What is the Blood Bank?

What is the Blood Bank?

I work in the blood bank (lab) at a large hospital. 

Although many may not be aware of the blood bank's presence in the hospital, our department plays an important role in patient care and when a patient needs a blood transfusion its our careful expertise that ensures that the safest blood products are dispensed.

Who Works in the Blood Bank?

Let's start with the people working in the blood bank.  The blood bank (along with most of the lab personnel of other departments) consists of either Medical Technologists or Medical Laboratory Technicians. 

Medical Technologists (MT) have a 4-year bachelors degree in science and an extra year of medical technology school under their belt.  Some universities offer a 3+1 inclusive Medical Technology bachelors degree.

Medical Laboratory Technicians (MLT)have an associates degree from a 2-year program offered through community colleges. 

Both positions are accredited through the ASCP and as expected the MLTs have a lower pay scale than the MTs (but not by all that much).

In our hospital the lab is departmentalized and only MTs are allowed to do the benchwork in the blood bank.  But in smaller hospitals MLTs do work in blood bank along with the other areas.

What Does the Blood Bank Do, Exactly?

The main job of the blood bank is to crossmatch red blood cells and choose the appropriate blood components (platelets and plasma) for our patients.

Nurses and CNAs are constantly at our window picking up blood for their patients. Those who are anemic due to surgery, disease, malnutrition, etc...need blood to raise their hemoglobin level.  We also have operating room emergencies and trauma patients (car crashes, gunshots, stabbings) that require blood products to quickly replace the volume they are losing.   These emergency situations can be very chaotic and frantic, but I also find it kind of exciting.

Sometimes patients who have been pregnant or transfused in the past develop antibodies to certain red cell antigens.  This means that if they are transfused with blood containing the antigen they have an antibody against, they may have a transfusion reaction.  

We spend hours of various testing to identify what antibody or antibodies are present in such a patient. Then we spend a couple more hours to test blood units for the corresponding antigen.  We would give the patient blood that is negative for the offending antigen.   Our blood bank screens incoming type O donor blood for common antigens throughout the week so that we can have access to antigen negative blood quickly, but it's impossible to predict exactly what and how many we'll need.

All cord blood blood comes to our blood bank.  We have to determine the blood type and run a direct coombs on them.  This is important because when RH+ babies are born to RH- mothers, the mother must be given a shot of RH immunoglobulin to prevent her from developing the RH antibody that could affect any future RH+ babies she carries. 

The direct coombs is a test to see if the baby has the mother's antibodies on its red cells.  A positive result could be due to the mother's natural ABO antibodies attacking baby red cells of a different type.  OR the mother may have a red cell antibody (like the RH antibody mentioned) against an antigen on the baby's red cells--this is usually more severe than a mother-baby ABO incompatibility.   In either case, the antibodies cause the baby red cells to hemolyze, resulting in an increased bilirubin level in their little bodies.  High bilirubin in babies can cause brain damage and death.

Those are the major duties of the blood bank but there are many miscellaneous tasks that fill our work day, like unpacking donor blood from our suppliers, thawing out plasma, pulling off blood syringes for our babies, titering prenatal antibodies, washing and irradiating blood for those who require it, testing units for sickle cell, and the list goes on.

Where Does the Blood Come From?  Can I Donate Blood at the Blood Bank?

In our blood bank we do not draw blood donations.  Our hospital occasionally has blood drives sponsored by our suppliers but one would not be able to come to the hospital blood bank to donate blood.  All of our blood products come from blood donation centers like the American Red Cross and its competitors.