AUDIT OF BLOOD BANK, JPNATC JANUARY

2013 – DECEMBER 2013

Dr S Arulselvi, Dr Sulekha Karjee, Dr Vedanand Arya

DONATIONS

ReplacementDonors

Voluntary donors Total donors

2010 7922 1045 8967

2011 7848 1339 9135

2012 7834 2079 9913

2013 7038 1768 8810

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REPLACEMENT DONATION

OPDCasualty

TC1 TC2 TC3 TC4 TC 5 TC 6 TC 7Autolog.

Therap.

2011 205 189 106 1550 2623 842 710 1047 1234 0 0

2012 140 97 468 1527 2714 1003 496 1224 1277 5 2

2013 48 97 481 1777 2322 819 482 991 1165 1 0

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COMPONENTS

PRBC FFP Platelets Cryo

2011 9135 8604 8152 399

2012 9912 9391 7892 463

2013 8810 7678 6925 865

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Component preparation since 2011 to 2013

TTI LAB

HIV HBsAg HCV Syphilis Malaria

No of tests done 9103 9189 9106 9364 8842

Positive donors 19 172 66 26 3

9103 9189 9106 93648842

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DONOR COUNSELING

Counseling of blood donors tested positive for the TTI was started in June 2009

296 blood donors who had donated in JPNATC blood bank in 2013, were called for counseling out of which 63 donors reported and were counseled for their respective infectious state

After a repeat test of these donors they are referred to the

ICTC (Integrated Counselling and Testing Centre)

Gastroenterology

Skin and VD

CROSS-MATCH TRANSFUSION RATIO

16851864

22502048

21842013

2262

2663 2607 2562

23302209

647 686 765 715 749629 696

818 855 868 819656

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Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

RBC units cross-matched - units issued

CROSS-MATCH:TRANSFUSION (C:T) RATIO

ratio of the number of blood units that are cross-matched for

patients to the number of blood units that are actually issued.

For the year 2011 the C:T ratio was 1:2.5 which increased to

1:2.6 in 2012 and 1:2.9 in 2013

Any blood unit cross-matched for a patient is kept reserved for

that particular patient for 24 hrs or till the time information is

not given to the blood bank that the blood unit is no more

required for the patient

A high C:T ratio indicates that more blood units are

unnecessarily being blocked and lesser free blood units would

be available for use

01:02.2

01:02.6

01:03.1

2011 2012 2013

C:T RATIO

C:T RATIO

SALINE CROSSMATCH (TOTAL=3640)

3162

340

93 430

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<15 min 15-20 min 20-30min 30-60 min

FULL CROSS MATCH (TOTAL=22738)

1465 1689

19584

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<45 min 45-60 min >60 min

REASONS FOR DELAY

Delay/ non receipt of requesting cross-matched

component

Wrong sample, labelling errors, incorrectly filled

requisition forms

Delay in obtaining consent for saline cross-match,

alternate blood group

Forward-reverse blood group discrepancies in

sample

ALTERNATE BLOOD GROUP ISSUED

MONTH NO. OF PATIENTS NO. OF PRBC ISSUED BLOOD GROUP

JAN 1 1 A pos --- A neg

FEB 8 24 O neg --- O pos

AB pos --- B pos

AB neg --- B neg

B pos --- B neg

MAR 2 3 (2 RB) A pos --- O pos (RB)

A pos --- A neg

MAY 1 4 O neg --- O pos

JUN 4 14 AB pos --- A pos

AB pos --- B pos

JUL 2 6 A neg --- O neg

B neg --- B pos

AUG 2 4 AB neg --- B neg

SEP 7 17 B neg --- O neg

AB neg --- A neg

B neg --- B pos

OCT 2 5 B neg --- B pos

B neg --- O neg

NOV 3 5 B neg --- O neg

A pos --- A neg

DEC 1 4 A neg --- O neg

TOTAL 33 87 (2 RB) Mostly Rh Neg patients

MASSIVE BLOOD TRANSFUSIONS

MONTH NO, OF PATIENTS TOTAL NO. OF PRBC ISSUED

JAN 2 46

FEB 3 71

MAR 7 119

APR 8 132

MAY 3 95

JUN 4 60

JUL 6 90

AUG 8 150

SEP 7 112

OCT 7 91

NOV 6 126

DEC 1 22

T0TAL 62 1114

PLATELETS AND FFP ISSUED

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Platelets issued 181 416 542 493 599 417 440 451 544 657 549 320

FFP issued 459 544 538 399 455 401 403 523 480 668 593 401

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BLOOD BANK MANUAL

Indications, dosage and

adequate use of blood

components

How to send samples and

requisition forms to blood bank

What to do in case of

transfusion reactions

Choices of alternate blood

groups

Maximum blood ordering

schedule

TEG use

BLOOD ORDERING SCHEDULE : NEUROSURGERY

TYPE OF SURGERY NO OF RED CELLS UNITS REQUIRED

Surgical Blood Ordering schedule

Decompressive craniectomy 9.68 10Trephine & EDH evacuation 9.6 10

Burr hole 0.07 1Cervical corpectomy & plating 3.98 4cervical discetomy & plating 0.46 1

Laminoplasty 1.85 2

Thoracolumbar corpectomy & instrumentation 7.97 8Percutaneous instrumentation 0.37 1

Cranioplasty 1.23 1VP shunt 0.38 1

Brachial plexus repair 1.16 1

BLOOD ORDERING SCHEDULE :SURGERY

TYPE OF SURGERY NO OF RED CELLS UNITS REQUIRED

Surgical Blood Ordering schedule

Laprotomy 9.91 10

Plastic Surgery 2.95 3

Vascular Injuries 3.11 3

Amputations 5.87 6

Extremity Soft tissue Injuries 5.36 5

Thorocotomy 5.94 6

Miscellaneous 6.68 7

BLOOD ORDERING SCHEDULE :ORTHOPEDICSTYPE OF SURGERY NO OF RED CELLS UNITS REQUIRED

Plating 0.72

Interlocking nailing 0.197

DCS (plating) 1.31

DHS (plating) 0.89

External fixation 0.2

Prosthesis 1.12

Decompression and plating 1.1-1.5

K wire fixation 0

Tension band wiring 0.55-0.75

Enders nail 0.41

Amputation 0.28

Total hip replacement 0.9

Disc removal 0.6

THANK YOU

BLOOD COMPONENTS ISSUED TO OTHER HOSPITAL

BLOOD BANKS IN 2013

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Jan Feb Mar Apr May

Jun Jul Aug

Sep

Oct Nov

Dec

PRBC 18 11 1 2 39 0 7 13 4 7 0 1

FFP 0 0 0 0 0 0 35 100 100 20 0 100

Platelets 10 0 0 0 0 0 8 0 38 62 10 0

Axis

Tit

le

Issued to other hospital blood banks

BLOOD AND COMPONENTS ISSUED TO OTHER

HOSPITAL BLOOD BANKS

Since we are a 100% component separation unit,

sometimes stock of few components are more than

adequate

To avoid the wastage of these blood components,

these are issued to the other government hospital

blood banks so that they can be used for the needy

patients admitted in those hospitals

250 units of PRBCs, 375 units of FFPs and 584

units of platelets issued to other blood banks.

THANK YOU