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Family Health Magazine
MODERN LIVING

Canada's Blood System
Depend on it

We can depend on our blood system and . . . it depends on us. Many patients, and Canadians in general, are wary of our blood supply. We have all heard of the tragic accidents where people received tainted blood. What we do not often hear about is how safe it is to donate blood and how badly those donations are needed by Canadians.

A Canadian receives blood blood either in an emergency, for surgery or as part of treatment for a serious, life-threatening disease almost every minute of the day. Hundreds of thousands of lives are saved each year from whole blood and plasma donations.

Donating blood is absolutely safe

Donating a unit of blood is safe, easy, and takes about an hour. Blood clinic staff screen all donors carefully to ensure they are healthy and that their lifestyles do not put anyone who receives the blood at risk. First, donors are asked to complete a confidential health questionnaire. When this is done, they are interviewed by a nurse trained in the procedures to ensure they have fully understood the questions being asked. If there is any concern about safety, the donor’s blood is not used. This deferment may be temporary or permanent, depending on the reason for it.

Blood clinic staff are sensitive to the fact that when someone goes to the blood centre with a group of friends, it may be embarrassing to explain why they have not been allowed to donate. Accordingly, once the health questionnaire is completed, the nurse leaves the room to allow the donor a chance to think once more about the responses provided.

Before leaving, the nurse gives the potential donor two bar-coded stickers, one of which is to be placed on the completed questionnaire. The first tells the nurse that the donor feels the blood can be used safely. The second says the blood should not be used. This use of stickers allows donors who are not fully confident about the safety of their blood to self-defer. This is an important safety feature, for while every unit of blood collected is extensively tested for known blood pathogens, turning away high-risk donors is one of the ways of making the blood supply safer.

Finally, both during and after donating, donors are monitored by a nurse. They are given food and beverages to boost their blood glucose (sugar) levels before leaving.

Canada's Blood Service

Canada’s blood system is being operated now by a completely new, independent, not-for-profit organization called Canadian Blood Services. This new blood service began in September 1998. Be reassured that the Canadian Blood Services (CBS) is a fundamentally different blood operator from the one we had in the past. It was created to operate the blood system in an open manner that makes it accountable to the health care system and all Canadians.

Every single minute of the day someone in Canada needs blood. Most blood transfusions are done under emergency or trauma situations when there is no time to plan for the availability of sufficient blood. That is why it is so important for Canadians to donate regularly to the blood supply.

Learning from the lessons of the past

Looking at the Canadian Blood Services, the organization was created in direct response to the weaknesses of the old system.

Safety is its primary focus

CBS is responsible for ensuring the safety of Canada’s blood supply system. They will ensure that domestic and international standards for safety are met. As well, regular independent safety audits of operations are conducted and made available to the public.

Independent and free to act quickly

CBS operates and manages its own funding independently so it can make quick decisions when the need arises. Maintaining a safe blood supply depends on CBS being able to react in a timely way to any immediate health concerns.

Full access to expertise

CBS has access to independent expertise. It created advisory committees of experts who provide early and informed review of key decisions, particularly those dealing with safety. There will be at least two committees, one for consumers and one for scientific research and development.

A push for blood research

CBS has a research and development budget that focuses on blood safety, alternatives to
blood and blood use. A typical blood donation as we know it is whole blood donation. By using a special process, many Canadians donate plasma only. Plasma and its many key components are used by accident victims and those suffering burns or shock. It is also used during treatment of anemia and cancer. CBS’s research will focus on finding ways to use these plasma components better as well as finding artificial alternatives for them.

Open to everyone

CBS treats blood as a public resource and will emphasize openness. They have created an extensive interactive website and have a toll-free information line. The agendas and minutes of board meetings will be made public, as will board decisions.

CBS is managed by an independent Board of Directors. This cross section of people represents the consumer (patient), medical, scientific, public health, business and regional interests of Canadians. Such a board will make better informed, correct decisions.

Finally, because the CBS is as an independent, not-for-profit charitable organization (much like hospitals), it is at arm’s length from government.

For donors, things remain the same

The hundreds of thousands of Canadians who donate blood saw little change in the donation process. Even most of the staff that worked with the Red Cross clinics are now with CBS. Donors wanted the process of donation and the people they see to remain the same. The generosity of blood donors and volunteers is crucial to the blood system. Hopefully, they will continue to support the blood program and more Canadians will become involved. The need never stops.

Canadian Blood Services

What changed to form Canadian Blood Services?

• New Board of Directors
• New CEO
• New funding
• Research and development
• Research and development budget
• Independent expertise
• Open to public scrutiny

What remained the same?

• Front-line employees
• Volunteers
• Process for donating blood
• Clinic locations
• Commitment to voluntary donations.

The Wonder of Blood

Who Can Give Blood?

Deferral of a blood donation

Most of us know that blood is the vital fluid that supplies oxygen and nutrients to our brain, lungs and organs. Yet blood does much, much more.

Less than half of blood is made up of cells (red, white and platelets) that are suspended in plasma. Red blood cells carry oxygen to the tissue, white blood cells help protect us from illness by fighting germs and viruses and platelets are used in the process of coagulation or clotting.

Fifty-five per cent of blood is made up of plasma. The components of plasma are processed to produce albumin to treat burns, clotting factor concentrates to treat hemophilia and immunoglobulin antibodies. Plasma also has the components that helps one’s blood to maintain its own pressure and volume.

Standards for donor selection have been set to make donation as safe as possible for the donor and the recipient. Donors must:

• be between 17 and 71 years of age if they have given blood in the past two years. They must be between 17 and 61 if they have never given blood before.
• provide identification bearing their signature or photograph.
• be in good health and feeling well on the day of donation.
• weigh 110 lbs (50.0 kg) or more.
• be on no prescribed medication that may affect the donor when donating.
• wait at least 56 days between donations.

All donors are required to complete a health questionnaire and blood safety form. they must also be interviewed by a screening employee each time they come to donate. If it is not advisable for a blood donation to be taken, the donor will be deferred. Depending upon the reason, this deferral may be temporary (for a defined period) or permanent.

Temporary Deferral

Some common reasons for temporary deferral to donate blood include:

• active case of flu, cold or a sore throat
• recent major surgery
• medications that would affect the donor when donating or affect the recipient
• pregnancy in the last six months.
• sexual contact or exposure to body fluids of a person with hepatitis in the last 12 months
• ear or body piercing or tattooing in the last 12 months
• immunizations
• travel to malaria-risk countries or antimalaria medications
• hemoglobin below required level.

Permanent Deferral

For the safety of the donor and the patient who receives blood, donations are not taken from people with some medical conditions. These include anyone:

• with a blood relative (mother, father or sibling) diagnosed with Creutzfeld-Jakob Disease.
• diagnosed with hepatitis, heart problems, high blood pressure, kidney disease, diabetes, cancer, blood disease or infectious disease.
• with a high risk of exposure to the AIDS virus.

Blood Components

• Red Blood cells carry oxygen to the tissues.
• White blood cells fight infection.
• Platelets are used in coagulation or clotting.
• Plasma is essential to maintaining both blood volume and blood pressure as well as preventing infections and excessive bleeding

Every Unit of Blood is Tested

Before blood is issued to hospitals for use in transfusion, it is tested for:

• Infectious diseases: syphilis, hepatitis B and C, HIV I and II (the viruses that cause AIDS) and HTLV-I and II (that can cause a rare form of leukemia in adults and chronic nervous system disease).
• blood groups and antibody screening: to determine ABO and Rh type, blood antibodies.

Facts About Blood Donors

• The average person has about five litres of blood. The process of collecting one unit of blood (450 ml) takes about one hour.
• A donor can give blood every 56 days.
• There are about 650,000 active blood donors across Canada who give blood at least once every 18 months, and over a million occasional donors. If each active donor gave blood twice per year, we would amply meet all of Canada’s annual blood supply needs.