SERVICE FOR THE SICK

Taranaki Daily News, 24 October 1930, Page 2

SERVICE FOR THE SICK

DONORS OF BLOOD NEEDED

SIMPLE SACRIIriQE. INVOLVED.

PRINCIPLES OF TRANSFUSION.

A call has gone out this month from the New Plymouth Public Hospital t° those normal, healthy people who pre willing by a very plight sacrifice of time and convenience to help the sick and injured with small contributions of thejr bipod. Transfusion of blood from a healthy person to a pick one suffering from a n umjsupl shortage of the life-giving fluid has often saved a human life- The amount given does not affect the normal person' who is the donor, and often persons with a surplus feel improved in health afterwards. Up to the time country people, who are not very conveniently situated for the purpose, have responded to the appeal better than townspeople. When loss of blood has taken place consequent upon severe haemprrhage, or the blood ’■ stream has become impoverished through anaemia or septicaemia, the services of donors ot\ blood may be urgently required. Upon the preliminary testing and classification of the blood of the dopprs a very great deal depends. Human blood differs considerably insofar as ite suitability for mixiim with that of another person is concerned. At present it is divided into four groups, This work is carried out in the hospital laboratory by the board’s bacteriologist, Mr. F- S< Hodson, as a small section of his varied A simple analysis of blood divides it into two portions: (a) A clear, colourless liquid portion or serum; (b) minute cells in enormous numbers which are suspended in the clear fluid or serum. These cells are principally corpuscles of two kinds, red and white, The red corpimcles derive their colour from a substance called haemoglobin. As long as these corpuscles aye unto’ jufed the serum will remain practieally colourless and the corpuscles be 1 en? meshed in a clflt after the blood has been taken from a vein. The serum then floats above the clot.

THE FIELD OF SCIENCE.

If the frloed be collected directly into a solution of sodium citrate of correct ntrength no clot forme and if left standing the corpuscles settle, leaving a clear mixture of aerum and sodium citrate. Should the citrate not be of the correct strength or. should water be added the red corpuscles are destroyed, the haemoglobin set free, and the clear fluid or Serum coloured red. In a cubic millimetre of normal blood, that is, in a cube l-25th of an inch square and deep, there are approximately 5,000,000 red corpuscles and 80VU white corpuscles. In 1900 Landsteiner found that when serum of certain individuals was mixed with the corpuscles of certain individuals agglutination, or "clumping’’ together of the corpuscles, occurred. He was able to divide human blood into three groups. In 1902 P eca » r tello and Sturli described a fourth group. 1n'1907 Jansky classified four groups. Independently of Jansky, Moss made the following classification in 1910:— , , Group I,—The serum frpm blood taken from any persons of this group will not clump any other person’s corpuscles. Their own corpuscles arc clumped by the serum of the blood of types 2, 3 “and 4» Those of group one can therefore receive from anyone but can Mve'only to their own group. ° Group 2.—Their serum clumps the corpuscles of groups 1 and 3, but their own corpuscles are clumped by sera oi types 3 and 4. Group 3.—Their serum clumps the corpuscles of groups 1 and 2, but their own corpuscles are clumped by the serum of groups 2 and 4. ■- , Group 4.—-Whose scrum clumps the corpuscle* of groups 1; ? and 3, but whose own corpuscles are not clumped by any serum (into which they are transferred), They are universal donors but can receive blood only from their own group. Jansky’* classification reverses three

groups, making class I the universal donor and class 4 the universal recipient. Moss' classification is more generally followed in France, England and U.S.A. Recent research indicates tfie existence of other groups) Testing directly the donor against _ the patient safeguards any complication, however. The proportion of each group io approximately group 1, 7 per cent, of adult population; group 2, 40 per cent.; group 3, 10 per cent.; group 4, 43 per cent).

PECULIARITIES of blood.

It may appear incongruous that type 4 can give, blood safely to any group in view of the fact that its serum clumps the corpuscles of all the other groups. ■ln half ' o pint of blood given from a class 4 donor there is, comparatively, only a small amount of serum which is mixed in the veins of the recipient with a large amount of the recipient’s own eerum. Also the blood given is diluted with sodium citrate solution, still further reducing the amount of serum edven. As stock sera from types 2 and 3 are unstable even when properly kept on ice it is important if there is guffir eient time to test the corpuscles of the donor against the serum of the recipLent, even though he has been tested type four. To do this about two cubic centimetres of blood is taken from the vein of the patient and allowed to clot. A few drops of blood from the finger of the donor are collected in a few drops of citrate gait solution to prevent the corpuscles clotting. As soon as the donor’s clotted blood shows a few drops of clear serum this is mixed •with the citrated corpuscles of the donor. If no clotting occurs all is satisfactory. ,

METHOD OF TRANSFUSION.

1 The blood M then taken from the donor by inserting a special' hollow needle into a vein usually in the bend of the elbow, a tourniquet having been applied round the upper arm. The blood ip allowed to flow into a sterile receptacle containing a sterile solution of sodium citrate which serve* two purposes. It keeps the mixture 'at the right density to prevent the corpuscles bursting and setting free the haemoglobin, ' It would not prevent clotting though, should a mistake have been made and the blood given to the wrong group. The patient has a vein exposed and a needle or tube inserted in the vein.’ The citrated blood which has been kept at body. temperature and stirred until ready ia allowed to flow in slowly. In many cages a remarkable change for the better . U apparent even before the full amount han been given, Blood may also be given directly without any citrate eolation. In most instances the donor is able to walk away immediately after- having given the blood and many feel better for the loss of blood,

A PRACTICAL TRST.

A News reporter going through the Scientific testing with Mr- Hofleon took the opportunity of having his own blood tested to ascertain its suitability for transfusion. After Im h a d swung his hand about to force the blood to the fingers, a rubber tourniquet was applied above the second knuckle joint and a needle prick made. Several large drops of the collected blood were taken up in a pipette and placed ip a small tube of citrate solution. A drop of the blood in citrate solu- . tion was placed on a glass aJifle with a drop of serum obtained frpm blQOfl. of group 2. Another drop of the filQpflJn citrate was placed on a similar elide with serum from blood of group 3, The elide* were gently ( rocked to ensure a thorough mixture qf the group serum with the corpuscle* and each examined at intervals. No change in either wa* observed, Serum from, groups 2 and 3 had no clumping effect op the reporter’s corpuscles, thus classifying him group 4 or universal donor. The finger of another person present was then pricked and drop* of blood collected in citrate and mixed with serum from groups 2 and 3. After a minute’s rocking' the mixture, instead of remaining smooth, began to show granules similar to cayenne pepper- and later these were observed as small clots. As each serum had the same effect this person belonged to class 1, that is, they could give their blood oply to another class 1, but could, receive from anyone. Under the microscope the slide of the reporter’s bipod showed millions of tiny separate dipcs or corpuscles, but the slide* of the class 1 subject showed big clumps and masses of corpuscle*, - The test was simplicity itself and should frighten no one. The actual transfusion, taken from near the elbow, is little more noticeable. The amount of blood drawn from th® vein* of the donor, near the elbow, is comparatively small, about half a pint, out of an average supply in the body of more than a gallon. The effect pt this drawing off of about one-sixteenth of the supply is of little consequence. Calls' are not frequently piade upon individuals, even if they are particularly hardy. Those who aye accepted a* suitable will be a very valuable reserve of volunteers for a public-spirited service. There is one reward in the knowledge that the strong are helping the weak and assisting the medical men in the cause of saving human life. The saving of life in this way may involve the "immediate presence of a donor at the hospital, when blood is required. For this reason it is desired to have a list of people whose blood has been tested and classified for suitability and who are able to attend when called upon.