Rajib’s Blog

Sourcing blood is complicated. Thankfully most of us never have to face the travails that this entails. Chronicled briefly below, is my experience in tackling the process of obtaining this life saver. A simple lesson learnt - donate blood, at-least once a year.

My FIL suffered multiple complications including Intra-cranial hemorrhage, Kidney failure, reduced liver functionality etc. To stabilize him and increase the much needed hemoglobin levels in his blood, doctor’s at Belle Vue Clinic (Kolkata) requested us to provide them with 2 units of blood.

The blood group of the patient is known (B-) but the doctors chose to play it safe and wrote ‘To Be Determined’ in the requisition sheet. A word of caution here: for the uninitiated, to obtain blood, you can’t just walk into a blood bank. You need a properly filled-up requisition sheet signed by the doctor first.

First step was to ask the blood bank at the hospital if the blood of the required type was available. The answer was no. B-ve turns out to be an extremely rare blood group and blood banks that we contacted over the phone, claimed helplessness. Human blood can be safely refrigerated for up-to 6 months and I would expect that blood banks (particularly the ones attached to hospitals) would stock a few units of the rare variety if not the more popular types. Blood bank’s standard response was - ‘Blood is precious. We do not want to see it wasted in the refrigerator’. An admirable sentiment not appreciated by those in need.

The Govt. run Institute of Blood Research (aka Central Blood Bank) refused to speak on the phone and re-iterated their request to come to the bank and submit the request. At the bank, we were told to submit the requisition along with a sample of the patient’s blood. Lucky us, our doctors had thoughtfully provided us the blood samples in the requested format.

The blood bank looked at our requisition form and then refused to accept it. The reason? The form was from a private institute and slightly different in it’s appearance. We were required to produce the form provided by the Govt. of West Bengal and get it signed by our private doctor. We used the standard Indian procedure for getting past this stage - use some influence. Our influence got the private form endorsed by the invisible government official and our form was accepted. We were now told to wait for 3-4 hours before the bank would tell us if blood of the required type was available.

This put us into a lot of problem since we had to submit 2 units of blood to the hospital the same day and time was not something we had in plenty. To top it all, we could not approach any other blood bank since only one form is issued and the blood bank will not move unless the form is submitted to them exclusively.

First we were told that a group determination test would be done and results would be known in 30 minutes. Perhaps the technology has become more complicated, because when I did this as a science project in high-school, it took us all of 2 minutes to determine the blood group of a person. After 30 minutes, we were told it would take another 3 hours to search the blood bank to see if B- blood was available.

Computers are available at the institute but apparently either the computer doesn’t report the status of the stock or the institute doesn’t determine the blood-type of the fresh blood it receives and screen it for infections in advance. No matter what blood group other patients were requesting (incl. common ones such as A+), the standard waiting time was about 3 hours.

Since other blood banks had already professed that they didn’t have B- blood ready in stock, we were left with no option but to wait. A few more well-wishers dropped in and exerted some more influence. As a result, after about an hour-and-a-half, we were told that Packed RBC of the required type was available. Our requirement was of whole-blood and the private doctors claimed that packed RBC could be administered only if whole-blood of B- type was absolutely unavailable in the city of joy with a population of 10 millions.

Loads of waiting time later, after 3 and half hours, we were called up. The clerk asked if we wanted to pay for the blood or did we have a donor card? Un-familiar, I asked what did he mean? It appears that either you can pay for the blood (Rs. 500/- at this Govt. institute, Rs. 700 - 900/- at other private banks) or exchange the blood for a donor card.

You receive a donor card every time you donate a unit of blood. The donor card is specific to the blood bank where you donated the blood (or the blood bank which organized the donation camp) and can be exchanged for 1 unit of blood of any type. Govt. institutes don’t charge anything over a donor card. Private institutes charge Rs. 100 - 350/- on top of a donor card as ‘Processing Fees’. Donor cards are valid for a period of 6 - 12 months depending on the institute.

A good Samaritan had pressed into my hands a donor card at the hospital’s blood bank. Not knowing what it was, I had simply shoved it into my pocket. I waved this donor card at the official at the blood bank and it turned out to be the key. It was issued by this very bank and was still valid. I was told that only 1 unit of B Negative blood was available and it would have to do. I was also told to pack it in ice and transport it.

The bank of-course doesn’t supply the blood packed in ice and we were told to approach the ice-vendor just outside the bank. Too convenient in my opinion. The vendor, a lady of 40+ and a under-teen kid stocked blocks of ice and charged Rs. 10/- for 2 Kgs of it. There was not weight-measure in sight, so two kilos meant whatever would fit into the thin plastic foil that the bank provided the blood in. The vendor offered to placed the blood packet in a plastic bucket instead and charge only Rs. 40/- for it. We declined and chose to simply fill the plastic packet with ice. The kid took out the blood packet and placed it into a much more substantial looking foil packet, filled it with ice and gave it to us. At this point, his uncle mysteriously appeared and claimed that the foil packet was Rs. 10/- extra and we would have to pay Rs. 20/- for their enterprise. We ponied up the cash and moved on.

The hospital actually isn’t far from the bank but the traffic meant, we traveled for about 40 minutes before we reached the hospital. The hospital received the blood and meekly said that we needn’t have packed it in ice since chilled blood takes about an hour to thaw in a packet and would have to be completely thawed before it can be administered. In short, if transported within the hour, no ice packing is necessary. I noticed that the entire ice had melted and the blood appeared chilled, hence considered Rs. 20/- well spent.

We obtained another requisition slip for blood again with another blood sample (our requirement of 2 units was only half met till now) and started the search again for blood. Various blood banks we contacted promised to get back to us at different times through the evening.

We found a donor of the appropriate blood type and rushed to the hospital to see if his blood could be extracted and processed. Turns out the hospital blood bank accepts donations only till 4 p.m. and ceases all activity at 6 p.m. When asked how much time the processing of donated blood takes, we were told about 5 hours. This means that even if you donated blood, they would make it available only on the next day. Since this was Saturday and the blood bank was closed on Sunday, this meant that I would receive my blood only on Monday. Totally unacceptable.

We went back to Central Blood Bank with our donor and and met the same fate there. They accepted donations till 6 p.m. and worked 24 hours. We were late by 30 minutes. Had we reached in time, we would have received our blood at 11 p.m. We were told to submit the requisition and wait for 4 hours to see if the required blood type would become available. We did but had a change of heart when a private blood bank let us know that they would accept blood donation at 10.30 p.m. and deliver it to us by 3 a.m.

We rushed to Ashok Blood Bank with our donor waited for transfusion specialist to arrive (to collect blood from our donor). En route, we received info that a private blood bank had found B- blood in their stock and could make it available in 2 hours. We diverted our car and reached the blood bank. Yet again, a donor card sourced from an acquaintance came in handy and we were told to wait about 1 hour and pay Rs. 100/- as processing charges.

We took this opportunity to finish dinner and headed for the blood bank. Finally at 11.40 p.m. we took delivery of the 2 unit of this miraculous element and headed for the hospital.

Two days later, another private blood bank (Life Care) serviced our repeat request for a fee of Rs. 150/- only. Since B- blood type is extremely rare, we requested the doctor to provide us with a requisition form so that we could source blood in advance and stock it in the hospital blood bank. A request he flatly refused stating oft heard phrases about not letting blood go to waste.

Summarised, we learnt:
- Donate blood to the largest blood bank that provides a donor card of the longest validity.
- Govt. Blood Banks may have requisiting formats of their own. You must source this form if possible and request your doctor to fill this form only.
- Always carry a requisition form and blood samples to a blood bank. Blood banks take anything between 1 - 4 hours to perform blood type matching before issuing blood.
- Hospitals insist on blood of the same type. I.e. B- for B-. Though science says O- can be administered to B-, doctors don’t prefer it unless absolutely necessary. Doctor’s at Kolkata ruled out this option, Doctor’s were Hyderabad agreed.

Filed under: Gyan, Rants