HEMOVIGILANCE
PROGRAMS &
IMMUNOHEMATOLOGY
IN MASS CASUALTY
EVENTS
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Hemovigilance programs
- are systems and processes established to monitor and improve
the safety and quality of blood transfusions.
- The term "hemovigilance" is derived from "hemo," which refers
to blood, and "vigilance," indicating the careful monitoring and
reporting of adverse events or reactions associated with the
administration of blood and blood components.
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Hemovigilance programs
- A set of surveillance procedures covering the entire transfusion
chain.
> from the DONATION, PROCESSING of blood and its
components to their PROVISION and TRANSFUSION to patients
and their follow-up.
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TRANSFUSION CHAIN
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BLOOD SAFETY
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Hemovigilance ensures blood safety
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Key components of hemovigilance programs
include:
❏ Monitoring and Reporting:
- Hemovigilance programs involve the systematic monitoring
of blood transfusions for adverse events, including
transfusion reactions, errors, and complications.
❏ Data Collection:
- Collection of data related to donor, recipient, blood
components, and the circumstances of the transfusion. This
information helps in identifying patterns, trends, and
potential risks.
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Key components of hemovigilance programs
include:
❏ Analysis and Evaluation:
- Analysis of collected data to assess the safety and efficacy of
blood transfusions. This includes evaluating the occurrence and
severity of adverse events and identifying areas for
improvement.
❏ Reporting Systems:
- Implementation of reporting systems that encourage healthcare
professionals to report any unexpected or adverse events
associated with blood transfusions. These systems may include
both voluntary and mandatory reporting mechanisms.
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Key components of hemovigilance programs
include:
❏ Feedback and Communication:
- Establishing feedback mechanisms to communicate findings,
recommendations, and lessons learned to healthcare providers,
blood establishments, and relevant authorities. This fosters
continuous improvement and enhances transfusion safety.
❏ Quality Improvement Initiatives:
- Implementation of quality improvement initiatives based on the
findings of hemovigilance programs. This may involve changes
to procedures, protocols, and training to prevent the recurrence
of adverse events..
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Key components of hemovigilance programs
include:
❏ Education and Training:
- Providing education and training to healthcare professionals
involved in the transfusion process, emphasizing best
practices and safety measures.
❏ Regulatory Compliance:
- Ensuring compliance with regulatory requirements related
to blood transfusion safety. Hemovigilance programs are
often established in accordance with national and
international regulations and guidelines.
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Key components of hemovigilance programs
include:
❏ Risk Management:
- Identifying and managing risks associated with blood
transfusions, including potential complications for both
donors and recipients.
❏ Public Awareness:
- Raising public awareness about the safety of blood
transfusions, the importance of blood donation, and the role
of hemovigilance in ensuring quality healthcare.
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❏ Risk Management:
- Identifying and managing risks associated with blood
transfusions, including potential complications for both
donors and recipients.
❏ Public Awareness:
- Raising public awareness about the safety of blood
transfusions, the importance of blood donation, and the role
of hemovigilance in ensuring quality healthcare.
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CONCLUSION:
Hemovigilance programs contribute to the overall safety
and effectiveness of blood transfusions, reducing the
risks associated with the transfusion process. By
systematically monitoring and analyzing data, these
programs play a crucial role in preventing adverse
events, improving patient outcomes, and maintaining
public confidence in blood transfusion services.
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The goal of achieving reforms in the Philippine healthcare system has moved
our government to push regulations in all key areas. With the objective of
ensuring access to safe, quality and affordable blood products, improved
facilities and services, the transfusion system in the Philippines is now in
focus. Hence, the issuance of several administrative memos to guarantee
the achievement of an effective blood service network in the country.
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The idea of Blood Services Centralization or Regionalization began to
be implemented over 30 years ago in United Kingdom, France, United
States, Australia, Japan and other countries. It was the World Health
Organization who conceptualized the blood center Model and
recommended the system to developing countries like the Philippines
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Legislations of the government:
Department of Health (DOH) released the Department Circular No. 99
s. of 1987.
➢ It aimed to provide an adequate supply of safe blood for
transfusion from voluntary non-remunerated blood donation.
➢
It also aimed to encourage the efficient utilization of blood
resources among blood service facilities (BSFs).
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Legislations of the government:
● Committee on National Blood Service Program
- comprised the DOH, Philippine Red Cross (PRC), and the
Philippine Blood Coordinating Council (PBCC).
DOH Administrative Order 118-A s. of 99 = Promulgated the National
Blood Services Program.
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Red Cross 143 (RC 143) program.
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a chapter based program wherein
every chapter recruits 43 volunteers in
each barangay (smallest unit of
government).
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The volunteers will be tasked to assist
the organization during disaster and
emergencies, support us in
community, health and welfare
activities and act as standby or
reserved donors who will donate
blood in emergency situations.
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The country has 43 000 barangays
and from the program, 1 800 000
volunteer donors will be recruited
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The strategic objectives for the operation of PRC
Blood Services are as follows:
❏ Safe and quality blood for all –
➢ each facility shall ensure to comply with
quality standards. Our mantra that every
client should not be turned away because of
lack of blood is directed to each blood
facility.
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The strategic objectives for the operation of PRC
Blood Services are as follows:
❏ 100% compliance with DOH standards and
regulations
➢ the organization shall comply at all times the
government’s regulation pertaining to
minimum manpower and equipment
requirement for blood service operations.
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The strategic objectives for the operation of PRC
Blood Services are as follows:
❏ Improve financial self-sustainability
➢ each blood unit corresponds to a blood
processing fee. The fee collected conforms to
the fee mandated by the government. For
indigent clients, the Red Cross has a Blood
Samaritan Program. The mechanism of the
program is the solicitation of monetary
assistance from individuals, groups, and private
and government units. The donation is
earmarked to subsidize processing fee of blood
of indigent patients.
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The strategic objectives for the operation of PRC
Blood Services are as follows:
❏ Attain ISO 15189 rating in 2014 for all
regional blood centers and other BSFs to
follow
➢ the Red Cross have 22 regional blood centers
that will aim to earn ISO 15189. In 2010, the
National blood center obtained ISO 9001:2008
(Quality Management System).
➢ They are also tasked to work out for ISO
15189. Quality embodies notions of efficiency,
effectiveness, competency and customer
satisfaction.
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The strategic objectives for the operation of PRC
Blood Services are as follows:
❏ 100% voluntary blood donation
➢ currently the national average of voluntary
blood donation of PRC is 79%. In parallel to the
global strategic objective, the PRC shall
improve voluntary blood donation to 100% by
2014.
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ALTERNATIVE MODELS FOR SUSTAINABLE BLOOD SERVICES
➢ Individual doctors as well as surgical and obstetric wards find their
own solutions to treat bleeding patients with blood transfusions even
if no nationally organized or other official blood service system
exists. Blood transfusion may sometimes be the only available
treatment in countries with limited resources for hospital care, partly
because alternatives to blood such as physiological saline solutions,
colloids or other plasma expanders are not available.
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ALTERNATIVE MODELS FOR SUSTAINABLE BLOOD SERVICES
➢ This in turn may lead to ineffective and unnecessary use of blood. It
is conceivable that having an organized blood service in the hospital
gives a better result with the same financial resources and saves
time and energy of the clinical wards. These arguments, in addition
to improved safety of transfusion, should be sufficient to justify
building a blood service in the hospital.
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Strengths, weaknesses, opportunities and
threats of the government-operated national
blood service system
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Strengths, weaknesses, opportunities and
threats of a Red Cross/Red Crescent
operated national blood service system
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Strengths, weaknesses, opportunities and
threats of a Red Cross/Red Crescent
operated national blood service system
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Strengths, weaknesses, opportunities and
threats of the hospital-based blood services
coordinated by national health authorities
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Strengths, weaknesses, opportunities and
threats of the hospital-based blood services
coordinated by national health authorities
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FUNDING
➢ Stable funding for a national blood service is best achieved by an
annual budget allocation from the government. The blood service
may also have a permission to charge the hospitals for products and
services (cost recovery principle), but this is less common in
developing countries owing to weak social security system,
non-existing sick insurance and inability of the patients to pay for
blood transfusions.
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PERSONNEL
➢ In developing countries, the expertise of the blood service logistics,
financing and medical and technical aspects often depends on the
knowledge and skills of only one or a few persons. Such skills are
also much demanded elsewhere. This makes the blood service
extremely vulnerable to personnel changes because, for instance,
private business and industry can often offer better financial as well
as career opportunities to these rare experts
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BLOOD DONORS
➢ A sufficient blood donor base is a prerequisite for the sustainability
of the blood service. Blood donation should be based on voluntary
and non-remunerated donors. They are the safest and in the long
run more reliable as regular blood donors than family and
replacement donors. Payment for blood donation, especially in a
developing country, may result in a temptation for the donor to hide
his/her lifestyle, illnesses or other factors which would cause
rejection from blood donation. In addition, payment for blood
donation creates a risk of exploitation of the poor.
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PRACTICAL ASPECTS OF BUILDING BLOOD TRANSFUSION
SERVICES
➢ If there are no national laws and regulations on blood transfusion
services, the blood service should make and write down its own
instructions according to which the operation must be run. Official
regulations and laws are helpful, but the lack thereof should not
prohibit the establishment of functioning blood services on a local or
even on a national basis. However, regulations and standards must be
written later on. They serve as a basis for the quality of blood collection
and transfusion and clarify the chains of responsibility, the existence of
which becomes important if untoward effects of transfusion occur.
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Immunohematology plays a crucial role in mass casualty events by
ensuring the safe and effective use of blood transfusions in emergency
situations. The primary goal is to rapidly provide compatible blood
products to those in need while addressing the challenges posed by the
scale and urgency of the event.
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key aspects of the role of immunohematology in mass
casualty events:
Rapid Blood Typing:
- Immunohematology laboratories perform rapid ABO and RhD blood
typing to quickly identify the blood groups of individuals affected by
the mass casualty event. This information is essential for determining
blood compatibility.
Universal Donor Blood:
- In situations where immediate blood typing is not possible,
immunohematology recognizes the importance of O-negative blood
as the universal donor. O-negative blood can be administered to
individuals of any blood type in emergencies.
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key aspects of the role of immunohematology in mass
casualty events:
Pre-Identified Donor Panels:
- Some blood banks maintain pre-identified donor panels, consisting of
individuals with known blood types and other relevant characteristics.
This allows for expedited access to compatible blood during mass
casualty events.
Emergency Release of Blood:
- Blood banks may implement emergency release protocols, allowing
for the quick provision of blood products in critical situations. This
process may involve bypassing some of the usual testing procedures
to ensure timely access to blood.
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key aspects of the role of immunohematology in mass
casualty events:
Limited Crossmatching:
- Immunohematology allows for limited crossmatching or abbreviated
crossmatching, which enables a faster assessment of compatibility
between donor and recipient blood without the need for extensive
testing.
Documentation and Record Keeping:
- Rigorous documentation of blood typing results, crossmatching, and
transfusion records is critical to ensure accuracy and traceability.
Proper documentation helps prevent errors and ensures patient
safety.
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key aspects of the role of immunohematology in mass
casualty events:
Communication and Coordination:
- Effective communication between immunohematology laboratories,
blood banks, healthcare providers, and emergency response teams
is essential. Coordination ensures that the right blood products are
available for the right patients at the right time.
Blood Donation Drives:
- Immunohematology is involved in organizing and conducting blood
donation drives to replenish blood supplies in the aftermath of mass
casualty events. These drives are essential to meet the increased
demand for blood products.
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key aspects of the role of immunohematology in mass
casualty events:
Education and Training:
- Healthcare providers involved in emergency response should receive
training on the specific immunohematological protocols and
procedures applicable to mass casualty events. This training ensures
that personnel can make informed decisions under time constraints.
Ethical Considerations:
- Immunohematologists and healthcare providers must consider ethical
principles, such as prioritizing the use of limited resources and
ensuring equitable access to blood products during mass casualty
events.
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SYNTHESIS:
In summary, immunohematology is fundamental in the rapid and effective
response to mass casualty events, ensuring that blood transfusions are
administered safely and efficiently to those in need. The ability to quickly
assess blood compatibility and provide timely access to blood products is
critical in saving lives and mitigating the impact of mass casualty events on
affected individuals.
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Transfusion
protocols
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Transfusion safety
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