A laboratory report on iron supplementation in blood donors. I.

Blood donation at the accepted frequency of one donation every 8 weeks is generally regarded as excessive for preservation of donor iron reserves, especially in women. A double-blind study was conducted of 627 individuals who had previously donated blood to determine the effect of iron supplementation on iron reserves. Half the donors received ferrous fumarate at a dosage of 66.6 mg elemental iron daily for 45 days. The other half received placebo. Eight blood variables reflecting the iron status of the donors were determined at the time of the initial donation and again 2 months later at the time of their second donation. Statistical analysis of the blood variables indicated that the prescribed amount of ferrous fumarate should be considered the minimal effective dose for maintenance of reduced iron storage in blood donors. However, the data are furnished for the analysis of panels of experts for any conclusions and recommendations concerning this study. Feostat, the iron supplement, was tolerated well by the participating donors. Gastrointestinal upset occurred in eight donors receiving Feostat and in 10 donors receiving placebo.

Fatal blood transfusion reactions. An analysis.

This analysis of fatal blood transfusion reactions includes statistics from the Bureau of Biologics provided through the Freedom of Information Act. The study of 126 reported transfusion fatalities occurring between 1976 and 1980 showed that the staff certifying compatibility and the personnel administering the blood have an approximately equal share of the problems. Resolution of blood bag labeling errors through automation leaves patient identification as a major obstacle to those certifying compatibility and the transfusionists. The patient identification wrist band is excellent. However, professional staff do not always utilize this information, relying on memory. In addition, professional staff do not always collate adequately the information on the blood transfusion request form, the blood bag label, and the wrist band of the patient to be transfused. Electronic collation is discussed as a means to identify discrepancies prior to transfusion. The special problem of staff dealing with a time-limited, life-threatening emergency is described and six critical areas related to the problem of fatal transfusion reactions are suggested for further analysis.

Forensic serology in the United States. I. Blood grouping and blood transfusion--Historical aspects.

The events of three periods occurring during 1900-1980 are traced to illustrate the sources from which forensic serology evolved. The growth of blood grouping and blood transfusion, especially during the periods of military exigency, comprise the basic structure of forensic serology. Chaotic serologic procedures and confusing A-B-O terminology presented multiple challenges to workers in the field, including hospital transfusion services. The 1940s saw a beginning of standardization achieved through a combination of training, research and recommendations of the National Research Council to the Armed Services.

Military blood banking: blood transfusion aboard a Naval hospital ship receiving multiple casualties in a combat zone, a controlled medical environment.

The materials, methods, and policies used in the Blood Transfusion Service aboard the USS Sanctuary (AH-17) during military operations off South Vietnam to transfuse multiple casualties are outlined. Materials and methods common to any blood bank were used with some modification to meet specific requirements. During the period 10 April 1967 to 1 May 1971, approximately 32,000 units of blood were recieved, and over 2,890 severely injured patients were transfused. The policies and techniques used enabled efficient and safe management of blood transfusion for these patients. These methods should be applicable in solving some of the problems which arises as a result of combat operations and civil disasters. A controlled medical environment is described.

Mass screening for sickle cell hemoglobin. Is there an optimal method?

The problem of screening large civilian and military populations for sickle cell hemoglobin and related conditions has been approached recently by three distinct methods. One method specifies hemoglobin electrophoresis as the initial screening technique, followed by a solubility (dithionite) test when a (nonspecific) "S band" is noted. Another method requires the use of the automated dithionite test, followed, when positive, by hemoglobin electrophoresis. A third method is a dual, automated technique for detecting anemia or hemoglobin S or both in the initial screening study; hemoglobin electrophoresis studies are done when indicated. All three methods provide data suitable for accurate diagnosis and genetic counseling, but substantial variations in costs and redundancy of data are found among these methods. Because it gives the "biggest diagnostic bang for the buck", the third merits widespread adoption.

A computer-based frozen blood inventory and information system.

A computer-based, time-sharing data processing system was developed to assist in maintaining information regarding units of red blood cells frozen for eventual transfusion. An automated system has been programmed to compile and retrieve data concerning stored units, prepare shipping documents as required, and maintain transfusion records in a retrievable manner for thawed or shipped units. Requests for frozen red blood cells are processed through this system. Units are selected by the computer to meet requirements specified by the operator of a keyboard terminal. These requirements include method of cryopreservation, specific antigenic characteristics required, and the number of units requested. The computer prints out on the keyboard terminal the units meeting the requirements and the keyboard operator then indicates to the computer the name of the requesting facility, if these units are to be shipped. This input initiates a programmed routine that generates a shipping invoice and a new file for these units in a permanent transfusion record which can by acessed by either donor number or the frozen blood cell code.