In order to qualify to donate blood you must be at least 17 years old in good health, weigh 110 lbs or more, know the names of all medications taken within the month prior to donating, have no symptoms for colds, flu, cold sores or have taken antibiotics 72 hours (3 days) prior to donating blood and have had no tattoos or body piercing in the past 12 months.

It takes about 60 minutes to donate blood at our fire station.

The process begins by taking a brief medical history from each donor. During this time, the donor receives educational materials describing AIDS and the high risk groups and asking that anyone in a high risk group not give blood.
Next, temperature, pulse, blood pressure and weight are recorded. Donors must weigh at least 110 pounds. A blood sample is taken from the finger to determine that the hemoglobin level (or red cell concentration in the blood) is high enough to allow for safe donation.

If the prospective donor is not deferred, approximately one pint of blood is drawn in a process that usually lasts four to ten minutes. The donor is then requested to rest for a brief time and given light refreshments prior to resuming normal activities.

The entire procedure from the time of arrival at the blood collection site to the time of departure is less than an hour. Within 24 hours, the donor's normal volume of blood fluid had been restored. Replacement of red cells takes several weeks.

YES!

To better serve the regular blood donors in our community, those donors who make an appointment in advance will be given the opportunity to be processed through the ‘express lane’. By limiting the ‘express lane’ to only donors with appointments, the Fire Company hopes to make the blood donation process even easier by shortening the time required to wait in line before donating blood. The ‘express lane’ concept is in response to feedback from busy donors at previous blood drives who wanted to donate, but were unable to do so because of tight personal schedules.

Call Mike Newman at 717-475-7555 to schedule your appointment for the express lane.

The blood is collected for the Lancaster Regional Medial Center (LRMC) and Heart of Lancaster Regional Medical Center blood banks.

Generally, your blood is kept cool and processed within six hours at the LRMC blood bank labratory. In the lab, your blood is tested to ensure a safe supply of blood to blodd product recipients and then seperated into its main compents and packaged for use by local recipients in Lancaster County.

Each unit of whole blood normally is separated into several components. Red blood cells may be stored under refrigeration for a maximum of 42 days, or they may be frozen for up to 10 years. Red cells carry oxygen and are used to treat anemia. Platelets are important in the control of bleeding and are generally used in patients with leukemia and other forms of cancer. Platelets are stored at room temperature and may be kept for a maximum of five days. Fresh frozen plasma, used to control bleeding due to low levels of some clotting factors, is kept in a frozen state for usually up to one year. Cryoprecipitated AHF, which contains only a few specific clotting factors, is made from fresh frozen plasma and may be stored frozen for up to one year. Granulocytes are sometimes used to fight infections, although their efficacy is not well established. They must be transfused within 24 hours of donation.

Other products manufactured from blood include albumin, immune globulin, specific immune globulins, and clotting factor concentrates. Commercial manufacturers commonly produce these blood products.

Giving blood is a safe and simple procedure that carries very little risk. It is not possible to acquire any disease through the donation process, since a new disposable, sterilized needle is used for each donation. A very small percentage of donors - less than one-half of one percent - experience a mild reaction during or immediately following the donation process. However, this usually passes very quickly with no lasting effects.

Specially trained Medical Technologists perform antibody testing and blood cross-matching to assure the recipient of the safest blood transfusion possible. The Blood Bank also stores and supplies platelets and fresh frozen plasma, often needed to control bleeding.

As of August 2004, more than 300 units.

As part of a commitment to overall community health, each blood donor will be offered a free total cholesterol level screening. Cholesterol plays a major role in a person's heart health. High blood cholesterol is a major risk factor for coronary heart disease and stroke. Blood cholesterol for adults is classified by levels. Your healthcare provider must interpret your cholesterol numbers based on other risk factors such as age, gender, family history, race, smoking, high blood pressure, physical inactivity, obesity and diabetes.

The free screening measures total cholesterol levels. Please DO NOT FAST before donating blood, it is not required for this type of cholesterol test, and you MUST eat before donating blood.

The results will be mailed to you within a few days from Lancaster Regional Medical Center.

* Anyone who has ever used intravenous drugs (illegal IV drugs)
* Men who have had sexual contact with other men since 1977
* Anyone who has ever received clotting factor concentrates
* Anyone with a positive antibody test for HIV (AIDS virus)
* Men and women who have engaged in sex for money or drugs since 1977
* Anyone who has had hepatitis since his or her eleventh birthday
* Anyone who has had babesiosis or Chagas disease
* Anyone who has taken Tegison for psoriasis
* Anyone who has risk factors for Crueutzfeldt-Jakob disease (CJD) or who has an immediate family member with CJD
* Anyone who has risk factors for vCJD
* Anyone who spent three months or more in the United Kingdom from 1980 through 1996
* Anyone who has spent five years in Europe from 1980 to the present.

The blood supply level fluctuates throughout the year. For example, after the Sept. 11 attacks, the blood supply swelled to very high levels, due to the overwhelming response of donors. During holidays and in the summer, levels tend to fall because donations decline, but demand remains stable or even increases. In addition, policies recommended by the Food and Drug Administration can eliminate, or defer, donors who may be at risk for variant Cruetzfeldt-Jacob disease (vCJD), the human variety of the disease that is commonly known as “mad-cow” disease. Also, FDA can recommend that a potential donor who may be at risk for a transfusion-transmissible disease such as West Nile virus be deferred. These policies reduce the number of people who are eligible to donate.

While a given individual may be unable to donate, he or she may be able to recruit a suitable donor. Blood banks are always in need of volunteers to assist at blood drives or to organize mobile blood drives.

The approximate distribution of blood types in the US population is as follows.

Distribution may be different for specific racial and ethnic groups:

O Rh-positive - 38 percent
O Rh-negative - 07 percent
A Rh-positive - 34 percent
A Rh-negative - 06 percent
B Rh-positive - 09 percent
B Rh-negative - 02 percent
AB Rh-positive - 03 percent
AB Rh-negative - 01 percent

In an emergency, anyone can receive type O red blood cells, and type AB individuals can receive red blood cells of any ABO type. Therefore, people with type O blood are known as “universal donors,” and those with type AB blood are known as “universal recipients.” In addition, AB plasma donors can give to all blood types.

After blood has been drawn, it is tested for ABO group (blood type) and Rh type (positive or negative), as well as for any unexpected red blood cell antibodies that may cause problems in a recipient. Screening tests also are performed for evidence of donor infection with hepatitis B and C viruses, human immunodeficiency viruses HIV-1 and HIV-2, human T-lymphotropic viruses HTLV-I and HTLV-II, and syphilis. The FDA is allowing national deployment of investigational nucleic acid amplification tests (NAT) to screen blood for West Nile virus (WNV) genetic material -- an approach similar to that taken for NAT to detect HIV and HCV.

The specific tests currently performed are listed below:

* Hepatitis B surface antigen (HBsAg)
* Hepatitis B core antibody (anti-HBc)
* Hepatitis C virus antibody (anti-HCV)
* HIV-1 and HIV-2 antibody (anti-HIV-1 and anti-HIV-2)
* HTLV-I and HTLV-II antibody (anti-HTLV-I and anti-HTLV-II)
* Serologic test for syphilis
* Nucleic acid amplification testing (NAT) for HIV-1 and HCV
* NAT for WNV

The follwoign text is from http://www.fortunecity.com/greenfield/rattler/46/haemopoiesis.htm

Formation of blood cells (Haemopoiesis)

Where blood is made

Haemopoietic cells (those which produce blood) first appear in the yolk sac of the 2-week embryo.

By 8 weeks, blood making has become established in the liver of the embryo, and by 12-16 weeks the liver has become the major site of blood cell formation. It remains an active haemopoietic site until a few weeks before birth. The spleen is also active during this period, particularly in the production of lymphoid cells, and the foetal thymus is a transient site for some lymphocytes.

The highly cellular bone marrow becomes an active blood making site from about 20 weeks gestation and gradually increases its activity until it becomes the major site of production about 10 weeks later.

At birth, active blood making red marrow occupies the entire capacity of the bones and continues to do so for the first 2-3 years after birth.

The red marrow is then very gradually replaced by inactive, fatty, yellow, lymphoid marrow. The latter begins to develop in the shafts of the long bones and continues until, by 20-22 years, red marrow is present only in the upper ends of the femur and humerus and in the flat bones of the sternum, ribs, cranium, pelvis and vertebrae. However, because of the growth in body and bone size that has occurred during this period, the total amount of active red marrow (approximately 1000-1500 g) is nearly identicalin the child and the adult.

Adult red marrow has a large reserve capacity for cell production. In childhood and adulthood, it is possible for blood making sites outside marrow, such as the liver, to become active if there is excessive demand as, for example, in severe haemolytic anaemia or following haemorrhage.

In old age, red marrow sites are slowly replaced with yellow, inactive marrow.

Red marrow forms all types of blood cell and is also active in the destruction of red blood cells.

Red marrow is, therefore, one of the largest and most active organs of the human body, approaching the size of the liver in overall mass although as mentioned it is distributed in various parts of the body.

About two-thirds of its mass functions in white cell production (leucopoiesis), and one-third in red cell production (erythropoiesis). However as we have already seen there are approximately 700 times as many red cells as white cells in peripheral blood. This apparent anomaly reflects the shorter life span and hence greater turnover of the white blood cells in comparison with the red blood cells.

It is now generally accepted that all blood cells are made from a relatively few 'uncommitted' cells which are capable of mitosis and of differentiation into 'committed' precursors of each of the main types of blood cell.

Blood formation


Red blood cells (erythrocytes)

The production of red blood cells is referred to as erythropoiesis.

Mature red blood cells develop from haemocytoblasts. This development takes about 7 days and involves three to four mitotic cell divisions, so that each stem cell gives rise to 8 or 16 cells.

The various cell types in erythrocyte development are characterised by
the gradual appearance of haemoglobin and disappearance of ribonucleic acid (RNA) in the cell
the progressive degeneration of the cell's nucleus which is eventually extruded from the cell
the gradual loss of cytoplasmic organelles, for example mitochondria
a gradual reduction in cell size

The young red cell is called a retlculocyte because of a network of ribonucleic acid (reticulum) present in its cytoplasm. As the red cell matures the reticulum disappears. Between 2 and 6% of a new-born baby's circulating red cells are reticulocytes, but this reduces to less than 2% in the healthy adult. However, the reticulocyte count increases considerably in conditions in which rapid erythropoiesis occurs, for example following haemorrhage or acute haemolysis of red cells. A reticulocyte normally takes about 4 days to mature into an erythrocyte.

In health, erythropoiesis is regulated so that the number of circulating erythrocytes is maintained within a narrow range. Normally, a little less than l% of the body's total red blood cells are produced per day and these replace an equivalent number that have reached the end of their life span. However that still represents a huge 200,000,000,000 cells

Erythropoiesis is stimulated by hypoxia (lack of oxygen). However, oxygen lack does not act directly on the haemopoietic tissues but instead stimulates the production of a hormone, erythropoietin. This hormone then stimulates haemopoietic tissues to produce red cells.

Erythropoietin is a glycoprotein. It is inactivated by the liver and excreted in the urine. It is now established that erythropoietin is formed within the kidney by the action of a renal erythropoietic factor erythrogenin on plasma protein, erythropoietinogen.

Erythrogenin is present in the juxtaglomerular cells of the kidneys and is released into the blood in response to hypoxia in the renal arterial blood supply.

Various other factors can affect the rate of erythropoiesis by influencing erythropoietin production.

Thyroid hormones, thyroid-stimulating hormone, adrenal cortical steroids, adrenocorticotrophic hormone, and human growth hormone (HGH) all promote erythropoietin formation and so enhance red blood cell formation (erythropoiesis). In thyroid deficiency and anterior pituitary deficiency, anaemia may occur due to reduced erythropoiesis.

Polycythaemia (excess red blood cell production) is often a feature of Cushing's syndrome. However, very high doses of steroid hormones seem to inhibit erythropoiesis.

Androgens (male hormones) stimulate and oestrogens (female hormones) depress the erythropoietic response. In addition to the effects of menstrual blood loss, this effect may explain why women tend to have a lower haemoglobin concentration and red cell count than men.

Plasma levels of erythropoietin are raised in hypoxic conditions (low oxygen levels). This produces erythrocytosis (increase in the number of circulating erythrocytes) and the condition is known as secondary polycythaemia.

A physiological secondary polycythaemia is present in the foetus (and residually in the new-born) and in people living at high altitude because of the relatively low partial pressure of oxygen in their environment.

Secondary polycythaemia occurs as a result of tissue hypoxia in diseases such as chronic bronchitis, emphysema and congestive cardiovascular abnormalities associated with right-to-left shunting of blood through the heart, for example Fallot's tetralogy.

Erythropoietin is also produced by a variety of tumours of both renal and other tissues.

The oxygen carrying capacity of the blood is increased in polycythaemia but so is the thickness (viscosity)of the blood. The increased viscosity produces circulatory problems such as raised blood pressure.

Ther is a condition known as primary polycythaemia (polycythaemia rubra vera), where there are increases in the numbers of all the blood cells, and plasma erythropoietin levels are normal. The cause of this condition is unknown.

The underlying cause of secondary polycythaemia is treated with the aim of eliminating hypoxia. Venesection (blood letting) is sometimes employed to reduce red cell volume to normal levels. Frequently blood is removed, centrifuged to remove cells and the plasma returned to the patient (plasmapheresis).

In anaemia there is a reduction in blood haemoglobin concentration due to a decrease in the number of circulating erythrocytes and/or in the amount of haemoglobin they contain. Anaemia occurs when the erythropoietic tissues cannot supply enough normal erythrocytes to the circulation. In anaemias due to abnormal red cell production, increased destruction and when demand exceeds capacity, plasma erythropoietin levels are increased. However, anaemia can also be caused by defective production of erythropoietin as, for example, in renal disease.

In order for efficient production of red blood cells to take place certain dietary requirements must be adhered to.

In the UK most people are able to maintain sufficient intake of proteins, vitamins and minerals required for adequate red cell production. However some people who eat 'quirky' diets can have blood problems as a result. For example some individuals who have eaten strict fruitarian or vegan diets have required treatment for anaemia. There is no reason why people cannot adhere to these dietary lifestyles so long as they are aware of balancing their food intake with vitamin and mineral supplements and ensuring adequate protein intake. Patients with eating disorders such as Anorexia nervosa can also cause themselves to become severely anaemic as a result of an insufficient diet.

The effects of diet on anaemia are discussed further on the anaemia page on this site.

The following table shows the dietary requirements for sufficient red blood cell production.
Dietary element Role in red blood cell production
Protein Required to make red blood cell proteins and also for the globin part of haemoglobin
Vitamin B6 Not clear what the role is but deficieny has occassionally been associated with anaemia
Vitamin B12 and folic acid Needed for DNA synthesis and are essential in the process of red blood cell formation
Vitamin C Required for folate metabolism and also facilitates the absorption of iron. Extremely low levels of Vitamin C are needed before any problems occur. Anaemia caused by lack of Vitamin C (scurvy) is now extremely rare
Iron Required for the haem part of haemoglobin
Copper and Cobalt There is some evidence that these two trace minerals are essential for the production of red blood cells in other animals but not in humans





Monocytes

Monocytes are produced in the bone marrow, developing from nucleated precursors, the monoblast and promonocyte. Mature cells have a life in blood of approximately 3-8 hours and, like granulocytes, there is a circulating and marginating pool.

img001.gif (20664 bytes)The diagram on the right shows the process of macrophage formation.

Monocytes are actively phagocytic (engulf other cells) and, on migration into the tissues, they mature into larger cells called macrophages (Derives from the Ancient Greek: macro = big, phage = eat), which can survive in the tissues for long periods. These cells form the mononuclear phagocytic cells of the mononuclear phagocytic system (reticuloendothelial system) in bone marrow, liver, spleen and lymph nodes. Tissue macrophages (sometimes called histiocytes) respond more slowly than neutrophils to chemotactic stimuli. They engulf and destroy bacteria, protozoa, dead cells and foreign matter. They also function as modulators of the immune response by processing antigen structure and facilitating the concentration of antigen at the lymphocyte's surface. This function is essential in order that full antigenic stimulation of both T and B lymphocytes can take place.

Granulocytes

As already mentioned granulocytes is the collective name given to three types of white blood cell. Namely these are neutrophils, basophils and eosinophils.

In terms of their formation (granulopoiesis) they all derive from the same type of committed stem cells called myeloblasts. After birth and into adulthood granulopoiesis occurs in the red marrow.

The process of producing granulocytes is characterised by the progressive condensation and lobulation of the nucleus, loss of RNA and other cytoplasmic organelles, for example mitochondria, and the development of cytoplasmic granules in the cells involved.

The development of a polymorphonuclear leukocyte make take a fortnight, but this time can be considerably reduced when there is increased demand, as, for example, in bacterial infection. The red marrow also contains a large reserve pool of mature granulocytes so that for every circulating cell there may be 50-100 cells in the marrow.

Mature cells pass actively through the endothelial lining of the marrow sinusoid into the circulation. In the circulation, about half the granulocytes adhere closely to the internal surface of the blood vessels. These are called marginating cells and are not normally included in the white cell count. The other half circulate in the blood and exchange with the marginating population.

Within 7 hours, half the granulocytes will have left the circulation in response to specific requirements for these cells in the tissues. Once a granulocyte has left the blood it does not return. It may survive in the tissues for 4 or 5 days, or less, depending on the conditions it meets.

The turnover of granulocytes is, therefore, very high. Dead cells are eliminated from the body in faeces and respiratory secretions and are also destroyed by tissue macrophages (monocytes).

No precise mechanisms for the control of granulocyte production have, so far, been found. However, in health, the count remains relatively constant so it is likely that homeostatic control mechanisms operate.

Refer back to the diagram above for a visual representation of granulopoiesis

Lymphocytes

Lymphocytes are round cells containing large round nuclei. The cytoplasm stains pale blue and appears non-granular under light microscopy. However, some cytoplasmic granules and organelles are present.

Morphologically, lymphocytes can be divided into two groups: the more numerous small lymphocytes, with a diameter of 7-10 mm; and large lymphocytes, which have a diameter of 10-14 mm. Lymphocytes are produced in bone marrow from primitive precursors, the lymphoblasts and prolymphocytes. Immature cells migrate to the thymus and other lymphoid tissues, including that found in bone marrow, and undergo further division, processing and maturation.

Platelets

Platelets are produced in bone marrow by a process known as thrombopoiesis. They are formed in the cytoplasm of a very large cell, the megakaryocyte. The cytoplasm of the megakaryocyte fragments at the edge of the cell. This is called platelet budding. Megakaryocytes mature in about 10 days, from a large stem cell, the megakaryoblast.

It is likely that there are thrombopoietic feedback mechanisms as the platelet count remains fairly constant in health, and platelet production is reduced following an infusion of platelets and increased following removal of platelets. However, these feedback mechanisms have not been discovered yet.

platelets.gif (187039 bytes)This looping diagrammatic animation shows the process of platelet formation from a megakaryocyte













At any one time, about two-thirds of the body's platelets are circulating in the blood and one-third are pooled in the spleen. There is constant exchange between the two populations. The life span of platelets is between 8 and 12 days. They are destroyed by macrophages, mainly in the spleen and also in the liver.