This narrative review examines current research on risk factors, prevention methods and management strategies for vasovagal reactions (VVRs) that occur during or as a result of blood donation. VVRs are important to blood collection agencies (BCAs) as they negatively impact the number of completed collections, perceptions of the safety of blood donation and rates of donor return. There has been significant progress in understanding and preventing VVRs in blood donation in recent years, with a multitude of risk factors identified. This has resulted in many BCAs implementing evidence-based strategies, such as donor age and weight restrictions. However, the profile of our most vulnerable donors and features of the donation setting that may protect these donors from experiencing a VVR have not been identified. Furthermore, an increased number of trials of physiological and psychological prevention interventions to reduce both immediate and delayed VVRs have been reported. However, a lack of methodological consistency in operationalising interventions to reduce or prevent VVRs means that the identification of effective VVR prevention strategies remains a challenge for practitioners. Furthermore, research is still required to determine how to successfully implement prevention and management strategies into standard operating procedures within collection centres. Finally, research in the management and mitigation of the effect of VVRs is currently only suggestive of what should be done to care for the donor who reacts and how to empower those donors to return. Collectively, research into these aspects of VVRs will provide support to donors and BCAs and improve the safety of blood donation.

Background and Objectives Temporary deferrals negatively impact on donor retention. However, little is known about why donors are deterred from returning. One unexplored area is the emotions experienced by donors when deferred. This study investigated these emotions from the perspectives of both the front‐line staff involved in applying deferrals and deferred donors themselves, with the aim of identifying which emotions impact on donors’ intention to return. Materials and Methods Telephone interviews were conducted with front‐line staff who apply deferrals (n = 47) to explore perceived reasons for donor non‐return following a deferral. Findings informed a survey administered to donors who had received a temporary deferral 1 day prior (n = 397). The questionnaire included items about donors’ emotional reactions to receiving the deferral and intention to re‐donate. Results Staff reported that donors frequently had negative emotional responses to being deferred–particularly anger, frustration and rejection. Exploratory factor analysis of 31 emotions assessed in the donor survey revealed six factors. Deferred donors’ intention to re‐donate was negatively associated with anger‐related emotions and positively associated with calm‐related emotions. The association between emotions and intention was moderated by whether the deferral was applied in‐centre or during the pre‐donation telephone call. Conclusion Emotional reactions to receiving a deferral impact on donors’ intention to re‐donate, particularly among those deferred in‐centre. Blood collection staff may be able to address donors’ emotional responses to help diminish the impact of being deferred on donors’ intentions to return.

BACKGROUND: This study examined the impact of donor adverse events (DAEs) on plasma donor return and compared these against trends in whole blood (WB) donors.STUDY DESIGN AND METHODS: Using a retrospective cohort design, donors who attempted to give plasma or WB in 2014-2015 were categorized by DAE and followed for 2 years. Analyses of return rate, time to return, subsequent donation frequency, and recurrent risk were performed. Donor characteristics associated with return were also assessed. RESULTS:For both plasma and WB donors, vasovagal reactions (VVRs) were the strongest deterrent to return, with a lower proportion returning, taking longer to return, and making fewer subsequent donations than those with uncomplicated donations. Despite a higher likelihood of a recurrent event among those who experienced a DAE, the majority had an uncomplicated subsequent donation. Donor characteristics associated with return varied by phlebotomy and DAE type. For donors experiencing a VVR, differences were observed by donor experience, age, sex, and site type between plasma and WB. For phlebotomy-injured donors, differences were observed by sex, blood type, donor experience, and donation outcome between the two groups. No factors associated with return after a citrate reaction were found. CONCLUSION:This study highlights the detrimental effects of DAEs on plasma return, in particular VVRs, and the differences in factors associated with return compared to WB donors. Further research is required to understand the mechanisms underlying the decision to return following a DAE.ABBREVIATIONS: DAEs = donor adverse events; RBCs = red blood cells; VVRs = vasovagal reactions; WB = whole blood.

BACKGROUND: A new national donor safety initiative was introduced in Australia in 2018, which aimed to encourage all whole blood donors to water load and to use applied muscle tension. This study evaluated the effect of this initiative on the rate of vasovagal reactions (VVR). STUDY DESIGN AND METHODS: Routinely collecteddata were used to identify whole blood donations and any associated VVRs before (n = 167,056 donations) and after implementation (n = 215,572 donations). Multivariate logistic regression analyses were performed to evaluate the differences in VVR rates.

Practicing AMT at VVR high-risk time points reduces the number of phlebotomist-registered VVRs.