May 13, 1981
Memorandum Circular
No. 10 series 1981
Medical Clearance for blood donors,
voluntary blood donation and blood component therapy
There is increasing
difficulty in obtaining qualified donors for blood donation. Since blood in
many instances is (1) life saving and is important (2) therapeutic procedures,
it is important to widen the pool of blood donors. In addition, the available blood
resources should be concerned and maximally utilized by the administration of
her proper component of blood indicated.
In many countries there is
trend toward increasing (1) voluntary blood donations. This is due to the
observation in many countries that there is greater risk to patients who
receive blood from (2) professional or paid donors. This is confirmed in a
study of the Bureau of Research and Laboratories.
Of 8,506 donors examined
by the Bureau from six commercial blood banks, 43% of blood donors had low
hemoglobin and 19% had hemoconcentration. Added to this group were the 4%
reactive to VDRL test and 15% to HBsAg. There was also a considerable number
who sought repeat medical clearance from a few days to less than four weeks
after the first clearance. Thus, if medical clearance is properly done, 72% of
blood donors would have been disqualified.
Recent inspection of 12
commercial blood banks in Metro Manila showed eight to have overcrowded
reception and bleeding rooms such that the sidewalks were being utilized as
waiting rooms. Of 11 blood banks who participate in a Serology Assurance
Program, only two were able to have perfect score of 5/5; another two, 4/5;
three had 2/5; two, 1/5; and two 0/5. Of nine blood banks with facilities for
hemoglobin determination, two had unsatisfactory results. These show the need
for a more strict medical clearance and donors to be undertaken by a government
agency.
In view of these, the
Ministry of Health is adopting the following measures for the public health
interest:
1. The medical
clearance of all blood donors applying in non–hospital private blood banks
shall be undertaken by the Bureau of Research and Laboratories prior to
extraction initially in Metro Manila until such time that another government
agency can take over the job.
2. The establishment
of blood banks shall be encouraged in hospitals, having a bed capacity of one
hundred beds and over to be managed by a competent Pathologists or Blood Bank
Physicians.
3. Pathologists and
physician–in–charge of blood banks in hospitals should institute strict
measures of medical clearance of their donors in accordance with the rules and
regulations of blood banks
4. The rules and
regulations governing blood banks should be reviewed to determine the need for
strengthening the procedures for medical clearance of blood donors.
5. The designation
of a transfusion officer in hospitals is encourage for consultation regarding
the blood needs of patients and further the cause of the proper utilization of
blood components.
6. Blood replacement
by relatives and friends of patients needing transfusion should be adopted in
government and private hospitals to minimize the outright purchase of blood.
7. An organized
educational campaign at all levels of the entire population regarding the value
of voluntary blood donation as well as the high risk in the use of professional
blood donors should be started and maintained. The cooperation of the private
sector, professional societies and mass media should be sought.
8. Information
regarding the medical indications of blood transfusion and the use of blood
components therapy should be widely disseminated to physicians, surgeons and
hospital administrators. They should be encouraged to promote voluntary
donation to the patients and friends.
9. A Joint Committee
on Blood Banking shall be created composed of the duly designated
representatives of the following:
a. Ministry of Health
b. Philippine National Red Cross
c. Philippine Medical Association
d. Philippine Hospital Association
e. Philippine Public Health Association
f. Philippine
Society of Hematology and Blood Transfusion
g. Philippine Society of Pathologists
The
Joint Committee shall plan, organize and implement a campaign for promoting the
voluntary donation of blood by the public on a long term basis and for the
proper utilization of blood components.
10. The Bureau of Research and Laboratories is hereby
directed to ensure implementation of the above.
ENRIQUE M. GARCIA, M.D.
Minister of Health
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