A little goes a long way (1977)

they took three X-rays and there was nothing on any of them they kept him in overnight and in the morning the doctor said he seemed much better his his stomach was rather swollen and they measured it every half an hour they took his blood pressure every half an hour but um he didn't improve during the day they said that he should have been sitting up asking for food and but you know he just laid there he wasn't at all well and they decided to operate to find out what it was this simple accident had ruptured her son's spleen resulting in a potentially fatal Hemorrhage three units of blood were required for immediate transfusion 5 weeks after a successful operation Peter could play again just one of hundreds of accidents each day which require blood in the United Kingdom but apart from acent surgical operations are increasingly performed to improve the quality of life this heart has a faulty valve to replace the valve whole blood is needed to help fill a machine which will take over the function of the heart and lungs blood is added to the machine and oxygen is bubbled through as it flows past heated coils which maintain the required temperature it is essential that no bubbles are left in the blood and so it passes through a def foma before oxygenated and bubble free it's ready for the patient on Venus line the roller pump takes over the function of the patient's heart Venus once the machine has started further examination of the diseased area is possible and the Heart can be isolated from the circulation allowing surgeon access to the diseased valve during this time the patient is being supported by the machine which was primed with donor blood the heart is preserved by cooling it until the replacement is completed heart rhythm is lost while the bypass is in operation all right now is about to go down the surgeon has prepared the site so that a synthetic disc valve can be inserted to replace the one which is diseased once the operation is completed an electric shock is then used to restore the heart's Rhythm the low a little please the monitor illustrates the now stabilized pattern throughout this operation blood from voluntary donors has helped to sustain life within days this man will be up and about again living a more active life but for the Moment Blood is still needed for supportive therapy throughout the year teams from the national blood transfusion service head out in all weathers to towns and Villages large and small throughout the country operating from 14 Regional centers they work a highly organized system somewhat like a traveling circus they have to take everything with them except the Big Top the driver and donor attendants have the problem of setting up a donor session ready for the volunteers who will come to give blood the place they're working at may be familiar or completely new but wherever it is to operate effectively requires a great deal of teamwork and a lot of planning they have to turn this Hall which less than an hour ago was used for serving School meals to a full blood donor session organization to make it all possible starts at the regional blood transfusion Center this is where the teams under the regional donor organizer not only plan months and years ahead but also where the vital records are kept which keep track of the known voluntary blood donors and their blood groups the system may vary between regions but the basic function is the same duplicates of all records are kept one to remain at the center and another set to go with the donor clerk to the blood donor session wherever it happens to be injection the last year yes this woman is giving blood for the first time and as at all public sessions passers by who drop in are welcome I can't master have you got a cold at the moment the procedure is simple but efficient you'll be asked about any illness which might make the giving of blood inappropriate from the point of view of your health or that of the person who will receive your blood you'll be asked also about any medicine you may be taking after registration a simple blood test is carried out to make sure the donors are not anemic a small sample of blood is dropped into copper sulfate solution if it sinks you can give blood if you're between 18 and 65 and are healthy you can offer your blood no matter where you were born men and women alike at every session a doctor will be present after a cuff has been placed on the arm a local anesthetic is given the blood can be painlessly drawn from the arm in a matter of minutes people who have given blood before will have a known blood group for this woman the group is o recus positive the quantity of blood taken is measured by the weight the pack is then sealed and two samples taken for further checks at the regional center where blood group tests are carried out on every donation automatically drawn from the sample tube it's split and mixed with reagents containing known antibodies to deter in the four main blood groups o a b and a the presence or absence of the Reus factor is also determined reaction with the reagent and antibody results in clumping of the red cells called agutin the clumping will show up on the paper Trace which is then checked against the blood donation blood taken from new donors is double checked by a manual lab procedure the second blood sample is used for health checks carried out under sterile conditions in this case a hepatitis test involves implanting a drop of blood into a test medium later any changes will show up like these ringed test positives used for standard comparison a blood bank is maintained at larger hospitals before it can be used for a patient a sample of the patient's blood together with identification must be sent to the hematology Department the patient blood must be grouped and in this case by a manual process the clumping or utenation is clearly visible this blood is a reesus positive but a final Cross Match must be undertaken with the donor pack to ensure compatibility before it can be used a strict procedure must be followed when collecting cross matched blood from the refrigerator where it's stored at 4° Centigrade at this temperature its useful life will be prolonged but eventually the red blood cells will lose their ability to carry oxygen effectively methods of analyzing a sample of a patient's blood can now be automated this machine is capable of indicating certain disease states which produce a change in the Red Cell volume as in certain anemias it also estimates the hemoglobin content of the Red Cell fraction the number of white cells an indication of the body's defense against disease is also estimated this hematology department stores all blood analysis on a computer file print outs are distributed to Hospital doctors and general practitioners advances in technology and the understanding of the different functions of blood factors have brought new possibilities for the national blood transfusion service whereas in the past one or more donations of blood would have been given to remedy a deficiency it's now often possible to provide several patients with different factors from the same amount of blood so one person's donation May now help a number of different patients whatever the ultimate use the quicker the blood gets back to the regional blood transfusion Center the greater its value the first stage of blood separation involves the use of a centrifuge the balanced containers are spun for 25 minutes this accelerates the normal settling process which would take 48 hours by using time lapse photography the same effect can be demonstrated in a matter of seconds the red cells fall to the bottom the yellow plasma is at the top and between the two is a thin layer containing white cells and platelets which assist with clotting of blood the plasma is now squeezed into the satellite pack and the tube can be clamped for a special component a further process is required involving deep freezing and separation the plasma is then drained leaving behind a valuable component called cryoprecipitate which is used for those suffering from a condition known as hemophilia where the blood fails to clot effectively for the blood to clot it must contain sufficient of a substance called factor 8 Neil was born unable to produce enough his mother now keeps an emergency supply in her freezer so that home treatment can be given as soon as there's evidence of bleeding this precipitate containing the missing factor 8 must be thored in warm water up to six packs will be needed for one treatment for Neil this means an average of one treatment every 3 weeks about 40 CCS have to be given intravenously this type of home treatment is only suitable for certain cases and only after Hospital training years ago children suffering from hemophilia were destined to lead sheltered lives protected from Cuts or bruises but today this component of blood allows the choice of Greater freedom cryoprecipitate is just one of a number of components which can be separated at the regional centers plasma is also pulled to make 5 L packs and then frozen into blocks to preserve it and facilitate storage from all the 14 Regional centers the Frozen plasma is sent to the blood products laboratory near London and the plasma fractionation laboratory at Oxford at these centers research and production are carried out on an increasing range of therapeutic products under clinical conditions the Frozen packs are thed and from this liquid plasma many other factors are taken an early stage is the separating out of various clotting factors such as fibrinogen and factors 8 and N immunoglobulins are isolated these carry antibodies against disease boosting the body's own defense mechanisms the bulk of the plasma is then loaded into fractionation Vats and a continuing process to extract various products takes place some of the components are freeze dried such as Albin and dried plasma all this research and development has meant that better use is being made of each unit of blood voluntarily given at a donor session sessions like this one in a factory in the industrial Northwest a large proportion of blood is provided by sessions organized within [Music] industry they've been giving blood here since 1940 and one of the most experien donors is Eric Davy Foreman in the heavy turbine Workshop which exports products around the world he started giving blood in the Army and has continued the blood transfusion service tries to build up a panel of regular donors the ideal is for donors to give blood every 6 months time in this region a local anesthetic is given by a gun but the general procedure is the same in all areas a short while lying down a cup of tea and back to work many of us will need blood or a blood component during our life although at any one time less than 5% of the population are donors although better use is now being made of blood advances in medical science are discovering more ways of treatment requiring more blood products for supportive therapy tonight this purpose-built Blood Donor Center has developed a computerized system not only to help the daily checking and registration of donors but also to select donors who may have antibodies in their blood which are in short supply such people may volunteer for a process known as plasmapheresis this man is such a donor as soon as his blood has been taken it's spun in a centrifuge and the plasma removed the red cells are going to be returned to the donor immediately since it's these red cells which the body takes longer to replace and therefore limit the frequency with which blood can be given using this procedure a plasma donation can be given much more frequently the ingredient required from this man's plasma is a valuable antibody known as anti-d protection for a Reus negative mother is needed when she gives birth to a baby which is rees's positive the baby's blood may have mixed with its mothers at Birth a protective in ction of this anti- reesus antibody is given shortly after the baby is born and is designed to prevent the mother forming her own antibodies which could cause complications in future pregnancies this family had to suffer as a result of rea's incompatibility at the birth of this little girl to save Francesca's life she had to have six exchange [Music] transfusions the development and event ability of anti-d will in time virtually eliminate this [Music] problem anti-d is only one of many antibodies which have been isolated from plasma [Music] even when many vital components from the blood plasma have been removed this important fluid known as plasma protein fraction is still available it has the ability to increase blood volume it does not require cross matching it can be pasteurized and has a long shelf life it is the most valuable product in an emergency situation such as a severe burn case when delay can be [Music] [Applause] fatal backup support is available from the transfusion service [Music] [Applause] [Music] a burnt or scalded area is already sterile and only requires protection the urgent need is for fluid and specialized treatment [Music] when a large area of tissue is destroyed there's a severe fluid loss from the circulation this is dangerous since without sufficient blood volume the vital functions will [Music] cease that's this plasma product speak imally restores blood volume on arrival at a Burn's Treatment Center the first priority will be to weigh the patient to assess his blood volume and estimate the amount of plasma required for the moment this plasma protein fraction will suffice but during treatment this patient may require a number of the components of blood [Music] a donation of blood can benefit many people a little goes a long way [Music] the [Music]