's important to respond to all questions honestly since every detail
you provide is utilised to protect both your safety and the recipient's.

• Verify your information again: Make sure your name, age, and other personal data are
accurate.

• Carefully read all instructions: Spend some time reading the whole form, paying particular
attention to any warnings and eligibility requirements, before signing it.

One simple but crucial step in the blood donation procedure is completing the donor form. You
may contribute to ensuring the safety of blood donations and the efficient utilisation of donated
blood for people in need by giving correct information. Please feel free to seek assistance from
the donation centre personnel if you have any questions regarding any section of the form.
Prior to and after blood donation

In order to protect blood donors' health and safety and to facilitate their speedy recovery after
the donation, pre- & post-donation care is essential. The following are the procedures that
should be followed throughout the blood donation process for avoidance (pre-donation) and care
(post-donation):

Prior to giving blood, pre-donation care

1. Verification of Eligibility

O Health Screening: To determine eligibility, donors must complete a medical history form.
They must be clear of any illnesses that might jeopardise the donor's health or the donation itself,
including as infections or chronic ailments like diabetes or hypertension.

O Age to Weight: Make sure the donor weighs at least fifty kilogrammes (110 lbs) and is
between the ages of 18 and 65. Depending on the nation, blood centres may have somewhat
varied policies.

2. Drinking plenty of water

O Drink Fluids: In the hours before the donation, it is advised to consume a lot of fluids, ideally
water or juice. This facilitates the donation procedure by preventing dehydration and ensuring
improved blood flow.

3. Have a Nutritious Meal

O Balanced Meal: A few hours before to making

a donation, eat a well-balanced meal. Steer clear of oily or fatty meals since they may affect
blood tests and screening. Iron-rich foods, such as green leafy vegetables, beans, or lean meats,
are good for you because they help keep your haemoglobin levels in check.

4. Steer clear of caffeine and alcohol.

O Restrict Alcohol and Caffeine: For a few hours before to donation, abstain from all forms of
alcohol and caffeine. Dehydration from these might result in light headedness or collapse after
or during the donation.

5. Clothes

O Dress comfortably: Donors should dress in short-sleeved shirts or anything that makes it
simple to reach the vein, which is often located in the inner elbow region.
This facilitates the technician's blood collecting process.

6. Get enough rest.

O Get Enough Sleep the Night Before: It's important to get enough sleep the night before giving
blood since this may assist prevent weariness or dizziness following the donation.

7. Steer clear of strenuous exercise.

O Avoid Excessive Exercise: Steer clear of physically demanding activities, particularly just
before giving blood, since this may cause dehydration or raise your risk of experiencing
dizziness.

8. Speaking with Medical Personnel

Ask Questions: Please do not hesitate to ask the medical professionals at the donation centre any
questions or concerns you may have about your well-being or the donation procedure.

After giving blood, post-donation care

• Recovery and Rest Right After Donation : O Take a 10- to 15-Minute Break: It's crucial
to take a 10- to 15-minute break in a chair that's comfortable after making a donation. This
keeps you from fainting or feeling lightheaded and helps your body adapt to the blood loss.

O Hydrate: After donating, be sure to stay hydrated by drinking plenty of water, juice, or sports
drinks. By doing this, dehydration is avoided and lost fluids are replaced.

2. Energy Snack

O food: Blood donation facilities often include a small food (biscuits,

fruits, or drink) after donation to assist replace depleted energy and raise blood sugar levels. It
is crucial to have this food before to departing in order to avoid feeling weak or lightheaded.
3. Keep an eye out for any negative effects.

O Remain Alert: Pay attention to any potential adverse effects, such as nausea, exhaustion, or
lightheadedness. These are frequent, although they normally go away quickly after rest and
water.

Contact Medical Staff: Notify the staff right away if you feel ill or if you suffer any odd
symptoms, such as severe bleeding, fainting, or persistent dizziness.

4.Steer clear of strenuous physical activity. O Resting for the Day: For the remainder of the
day, refrain from hard lifting, exercise, and physically demanding activities. This can assist
avoid fainting or dizziness and allow the body time to heal. O No Driving Right After Donation:
Avoid using heavy equipment or driving if you feel lightheaded. Before you resume your regular
activities, be sure you are feeling well.

5. Drink plenty of water and eat healthily.

O Keep Drinking Fluids: Donating blood may cause your fluid levels to temporarily drop, so
make sure you keep drinking liquids throughout the day. Rehydration facilitates a quicker
recovery.

O Consume Iron-Rich Foods: Following donation, increase your intake of iron-rich foods such
as spinach, red meat, and lentils. Red blood cells that are lost during donation may be replaced
with iron.

6. Don't drink or smoke for a few hours.

O No Alcohol or Smoking: It is recommended that you abstain from alcohol and smoking for a
couple of hours after blood donation. This is because these behaviours may impair your
recuperation and your body's capacity to stabilise following the donation.

7. Keep an eye on your health throughout the next several days.

O Keep an Eye Out for Symptoms: Get in touch with the donation centre or a medical
professional if you suffer from persistent lightheadedness, exhaustion, or discomfort.

O Feel Sure to Rest More: Allow a few days for your body to recuperate completely.

After donating, the majority of people feel totally good around a couple of hours to a day.

6. Next Donation of Blood

O Wait for Suggested Interval: Blood donation facilities generally advise delaying further blood
donation for the minimum of eight weeks (such as, for the whole blood donation) or longer (for
platelets or plasma donation). This enables your body to properly recuperate and restore the
blood flow.

Crucial Information:

• Side Effects to Watch Out for: Feeling exhausted, lightheaded, or dizzy are some typical post-
donation symptoms. These are often transient and go away fast with enough rest and fluids.

• Warning Signs of Needing Medical Attention: Get help right away if you suffer from severe or
protracted adverse reactions, such as excessive bleeding, chest discomfort, or trouble breathing.

For the donor's safety and wellbeing to be guaranteed, pre- and post-donation treatment are
essential. Donors may help avoid difficulties and speed up their recovery by adhering to the
instructions both before and after giving blood. Donors may preserve their own health while
making a good effect by donating blood, which can save lives.

How the blood bag should be sent In order to guarantee that the blood components are
transported to the appropriate medical units in a timely and safe way, a blood bank's dispatch bag
and dispatch form procedures include a number of crucial processes. Here is a thorough
rundown of the procedure:

1. Blood Bag Preparation and Final Inspection

• Blood Bag Labelling: Each blood bag is meticulously labelled with the following details prior
to shipment:

O Blood type and donor ID

O Type of component (e.g., platelets, plasma, red blood cells)

Date of expiration

O Findings from infectious marker tests (if the blood is safe for transfusion after screening)

• last Inspection: To make sure the right type of blood and component are ready for shipping, a
last inspection is carried out. To make sure the blood bag is suitable for usage, its integrity and
storage conditions are also examined.

2. Component Allocation of Blood

• Depending on patient demands, blood components (such as blood cells, red blood cells, the
plasma, and platelets) are distributed throughout various hospital departments. This could
consist of:

Intensive Care Unit (ICU)

• O Transfusion Medicine O Surgical Units O Emergency Department

• Based on their clinical needs, each department wants various parts of the blood for their
patients (e.g., trauma patients wanting whole blood or anaemia patients needing red blood cells).

3. Form for Dispatch

• A vital document at the blood banks for monitoring the distribution and transportation of blood
bags is the dispatch form. It includes information like:

• O Details about the blood bag (blood kind, component, and amount) O Recipient information
(patient or hospital ward/unit, if relevant)

• O Test findings (verification of the absence of infectious indicators)

• O The delivery date and time (to guarantee timely use and for record-keeping purposes)

• O The authorised personnel's signature (who is in charge of sending the blood)

• O Transportation conditions (e.g., room temperature or refrigerated, if required)

• By monitoring and recording the transfer of blood components, the dispatch form makes sure
that every unit can be located in the event of a problem.

4. Delivery and Transportation

• Typically, blood bags are delivered in temperature-controlled containers (such as cool boxes
for plasma or red blood cells) from a blood centre to the hospital's wards or patient units.

• To avoid clumping, platelets are moved at room temperature (20–24°C) while being stirred.

• To ensure chain-of-custody and avoid confusion, qualified staff transport the blood bags
straight to the department making the request or the patient care unit.

5. Recognition and Document Upkeep

• The receiver unit (such as an ICU nurse, doctor, or ward staff) signs the dispatch form to
confirm receipt for the blood components once the blood bags are delivered to the receiving
department.

• Since it is part of a hospital's inventory & traceability system, the signed form is sent back to
the blood bank to be filed and kept there. This guarantees that the donors and the healthcare
facility unit that got the blood may be identified for each unit.

6. Keeping an eye on the blood

• A system for tracking blood use is also implemented by some blood banks. The receiving unit
records the transfusion time, the patient's reaction, and any potential negative responses once the
blood is administered. To guarantee the transfusion's efficacy and safety, this input is recorded.

An overview of the main steps involved in dispatching:

1. The blood bag's final examination and labelling.

2. creation of the dispatching form, including test results, donor data, and component details.

3. distribution of blood to the proper patient units or departments.

4. Blood bags are transported in containers with regulated temperatures.

5. delivery with a signed acknowledgement of receipt to the department making the request.

6. using the dispatch form for blood delivery monitoring and record-keeping.

Sharda Hospitals Blood Bank guarantees the safe and effective dispatch of blood by adhering to
this structured process, maintaining all required documents for safety, tracking, and regulatory
compliance.

THE NEED FOR BLOOD TRANSFUSION

Many transfusion-dependent patients lack prompt availability of safe blood. Donations are
always needed since blood cannot be kept permanently. To guarantee that there is dependably a
supply for people in need, regular contributions are necessary.

Someone, someplace, needs blood every few seconds. Each year, blood and blood-related
transfusions save millions of lives. Everyone should have the ability to receive safe transfusions
of blood whenever and wherever they are needed since healthcare is a human right.

To ensure that all facilities have a sufficient supply of blood, everyone who is able to donate
should think about making frequent voluntary, unpaid contributions. A vital part of efficient
health systems and a need for universal health care is the availability of secure blood and blood-
related products.

Prior to Transfusion: The following actions are taken before the patient receives blood.
• Checking for syphilis, HIV, hepatitis C, hepatitis B, malaria, and other transfusion-transmittable
illnesses
Doing an antibody screen

•A test for donor and recipient compatibility • Quality assurance

OVERSITE REGULATORY
Numerous federal and state organisations control blood centres and transfusion services. The
FDA is in charge of regulating blood donors and producers of components for blood, and its
inspectors make sure that rules are followed. (the CLIA), which regulate all laboratory testing
on human specimens, are

enforced by the Centres for Medicare and Medicaid Services (CMS). By certifying organisations
whohave shown that their standards and criteria meet or beyond the CLIA laws, CMS assures
compliance with the legislation. To provide the best possible care for donors and patients,
accrediting bodies like the College of American Pathologists and (AABB) collaborate with
blood banks, transfusion services, and donation centres. Principles of Quality in Transfusion
Medicine
Evaluations: Internal and External
Blood banks and blood transfusion
facilities must monitor quality indicators and, if necessary, implement proficiency testing
programs to evaluate their quality systems. The information gathered from this surveillance
should be examined for patterns and chances to enhance procedures. Process and system audits
should also be a part of internal evaluations. The monitoring system should be described in
protocols, including how to handle any problems that are discovered. Many organisations, such
as the government, the FDA, CMS, AABB, and others, are able to conduct external evaluations.
Data should be used to identify areas where
transfusion services and blood banks can improve. The efficiency of adopted corrective and
preventative measures should be assessed, and management of blood banks and transfusion
services should routinely examine data to ascertain the state of the operational procedures and
quality management system. GxP's Conformance to Current Cell Therapies Quality Standards
An Abbreviations List
AABB : Association of American Blood Banks
AHCTA: Harmonisation of Cellular Therapies Accreditation Alliance
ATMPs: Products for Advanced Therapy
CAPA: Preventive/Corrective Measures
CMBPs: Cell-Based Pharmaceuticals
CMO: Organisation for Contract Manufacturing
CRO: Organisation for Contract Research
Federation for Immunogenetics in Europe
GxP : Ethical Scientific Methods
GCP
Appropriate Clinical Procedures
Appropriate Laboratory Procedures
Good Manufacturing Practices
GTP
Appropriate Tissue Techniques
AFACT
The Cellular Therapy Accreditation Foundation
TheFDA
The FDA (Food and Drug Administration)
HCT/P
Human Tissue, Cells, and Tissue-Based and Cellular Products
The stem cells of haematopoietic
ICH
International Harmonisation Conference
IQ, OQ, and PQ
Qualifications for Installation, Operation, and Performance
IND
New Drug Under Investigation
Pluripotent stem cells that were induced
ISBT
International Blood and Transplant Standards
ISCT
The International Society of Cellular Therapy
ISO
Organisation for International Standardisation
ISCT Europe's Joint Accreditation Committee
QA
Assurance of Quality
QbD
Design-Based Quality
Control of Quality
Standard Operating Procedures

COMBINED MEDICINE
The history of "blood banking"
Examples of matured and end-stage cellular
components of the blood that are incapable of undergoing further mitosis or expansion include
red blood cells, platelets, and granulocytes. Historically, the collection,
storage, and use of these types of blood products have been carried out by blood banks. Red
blood cells were the first biological component of human blood for which standardised, reliable
protocols for administration, storage, & collection were created. The ABO system was
discovered by Landsteiner in 1901.1. Oswald Hope Robertson was able to establish a "blood
depot" because to Richard Weil's development of refrigerated storage and Albert Hustin's 1914
creation of sodium citrate for use as an anticoagulant. The United States' first blood bank was
founded in Chicago by Bernard Fantus.3. In order to store and deliver platelet count, red blood
cell plasma, and other components of whole blood independently, techniques were eventually
devised to separate the blood into its constituent elements.
The segregation of components of blood is one of the most crucial processes that occurs in a
blood bank. The many components of blood, such as blood vessels, blood cells, plasma, platelets,
and white blood cells, may be separated and stored independently thanks to this technology. This
facilitates the delivery of the relevant component to patients based on their specific medical
needs. The steps listed below may be used to separate the components of bl

• The collection of blood

• The collection of whole blood involves the transfer of blood from an individual who donated it
into a blood bag that contains a substance called anticoagulant (such as citrate phosphate
dextrose or CPD) in order to prevent the blood from clotting. The collected blood normally
contains all of the components, including red blood cells (RBCs), plasma, platelets, white blood
Other components include platelets.
Eltek Micro-Controller based Blood Centre Weighing Scale is the product in question.
This Blood Bank Weighing Scale, which is based on an Eltek Microcontroller, was developed
specifically for the purpose of weighing blood as well as its components. According to the
specific gravity of the blood components, it is able to provide a precise measurement of the value
01 Blood components.

The Process Called Centrifugation

• The preparation for separation begins with the cautious transfer of the whole blood to the tube
of the centrifuge (or many tubes, if more than one donation is being processed). This occurs after
the blood has been collected. A centrifuge machine is then used to insert the tube once it has
been sealed.
The blood sack or tube is put into the centrifuge, which is then spun at a high speed. This is the
centrifugation process. As a result of the centrifugal force, the components of the blood are
separated according to their respective densities.
O Because they are the heaviest, the red blood cells (or RBCs are the ones that end up to the
bottom. Plasma, that is the component with the least amount of mass, continues to be at the top.
When platelets come into contact with plasma & red blood cells, they create a thin coating that
is referred to as the buffy coat.
• The spinning process typically lasts for around ten to fifteen minutes at a certain speed, with
the whole duration being determined by the tools and the amount of blood being spun.
3. The Segmentation of Components
 Following the centrifugation process, the components of the blood have been physically
separated and are now prepared for collection. Through the use of sterile methods, the various
components are meticulously removed or pulled out.

• Red Blood Cells (RBCs): These are extracted from the bottom of the tube and
placed into a separate bag for storage. RBCs are used to treat anemia, major blood loss, or
surgeries where oxygen-carrying capacity is needed.

Banking of Cord Blood:

Cord Blood Banking Types: Private and Family Banks For-profit businesses known as private
CB banks let people store CBUs for their own or their families' use. Private CB banks have a
presence in many hospital birth areas and obstetrical waiting rooms, and they promote
extensively to the general public and medical professionals. According to their marketing
materials, CB might be used as a source of stem cells for allogeneic or autologous HSC
transplantation.
Donation Directed The CBU may be kept for a patient who already has a family member with a
disease (either hereditary or malignant) who could benefit from a CB transplant. Blood Banks for
Public Cords
CBU donations are received by public CB banks and may be used to any eligible patient who is
not connected to the baby donors. Import/Export and International Development—WMDA:
The Be a Match Registry, a network of blood banks for cord blood in the United States, is among
the biggest. The organisation that runs Be The Match, the NMDP, builds partnerships with public
blood banks in the US and abroad. Every bank in the consortium complies with stringent
requirements and standards to guarantee the quality of every unit posted on the Be a Match
Registry.26 One of these requirements involves having the cord blood of every bank maintain
certification by either the AABB or NetCord-FACT. Of the 24 cord blood banks in the network,
19 are in the United States.27 The remaining cord blood banks are non-US . On September 30,
2013, Canadian Blood Services established a national blood and cord blood bank in Ottawa. The
Hema Québec Cord Blood Centre is another Canadian blood supply bank.

The Value of Blood Banks

Numerous lives are saved by blood banks, which are essential organisations. When a patient
needs a transfusion, they gather, maintain, and deliver blood and blood products. This guarantees
a steady supply of blood for those with blood problems, cancer patients, accident victims, and
surgical patients. Because they provide a consistent and secure supplies of blood to patients in
require transfusions, blood banks are crucial to the healthcare system. They are significant in a
number of important ways:
1. Life-saving Treatments: Patients requiring frequent transfusions due to illnesses including
anaemia, haemophilia, and sickle cell disease, as well as those undergoing surgery, trauma
survivors, and cancer patients, depend heavily on blood banks.
2. Emergency Response: Blood banks are essential for providing prompt access to blood in times
of emergency, such as tragedies or natural disasters, which may mean the difference between an
injured patient'slife and death.
3. Quality and Safety Control: To make sure donated blood is safe for recipients, blood banks
screen it for infectious illnesses. They lessen the chance of spreading diseases like syphilis,
hepatitis, and HIV by upholding stringent procedures for testing, storage, and collecting.
4. Stock Management: To maximise treatment results, blood banks guarantee a consistent supply
of diverse blood components (such as red blood cells, the plasma, and platelets) that are suited
for specific medical demands.
5. Fostering Medical Progress: Blood banks contribute to the advancement of research and the
creation of novel treatments for conditions involving blood and transfusion therapy. In
conclusion, blood banks are essential to contemporary medicine since they not only provide
critical resources for patient treatment but also support medical innovation and public health
safety. Benefits of hospital blood banks
Hospital blood banks provide a number of important benefits, including ensuring that patients get
timely and adequate treatment.
Here are a few main advantages:(2)
1. Prompt Blood Access: O Hospitals that have blood banks guarantee that patients who need
immediate transfusions—such as those having surgery, trauma survivors, or those suffering from
severe anaemia or bleeding disorders—can get blood easily.
2. Life-Preserving Asset: O Transfusions of blood are often necessary to save lives after major
operations, organ transplants, difficult deliveries, or serious accidents involving large blood loss.
3. Specialised Blood Components: Depending on the demands of the patient, hospitals are able to
store and provide certain blood components (such as white blood cells, plasma, and platelets).
For example, red blood cells can be utilised for trauma victims, while platelets may be given to
cancer patients receiving chemotherapy.
4. Emergency Preparedness: Blood banks help hospitals be ready for medical crises when a lot of
people could need blood, such as pandemics, mass accidents, or natural disasters.
5. Better Patient Care: Hospitals can handle complicated cases more skilfully when there is a
ready supply of blood, which improves patient outcomes by providing the right care in dire
circumstances.
6. Virus Control: Hospital blood banks adhere to stringent guidelines for testing and screening
blood donations of infections, guaranteeing the security for blood products and lowering the
possibility of spreading illnesses like syphilis, hepatitis, or HIV.
7. Support for Chronic illnesses: Regular availability to blood products guarantees continued
treatment and an improved quality of life for individuals with chronic illnesses such as
haemophilia, thalassaemia, or sickle cell anaemia.
8. Supporting Research: Hospitals blood banks also assist with clinical research, which enables
researchers to examine blood problems and create novel cures. Essentially, hospital blood banks
provide a quick, safe, and dependable source of blood for a range of medical requirements,
increasing patient care and health outcomes.

Blood Component Extractor and

Apheresis Machine.
The government of India must establish additional blood banks for a number of reasons.
A rise in the demand for blood With a big population, India's need for the blood and its
constituents is continuously expanding as a result of more operations, medical procedures,
accidents, and chronic illnesses including anaemia and cancer. Having more blood stores would
help guarantee a sufficient supply.
2. Fair Blood Distribution: O Since most blood banks are now located in cities, access to blood is
restricted in rural and isolated places. All patients, no matter where they live, would have access
to lifesaving blood supplies if there were more government-owned blood banks spread out
around the nation, particularly in underprivileged regions.
3. Better Healthcare Infrastructure: The construction of more blood banks fortifies the healthcare
system as a whole. It enables medical facilities to provide patients in need of blood transfusions
prompt, high-quality treatment, lowering complications and enhancing patient outcomes.
3. Being Ready for Emergencies and Disasters:
Having additional blood banks would guarantee that there is a sizable, readily accessible supply
of blood ready for use right away in emergency circumstances, such as pandemics, accidents, or
natural disasters, potentially saving lives.
4. Assistance for Long-Term Conditions:
A sizable population in India needs frequent blood transfusions due to illnesses including
haemophilia, sickle cell anaemia, and thalassaemia. These patients' quality and life and health
results would improve if there were more blood banks to guarantee a consistent supply.
5. Secure Blood Source:
O Strict guidelines are followed by government-run blood banks for testing blood for syphilis,
HIV, Hepatitis B and C, and other infectious disorders. The government can guarantee that more
individuals have a choice of safe, screened blood and lower the dangers of disease transmission
by expanding these facilities.
6. Cost Cutting:
O By lowering the expense of blood gathering, testing, and storage, public blood banks may
assist those in need—especially those from low-income backgrounds—afford blood transfusions.
7. Raise Awareness of Blood Donation:
In order to ensure a sufficient supply of blood, greater numbers of blood banks would promote
public awareness and involvement in voluntarily donating blood programs. If blood donation
facilities were easily accessible, these initiatives would have a higher chance of success.
8. Medical Research and Developments:
O Additionally, government-run blood banks might act as research hubs, assisting in the creation
of novel methods for blood storage, transfusion, and the treatment of blood-related illnesses, all
of which would eventually improve the healthcare system. To sum up, adding new blood banks
to India will solve important problems with infrastructure, safety, accessibility, and blood
availability—all of which are key for enhancing the country's healthcare results and saving

Regulations and Accreditation/Licensing

Because CBB and UCB donation operations include the transportation and shipment of a
biological product across nations, they must function in a highly controlled setting to guarantee
the safety and quality of the donated tissue. To facilitate this work, the AABB and NetCord-
FACT have created standards and certification programs. According to these criteria, all labs that
support CBB operations must also have the necessary supplementary accreditations in place,
such as WMDA for the registry aspects and the European Federation for Immunogenetics or
the aspects. Internationally, Standards, not the NetCord-FACT or AABB Standards, govern every
aspect of clinical transplantation of UCB cells.
In recent years, there has also been a notable growth in the regulatory issues pertaining to CBB's
operations. Human tissue and cell donation, purchasing, testing, manufacturing, conservation,
storage, and distribution are all governed by EU Directives 2006/17/Ec and 2006/86/EC, which
address quality and safety concerns. According to these instructions, every member state must
have mechanisms in place for certification and inspection to make sure that all banks offering
these services adhere to a set of established criteria. The Humans Tissue Act was established in
2004 and went into effect in April 2006.98 In the UK, all facilities that provide human tissues
and cells for medicinal purposes are covered by the Standards of Conduct for Tissue Banks,
which was issued in 2001. This serves as the foundation for a Department of Healthcare
accreditation program, which all CBBs in the UK must adhere to in order to get a licence. The
Medicines and Health Products Regulatory Agency conducts inspections.
In order to promote adherence to Current Good Tissue Procedures 21 CFR 1271.210, the FDA
(Food and Drug Administration) in the United States implemented regulations governing the
production of unrelated UCB in 2005. The FDA released a draft recommendation later in 2007
suggesting that CBB be licensed to produce UCB units. This was ultimately put into effect in
2011, and in order for any producer of UCB units to transport a UCB into the US, they must have
an approved Pharmaceuticals License Registration or Investigational The new Drug Application.
A UCB unit is treated as a biologic drug under this rule.

Overview:
Blood serum that contains antibodies against certain antigens is referred to as an antiserum. It is
frequently employed in the grouping of blood to determine if certain antigens are present on red
blood cells (RBCs). Blood grouping is essential for organ transplants, safe blood transfusions,
and preventing haemolytic illness of the foetus and newborn (HDFN) during pregnancy.

Principles of Antiserum-Based Blood Grouping:

• Reaction between Antigen and Antibody
The agglutination principle, in which antibodies within the antiserum attach selectively to
antigen on the red blood cells, is the basis for blood categorisation. The presence of a
particular antigen is confirmed by this binding from observable clumps (agglutination).
2. Antiserum Specificity Antisera have a high level of specificity. For instance:
• RBC A antigens are bound by anti-A serum.
• B antigens are bound by anti-B serum.
• The factor known as Rh (D antigens) is detected by anti-D serum.
• Cell grouping, or forward typing.
• • Certain antisera (anti-A antibodies, Anti-B, and Anti-D) are combined with a patient's
red blood cells.
 • The presence of matching antigens is shown by agglutination.
4. Reverse Typing (Serum Grouping): Known A and B RBCs are combined with the patient's
serum.
• The presence of antibody in the serum is shown by agglutination.
ABO and Rh tolerance are determined by the use of antiserum in blood grouping.
• Management of Pregnancy
To avoid this, find Rh incompatibili

Anti Serum ABD Blood Grouping.

Method:
1. Get the materials ready Gather the patient's blood sample, antisera (the anti-A, the anti-B, and
anti-D), and sanitised glass slides.
2. Blending On a glass slide, place one drop of every antiserum in a different position. Then, add
a drop of the blood for each spot and combine
3. Observation: Examine the agglutination of the adversary in the presence of light. Complement
the findings with established antigen-antibody responses.
Use: 1. Transfusion of Blood prevents transfusion reactions by guaranteeing blood type
compatibility between the donor and the receiver.
2. HDFN Organ Transplant.
3. Medicinal Science used in criminal investigations and paternity testing. Take the following
precautions:
Use new reagents and appropriately marked antise
. Prevent sample contamination.
. To guarantee accuracy, interpret the results within a certain time limit.
Blood Grouping by ABO: Based on the existence or lack of certain antigens on the outermost
layer of the red blood cells with the associated antibodies in the plasma, the ABO blood
classification system serves as a way to categorise human blood. Karl Landsteiner won the 1930
Nobel Prize in medicine or physiology for his 1901 discovery. ABO Blood Grouping Principles:
1. Red blood cell antigens: • Blood group A contains antigen A.
Blood group B contains antigen B.
• Blood group AB contains the two antigens A and B.
• Blood group O contains no antigens. Plasma Antibodies:
• Anti-B antibodies are present in blood group A.
• Blood group B: Anti-A antibodies are present.
Blood group O: Has antibodies against both A and B (universal donor); blood group AB: Has no
antibodies (universal receiver).
Inheritance: • The ABO gene, which has three alleles (A, B, and O) on chromosome 9,
determines blood type.
• Mendelian genetics governs blood type inheritance, with the O allele being recessive and the A
and B alleles codominant.
• Agglutination response:This response serves as the foundation for blood grouping.
• Agglutination is a sign that the relevant antigen is present when blood is combined with certain
anti-B antibodies.
5. Cross-matching: To make sure there is no agglutination, both donors and recipients of blood
are mixed prior to transfusion to verify blood compatibility. Classification of the ABO Blood
Group System: Blood Antigens and Antibodies Group on RBCs in plasma: Donor-Recipient
Compatibility Compatibility
A A Anti-B A, O A, and AB Anti-A B, O B, and AB B B B ,AB, A, and B Not one AB Universal
Recipient O Nonexistent Universal O and Anti-B Donors (o) and Anti-A
Uses: 1. Blood Transfusion: To prevent transfusion reactions, make sure the donor and receiver
are compatible.
2. Organ transplantation: Used to assess compatibility between donors and recipients.
3. Paternity testing: Disputes may be settled by blood group inheritance.
4. Forensic Science: The blood grouping helps identify victims and conduct criminal
investigations.
1. Avoids Immune Responses
• The recipient's immune system could attack the blood of the donor cells if inappropriate blood
is transfused since the immune system is able to identify alien substances. In order to avoid
potentially serious responses like haemolysis (the breakdown of red blood cells), blood grouping
makes certain that the blood's cell type (A, B, AB, and O) & Rh factor (whether positive or
negative) match.
2. Determines Blood Types That Are Compatible

Blood Type B contains B antigens with anti-A antibodies, whereas Blood Type A includes A
antigens in red blood cells & anti-B antibodies within plasma.
• Blood Type AB (universal plasma donor) contains both the A and B antigens & no anti-A as
well as anti-B antibodies.
• Blood Type O contains antibodies against both A and B, but neither A nor B antigens.
Agglutination, or the clumping of the red blood cells, and haemolytic responses, which may
harm organs and be lethal, are two potentially catastrophic outcomes of incompatible
transfusions.
3. Guarantees Safe Transfusion and Blood Donation
• Blood grouping aids in identifying universal receivers (Type AB positive) and universal blood
donors (Type O negative). This is especially helpful in emergency situations when precise
matching might not be feasible due to time constraints.
• Another crucial component of blood compatibility is the Rh factor. Receiving Rh-positive
blood might cause an individual with Rh-negative blood to develop antibodies that attack the Rh
antigen, which could cause problems with further transfusions or pregnancies.
• Prevents newborn haemolytic disease (HDN)
• Haemolytic disease of a newborn (HDN) may result from a Rh-negative mother carrying a Rh-
positive
child because the mother's immune system may create antibodies that attack Rh-positive blood
cells. Rh factor testing and blood grouping aid in the management of such circumstances, and Rh
immunoglobulin is given to avoid problems.
• Enhances Blood Utilisation
• Accurate blood typing enables blood banks to maximise the availability of various blood types,
guaranteeing that patients may get the appropriate kind of blood according to their
certain requirements. Depending on the patient's blood group, hospitals might ask the blood bank
for certain blood components (such as blood cells that are red, platelets, and plasma).
6. Raises the Success Rate of Transfusions
• Especially in cases of surgery, trauma, cancer therapies, and chronic illnesses that need repeated
transfusions, appropriate blood grouping as well as crossmatching serve to optimise a successful
of the blood transfusions, minimising adverse responses and increasing patient outcomes.
Blood grouping in blood banks is crucial for both patient safety & the effectiveness of
transfusion treatments. In order to minimise potentially harmful responses and improve patient
care, it guarantees that the blood transfusion is compatible to the recipient's immune system.

Infections passed transmitted via blood transfusions

The prevalence of HIV positive among donors of blood was determined to be 0.14%, whereas
the prevalence of hepatitis C was 0.34%, hepatitis B was 0.87%, syphilis was 0.17%, and malaria
was 0.06%. Nevertheless, there is a significant amount of variety amongst the various states.
The Separation of Components In India, about 71% of the blood units that were collected by
blood banks that housed component separation facilities were used for the purpose of component
separation.
The proportion of components that were separated was greater in blood banks that were not
funded by NACO (75.4%), as opposed to blood banks that were supported by NACO (67.3%).
Systems for the Management of Quality
It was stated by 91.5% of blood supply banks that they followed the rules set out by the NBTC.
The availability of a system for managing documents was reported by a smaller percentage of
blood donation centres in the nation than other blood banks. Nearly 42 percent of blood banks
that are funded by NACO and 55 percent of blood banks that are not supported by NACO
reported having a records control system. Blood banks have reported having SOPs, or standard
operating procedures, for technical operations, with more than 95% of them having these
procedures. Internal quality control (the IQC) for immune haematology was stated by 78 percent
of the blood banks, while IQC for transfusion-related infections (TTIs) was reported by 52% of
the blood banks. On the other hand, there was a modest difference between blood banks that
were sponsored by NACO and those that were not supported by NACO.
It was observed that roughly 86 percent of the blood banks in the area carried out quality control
procedures for blood bags, kits, and reagents. The percentage of blood banks in India that have
registered themselves in Exterior Quality Assurance Systems (EQAS) by recognised suppliers
for immunohematology and TTIs, respectively, is just 12.6% and 11.2%, respectively. The
National Accreditation Board of Hospitals and Healthcare Providers (NABH) granted
accreditation to just 73 blood banks, which is a mere 2.9% of the total number of blood banks
that took part in the evaluation.
In 37.9% of the blood banks, authorised as well as trained Quality Managers were available,
while in 48.2% of the blood banks, skilled Technical Managers were accessible. It was reported
by more than 85 percent of the blood banks that they had a program for the routine maintenance
of their equipment, and almost 89 percent of them said that regularly calibrate the equipment
according to the requirements.
Taking into consideration the evaluation, the existing situation of blood banks
A mean score of 62 was allocated to blood banks throughout the nation, with a standard
deviation of 11.19. The non-NACO blood donation centres had a significantly better score
(62.68; standard deviation: 10.63) than the blood banks that were financed by NACO. Nearly
seventy-eight percent of all blood banks that were funded by NACO were located in the public
sector and were present in sub-divisional and divisional/district hospitals. These blood banks
served all segments of the population, including rural regions. However, the vast majority of the
non-NACO blood donation centres were located in thenonprofit and not-for-profit sectors,
accounting for 95% of the total.
The blood banks that were recognised by (the NABH) were found to have a mean score that was
greater than the scores of those blood banks that were not accredited. The results of the
evaluation make it abundantly clear that blood banks that placed a greater emphasis on quality
improvement methods did much better than their counterparts. Taking into consideration the
detrimental impact that low-quality practices have upon patient care, it's of the utmost
importance that specific programs and strategies to enhance high-quality systems for blood
transfusion centres be devised and put into action throughout the nation.
Does a blood bank's viral marker test matter?
To guarantee the safety for blood-related substances used in transfusions, blood banks must
perform infectious marker testing. All donated blood undergoes these tests in order to identify
any possible illnesses that may be passed on to the receiver. This is why they are so important:
1. Stops the Spread of Disease : Blood donors undergo extensive testing for infectious disorders
such as malaria, syphilis, hepatitis B and C, and HIV. In the absence of these tests, the receiver
runs the danger of contracting infections from the donor, which might cause life-threatening
illnesses or even death.
2. Guarantees a Secure Blood Supply
• Infectious marker testing guarantees the safety of transfusion-grade blood. It is crucial to make
sure that blood is clear of germs that might cause serious diseases like HIV, Hepatitis, as well as
West Nile Virus since blood products will be transfused straight into a patient's circulation.
3. Safeguards Both Recipients and Donors
• Safety of the donor: Certain tests, such those for hepatitis or HIV, may also help detect illnesses
in the person who donates that they might not be conscious of. This lowers the chance of the
infection spreading further by enabling a blood centre to offer guidance or a referral for suitable
treatment.
• Recipient safety: The main goal is to prevent receivers from contracting infectious infections,
particularly those who are having surgery, crucial therapies, or have compromised immune
systems.
4. Lowers the Chance of Infections After Transfusion
• To lower the risk of post-transfusion infections, blood banks screen for diseases including
hepatitis, HIV, and syphilis. Although they are uncommon, transfusions of contaminated blood
may result in immune system diseases, chronic infections, and other severe health issues.
5. Observance of safety regulations
• Health authorities in several nations, including India, have established stringent rules and
regulations for blood banks. These rules, which include infectious marker testing, guarantee that
blood banks meet both domestic and international safety and quality requirements.
6. Avoids Hazards to Public Health
The importance of blood banks in public health is vital. The tests aid in limiting the possibility of
infectious illnesses spreading to large populations. For instance, if blood is not adequately
screened, transfusion-transmitted HIV or hepatitis might have major public health repercussions.
7. Encourages Confidence and Trust in the Donating Blood System
• The public's confidence in the process of blood donation procedure is bolstered when blood
banks do thorough testing for infectious illnesses. If donors are aware that the blood being drawn
is being tested for safety, they are more inclined to donate. In a similar vein, both patients and
medical professionals are certain that transfusions remain safe.
8. Boosts the Efficiency of Blood Banks
• The integrity and security of the human blood supply are preserved when contaminated blood is
recognised and disposed of before it is utilised. It maximises the blood bank's overall
performance by guaranteeing that only safe, clean blood is accessible for medical use.
Typical Infectious Marker Tests:
Human immunodeficiency virus, or HIV: To identify HIV-1 and HIV- 2
• Hepatitis B: Antibodies to the HBV core and tests of the surface antigen of HBV (HBsAg).
• Hepatitis C: Checks for antibodies to HCV or the genetic material (RNA) of the virus.
• Syphilis: Treponema pallidum antibody detection.
• Plasmodium spp. testing for malaria. (parasites of malaria)
An essential part of blood safety is the use of infectious marker testing. By assisting in the
detection of any illnesses in given blood, they lower the possibility of disease transmission to
recipients. These tests safeguard the public's health, guarantee the safety of blood transfusions,
and improve blood banks' overall capacity to save lives.
Principles and Procedure for Cross-Matching Blood Tests in Blood Banks:
Definition:
Before a blood transfusion, a laboratory test called cross-matching is done to make sure the
recipient's and donor's blood are compatible. The test finds any possible incompatibilities that
might result in a transfusion response, such agglutination or haemolysis.
Cross-Match Types:
• Significant Cross-Match:
• Makes a comparison between the recipient's serum and the donor's red blood cells (RBCs).
• Identifies recipient antibodies that could react with donor red blood cell antigens.
• Small Cross-Match: • Examines the recipient's red blood cells and the donor's serum.
• Identifies antibodies in the donor's plasma that might react with recipient red blood cells (less
often done since donor blood is pre-screened).
The idea Antigen-antibody interactions are the foundation of the cross-matching principle:
 1. Agglutination: Visible clumps are formed when antibodies in the recipient's serum attach to
antigens on the donor red blood cells.
2. Haemolysis: Donor red blood cells may be destroyed as a consequence of incompatible
responses.
The test makes sure that: • When donor and receiver blood samples are mixed, neither
haemolysis nor agglutination takes place.
• The receiver of the blood transfusion won't react negatively.
Cross-matching steps:
• Gathering of Samples:
• Take blood samples from the receiver as well as the donor.
• To prevent mistakes, label and store properly.
• Important Cross-Matching Steps:
• Step 1: Combine donor red blood cells with the recipient's serum.
• Step 2: Give the mixture a 15–30 minute incubation at 37°C.
• Step 3: To identify partial antibody responses, add an anti-human globin reagent
(Coombs reagents).
• Step 4: Use a microscope to check for agglutination or haemolysis.
3. Procedure for Minor Cross-Matching:
• Using a similar procedure, combine recipient RBCs and donor plasma and monitor for
responses.
• Meaning:
• Compatible: There was no evidence of haemolysis or agglutination. Incompatible: If
haemolysis or agglutination is found, the blood shouldn't be transfused.
The significance of cross-matching
• stops transfusion-related reactions like:
• An acute haemolytic response.
• Non-hemolytic, foetal responses
• Anaphylaxis or other allergic responses.
2. Make sure blood transfusion procedures are safe.
3. detects unexpected antibodies or uncommon blood type incompatibility.
Restrictions:
• Unable to identify uncommon antigens or very low antibody levels. • Takes longer than
electronic cross-matching.

Techniques
Methods used in blood banks to screen for infectious markers To guarantee that blood donated is
safe for transfusion, a blood bank must screen for infectious indicators. Infectious disorders
including syphilis, hepatitis C, hepatitis B, and HIV are less likely to spread as a result. Blood
may be tested for these very sensitive and dependable infectious indicators using a variety of
methods. The primary methods are listed below.
• ELISA, or Enzyme-Linked Immunosorbent Assay
• How it operates: ELISA is a popular immunoassay method for identifying blood antigens or
antibodies. There are many stages involved:
O Antigens or antibodies unique to the infectious disease are combined with the sample
(donated blood).
O The pathogen will attach itself to the appropriate antibody or antigen if it is present within
the blood.
O The presence for the infection is shown by a colour shift caused by an enzyme connected
to the antibody.
• Uses: HIV, Hepatitis B and C, , & Syphilis are often tested for using ELISA.

Testing for Nucleic Acids (NAT)

• How it operates: NAT is a very sensitive
test that finds the pathogen's genetic material (DNA or RNA) instead of antibodies or antigens.
The procedure entails: Taking the blood sample and extracting the nucleic acid.
The PCR, or polymerase chain reaction, is used to amplify the target RNA or DNA. O Finding
out if the pathogen is present by detecting the amplified material.
• Uses: NAT is mainly used to identify hepatitis B, hepatitis C, and HIV infections within
donated blood. Compared to antibody-based testing, it may identify infections sooner.
Among its benefits are its increased sensitivity and ability to identify infections within the
"window period"—the interval between infection and the generation of detectable antibodies.
• The Western Blot Test
• How it operates: Western Blot serves as a confirming test that finds certain blood proteins,
often known as antigens or antibodies.
O To separate proteins by size, a human blood specimen is first subjected to gel
electrophoresis.
O Following their transfer to a membrane, the proteins are treated with certain antibodies.
O Bands on the cell membrane will indicate the presence of certain proteins, which are a sign
of infection.
• Uses: It frequently serves as a hepatitis C, HIV, and sometimes syphilis confirmatory test.
• Benefits: It has a good specificity and may support the validation of ELISA and other
screening test findings.
4. RDTs, or rapid diagnostic tests
• How it operates: RDTs are straightforward, rapid, and user-friendly tests that provide
answers in a matter of minutes. Such tests use immunochromatographic techniques, in which
a visible result is produced when the blood sample's antigen or antibody binds with a reagent
on a test strip.
• Uses: RDTs are often used for screening for Hepatitis B, HIV, and Hepatitis C.
• Benefits: These tests are rapid and simple to administer, which makes them helpful for
point-of-care testing or in environments with limited resources.
• Immunoassay using Chemiluminescence (CLIA)
• How usually works: CLIA functions similarly to ELISA, however it indicates a positive
result via chemiluminescence, or light emission, rather than colour change.
O When triggered by a chemical process, antigens or antibodies are affixed to a
semiconductor that releases light.
O The quantity of infection-related material in the blood is assessed by measuring the light
that is released.
• Uses: Hepatitis B, Hepatitis C, and HIV may all be detected using CLIA.
• Benefits: CLIA offers superior precision in identifying low levels of disease indicators due
to its great sensitivity and accuracy.
6. Immunofluorescence Indirect (IFA)
• How it operates: IFA is a lab procedure in which the appropriate antigen placed on a slide is
bound by antibodies within the blood sample. After then, a secondary antibody that has been
fluorescently labelled is added. The attached antibodies will glow when exposed to UV light,
indicating the existence of infection.
• Uses: Although it is less popular than other techniques, it is used for screening for syphilis,
HIV, and hepatitis B.
• Benefits: IFA is used to establish the presence of certain infectious agents and is very
sensitive and specific.
• PCR stands for polymerase chain reaction.
• How it operates: PCR increases an infectious agent's DNA or RNA to levels that can be
 detected. Even if measurable antibody levels have not yet been produced by the
immunological response, this test can nevertheless identify virus-specific genetic material.
• Uses: PCR may be used to identify West Nile virus, HIV, Hepatitis B, and Hepatitis C. It is
particularly helpful in the early detection of viral infections.
• Benefits: PCR, which may identify infections throughout the "opening period," when
antibodies may not yet be present, is very sensitive and accurate.
• Tests for Haematology (Syphilis)
• • How it works: Tests for syphilis, such as the Rapid Plasma Reagin (RPR) test and the
VDRL, or Venereal Disease Research Laboratory, test, identify the presence of specific
antibodies produced in reaction to the traitor bacterium (Treponema pallidum).
O A combination of patient blood and antigen is used in the tests; the presence of antibodies
is indicated by the creation of clumps or flocculation.
Uses: Syphilis via blood donations is especially detected by these tests.
Benefits: They are simple and rather fast to complete.
• Blood Culture for Infections by Bacteria
• How it works: Blood culture tests may be carried out when a bacterial infection is
suspected. For the purpose of identifying the bacteria, a blood sample is cultivated in a
growth medium.
• Applications: Although it's less often used for normal blood screening, this test is primarily
utilised to identify bacterial illnesses like sepsis or bacterial endocarditis.
• Benefits: It is a very targeted technique for identifying bacterial infections.
The methods a blood bank uses to screen for infectious indicators guarantee that donated
blood is safe during transfusion and aid in stopping spreading of infectious illnesses. ELISA,
or NAT (Nucleic Acid Test), Western Blot, rapid diagnostic tests, and CLIA are some of the
primary methods.
These tests guarantee that patients get only safe blood since they are very sensitive and
specific.

In conclusion
Every day, around 15 patients in need of blood donations come to our blood bank. Only ten
people are able to give blood every day, however. About 60% of these 10 contributors come out
to provide money expressly to help a friend or family member who represents a client in need.
To guarantee the safety and purity of the blood, we conduct thorough infectious marker testing
after the donation. Our results indicate that around 20% of screened blood donors exhibit
infection-related symptoms. Because of the potential for infection transmission, we are unable to
keep the blood donated by these contributors in the blood bank. This emphasises the need of
appropriate donor screening as well as the necessity of ongoing watchfulness to guarantee that
only secure blood is kept in storage and utilised for transfusions. To guarantee the effectiveness
and safety of blood donations, gathering, evaluation, separation, storage, and dispatch, Sharda
Hospital Blood Bank uses a number of crucial procedures.
Here is a quick summary of the main methods and approaches used:
Methods for Learning the
Infectious Marker Test
• Testing for infectious markers is essential to guaranteeing the safety of donated blood. In order
to identify illnesses like the HIV virus, Hepatitis B, C, and Syphilis, the blood is examined using
methods like Western Blot, Nucleic Acid Testing (NAT), an Enzyme-Linked (ELISA), (RDTs).
This prevents illnesses from spreading by guaranteeing that only healthy blood is kept for
transfusion.
Blood Collection for Donation • Following a rigorous screening procedure that includes
background checks and eligibility requirements according to age, weight, and health, donors'
blood is taken. Usually, a sterile needle is used to draw blood from a donor's vein, which is often
in the arm. To avoid clotting, the entire blood is drawn and placed in a blood bag containing an
anticoagulant. Following the collection, donors are requested to take a break and drink some
water.

Blood Bag Types • The blood bank uses sterile blood bags, which are available in different
varieties to collect different blood components. Among the most prevalent kinds are:
O Whole blood bags: Used for whole blood collection.
O Component separating bags: specialised multi-compartment bags that separate blood
components such as red blood cells, platelets, and plasma.
O Platelet or plasma bags: For a particular kind of platelet or plasma collection.
Anticoagulants such as citrate phosphate dextrose (CPD) are included in these bags to preserve
blood's nutrients and stop clotting while it is being stored.

• Pre- and Post-Donation Care

• Pre-Donation Care: Donors are evaluated for eligibility before to donation, which includes
making sure they are hydrated, healthy, and free of illnesses. It is recommended that they
have a well-balanced diet and stay hydrated.

• Post-Donation Care: In order to restore blood volume, donors are encouraged to relax for
ten to fifteen minutes and drink fluids. A little snack is offered to aid with energy restoration.
Additionally, donors are encouraged to stay hydrated and refrain from physically demanding
 tasks for the following 24 hours.

Distinguishing Blood Components

• Following collection, centrifugation is used to separate the components of the blood. This
entails rapidly centrifuging the blood to separate its constituent parts:
O Plasma, or the liquid part
O Red red blood cells (for those with anaemia)
O Platelets (for diseases of coagulation)
O White blood cells (occasionally used for certain medical procedures)
• Every part is gathered into distinct bags, guaranteeing that each one may be used to certain
medical situations.
Blood Storage

• To maintain their integrity, blood components are kept at certain temperatures in blood
refrigerators:
O The red blood cells have a 42-day shelf life and are refrigerated at 2–6°C.
O Plasma may be kept for a maximum of twelve months when frozen at -18°C.
O Platelets must be utilised within 5–7 days and are kept at room temperature (20–24°C) with
continuous stirring.
• Proper preservation preserves the blood components' usefulness for transfusion and guarantees
their lifespan.
Sending the Blood Bag Out
• The blood components are prepared for shipment after testing and storage. The blood bank
makes certain that the proper supplies are sent to the necessary hospital departments, including
the intensive care unit, emergency room, surgical units, and other healthcare areas.

• The donor's details, blood type, and any pertinent test results—including those from infectious
marker tests—are meticulously labelled on blood bags. Blood is delivered in a safe manner to
preserve its quality until it is transfused thanks to the dispatching procedure.
In order to supply safe blood for patients in need, Sharda Hospital Blood Bank makes sure that
all processes—from donation to examination, separation, storage, and dispatch—follow the
strictest guidelines.
Systems for the Management of Quality
It was stated by 91.5% of blood supply banks that they followed the rules set out by the NBTC.
The availability of a system for managing documents was reported by a smaller percentage of
blood donation centres in the nation than other blood banks. Nearly 42 percent of blood banks
that are funded by NACO and 55 percent of blood banks that are not supported by NACO
reported having a records control system.
Blood banks have reported having SOPs, or standard operating procedures, for technical
operations, with more than 95% of them having these procedures. Internal quality control (the
IQC) for immune haematology was stated by 78 percent of the blood banks, while IQC for
transfusion-related infections (TTIs) was reported by 52% of the blood banks. On the other hand,
there was a modest difference between blood banks that were sponsored by NACO and those
that were not supported by NACO.
It was observed that roughly 86 percent of the blood banks in the area carried out quality control
procedures for blood bags, kits, and reagents. The percentage of blood banks in India that have
registered themselves in Exterior Quality Assurance Systems (EQAS) by recognised suppliers
for immunohematology and TTIs, respectively, is just 12.6% and 11.2%, respectively. The
National Accreditation Board of Hospitals and Healthcare Providers (NABH) granted
accreditation to just 73 blood banks, which is a mere 2.9% of the total number of blood banks
that took part in the evaluation.
REFERENCE

• C.D Hillycr, et al., blood banking and transfusion Med icin: Basic principles and practice,
2nd ed. Philadciphia, PA: Elsevier, 2007
• Elston, R. C., and J. C. Pickrel: Guides to inventory levels for a hospital blood bank,
determined by electronic computer simulation.
3.Hod. Eldad A.: Zhang, Ning; Sokol, Set A.; Wojczyk, Boguslaw S.; Francis, Richard O.;
Ansaldi, Daniel; Francis, Kevin P.; Della-Latta, Phyllis: Whittier, Susan; Sheth. Sujit
Hendrickson, Jeanne E.; Zimring, James C.; Brittenham, Gary M.; Spitalnik, Steven L (27 May
2010)
4. Devine, D. V.; Serrano, K. "The Platelet Storage Lesion". Clinics in Laboratory Medicine.
30 (2): 475-87. Doi: 10.1016/j.cll.2010.02.002. PMID 20513565
• Landsteiner, K. (1901). "Uber Agglutinationser scheinungen normalen menschlichen
Blutes." Wiener Klinische Wochenschrift, 14(52), 1132-1134.
• Dean, L. (2005). The ABO Blood Group System. National Center for Biotechnology
Information (NCBI).
7.Daniels, G. (2013). Human Blood Groups. John Wiley & Sons.
8. 1. Harmening, D. M. (2018). Modern Blood Banking and Transfusion Practices. F.A.Davis
Company.
9.WHO. (2023). Guidelines on Blood Group Serology. World Health Organization