Driving the Blood Drive Bus
Sometimes, when Kim Chi Bui holds her boyfriend’s arm, her hand unconsciously creeps onto his inner elbow, where she can feel his juicy veins pulsating with fresh blood.
At other times, she finds herself taking his pulse without him knowing, mechanically scanning him for other particularly sanguine spots. She really does not mean to do this, but as a hospital assistant on the UCI Medical Center’s blood donation bus, she can’t help it.
“At first, it’s weird,” Bui said. “We’re like vampires. It blows my mind how many people walk up and say they want to donate.”
Unlike a vampire, she can easily enter a college campus (often UC Irvine or nearby Vanguard University) on the UCI Medical Center bus and watch as eager donors gather to offer their blood.
Bui stands out from the nurses she works with, however, simply because she never had any formal medical training. She graduated from UC Irvine in 2007 with a degree in social science, eager and equipped to make a positive social impact. As part of a service-learning program, she first spent two months as an English teacher in Vietnam.
Once she returned, she was eager to work and, through a temp agency, landed a job as a receptionist with the UCI Medical Center. Bui then proactively trained herself in all the various tasks and duties on the Center’s blood donor bus.
Although she is officially a hospital assistant, now she can work as a receptionist, take donor histories, draw donor blood, and even drive the bus. She never originally saw herself doing any of this; she wants to work in higher education. That she in some way can help sincere college students bring their ideals to fruition is enough.
The UC Irvine Medical Center cannot afford to be picky about its donors, either. The Center functions as both a training ground for the UC Irvine School of Medicine and as Orange County’s central public hospital.
Had they no facilities for collecting donor blood, the Center would have to buy its blood from the American Red Cross, each pint of which sells for about $300. The national demand for blood far surpasses Orange County’s.
According to the American Red Cross, every two seconds, somebody in the United States needs blood, which creates a demand for more than 38,000 donations each day. The average blood cell transfusion is about three pints or three units, though some victims may require upwards of 50 units. There are approximately 14 million transfusions done in the United States each year. Still, the national demand for blood grows faster than the blood supply at a rate of six percent each year.
Besides the American Red Cross, three hospitals in Orange County operate their own blood donation clinics: Hoag Memorial Hospital in Newport Beach, St. Joseph Hospital in Orange, and the UC Irvine Medical Center.
One medical student, Abid Mogannam, approached the bus on the side where a desk sits under a canopy and a smiling receptionist was waiting to take ask for some information and give him a clipboard form to fill-out.
Beyond name and date of birth, the clipboard forms ask for his social security number, address, phone number, and emergency contact information, which are appetizers for the real battery of tests.
Following those, he then faces a barrage of “yes or no” questions, only two of which can legitimately be answered “yes.” The first “yes” question is basic: “Are you feeling well and healthy today?” (The other “yes” answers the question: have you read the rest of this packet?)
After that, the more probing questions: Are you on any antibiotics, aspirin, or medication? Have you ever been paid money or drugs for sex? If female, have you been pregnant in the last six weeks? If male, have you ever had sex with another male? Less than 38 percent of the United States population is eligible to donate. Bui keeps a list of these questions and each of their “yes” answer’s requisite deferral periods with her at work, just in case.
Once Mogannam completes the forms, he goes into a small booth on the bus, where Bui greets him, reviews his forms with him, and takes a small blood sample.
On the same piece of paper where Bui keeps her questionnaire procedures, she has a small set of instructions for taking blood pressure. She cuffs Mogannam’s arm with the gauge facing her direction, pumping until it reaches between 160 and 180 millimeters. Slowly, she releases pressure at two mm per second. The first beat, the systolic or maximum pressure, should be no more than 180 millimeters and no less than 90 millimeters. The last beat, the diastolic or minimum pressure, should be no more than 100 millimeters and no less than 50 millimeters. She then takes his pulse and pricks him for a slide sample of blood to test hemoglobin levels.
“Girls often have a low iron or hemoglobin count,” Bui said. “They’re either on their period or they eat less red meat than guys. If there’s too much iron, that’s a problem too. Then we do what’s called therapeutic phlebotomy to drain out some of the unusable blood and iron.”
Her needle has a bevel at its tip so her approach is crucial – 45 degrees or so on the Median Cubital. When she started training, Bui first practiced on smooth-skinned hot dogs before moving onto her coworkers.
For a donor, assuming the nurse pricks the vein correctly, the entire process is painless. He or she feels a sort of rush. Someone somewhere will live, forever sustained by and indebted to 450 milliliters of his life force. It is an almost spiritual experience. Of course, the free snacks, free Gatorade, and choice of either a free t-shirt or a free Baskin Robbins ice cream coupon at the very end also sweeten the deal.
The wide variety of donor reactions fascinates Bui. Most often, a donor’s reaction is mild – a light-headed feeling symptomatic of a sudden-loss of oxygenated blood cells. Sometimes, donors lose consciousness, often because of dehydration, not eating before donating, or just plain nervousness. In those cases, Bui and the other attendants raise the donor’s feet to shift blood to the brain and if that does not work, they hold ammonia under the donor’s nose. The smell is usually strong enough to shake a donor awake. Once awake, the donor is encouraged to cough to bring oxygen back into the brain, vomit if he or she has to, hyperventilate and drink liquids. And then there are the strange cases.
Right out of college, “there was no way in hell” Bui thought she would ever do something like this. Her time with the Center will end in August when leaves for Ohio State University to earn her Masters degree in Student Affairs. When she attended UC Irvine, she worked as a resident advisor for Mesa Court, an on-campus housing complex. The college students she watched over then and those who offer their blood to her now inspire her and will define her work in Ohio.
Still, old habits die hard. No one who draws this much blood easily forgets the allure of a juicy vein.