Reduced risk of vasovagal reactions in Australian whole blood donors after national implementation of applied muscle tension and water loading

Thijsen, Amanda; Masser, Barbara M.; Davison, Tanya E.

doi:10.1111/trf.15701

Cited by 17 publications

(28 citation statements)

References 13 publications

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“…Because of differences in donor hemovigilance systems, it can be difficult to compare reaction rates across blood centers. However, the reduction in reaction rates observed in our study compare favorably to implementation of wellness initiatives in Australia and the province of Quebec 11–13 . Unfortunately, data collection had to be stopped due to substantial changes to donor room collection policies related to the onset of the COVID‐19 pandemic.…”

Section: Discussionmentioning

confidence: 66%

“…Héma‐Québec, the blood supplier for the province of Quebec, Canada, implemented pre‐donation water loading and a salty snack pre‐donation in 2017, accompanied by major staff education efforts and the use of strong on clinic messaging to enhance donor participation. A statistically significant reduction in all vasovagal reactions by 14% and vasovagal reactions with LOC by 11% occurred post‐implementation; reduction in reaction rates persisted 2 years post‐implementation 12,13 …”

Section: Discussionmentioning

confidence: 93%

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Implementation of measures to reduce vasovagal reactions: Donor participation and results

et al. 2021

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Background There are several strategies to reduce donor reactions. We report donor participation and reaction rates before and after implementing multiple measures at Canadian Blood Services. Study design and methods We introduced a structured program of 500 mL of water and a salty snack pre‐donation and applied muscle tension (AMT) during donation. Donors were not deferred for out of range blood pressure (BP); however, BP was measured in first time donors. Time on the donation chair post‐donation was decreased from 5 to 2 min for repeat donors. We assessed participation rates using our quarterly survey of 10,000 recent donors. We extracted vasovagal reactions with loss of consciousness (LOC) from our operational database and compared pre‐implementation (Oct 12,018‐March 31,2019) and post‐implementation (Oct 12,019‐March 31,2020) periods. Results Survey response rates varied from 11% to 16%. The percentage of donors who drank the water and ate the salty snack increased from 58% to 82% and 44% to 70% over 4 quarters; those performing AMT increased from 24% to 41%. Reactions decreased from 19.07 per 10,000 (744 reactions in 390,123 donations) to 14.04 per 10,000 (537 in 382,382 donations) (p < .0001). No first‐time donors with high BP (n = 684) but 5 with low BP (n = 718) had reactions, CI were very large. Conclusions Achieving optimal participation was challenging. After implementation of a donor wellness initiative based on best practice, rates of vasovagal reactions with LOC decreased by 25%. A larger dataset is necessary to assess the safety contribution of BP deferrals when other mitigation measures are in place.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 93%

Implementation of measures to reduce vasovagal reactions: Donor participation and results

et al. 2021

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“…In our sample, the most common reported reason for not drinking water (i.e., water loading) was “not needing” to. Indeed, understanding and adherence among donors to AMT, distraction, and water loading is variable and donor education efforts are required for less experienced donors 8,40 . There were no effects of Condition or Donation Type on water loading compliance, nor on the use of AMT or distraction ( p's > .05).…”

Section: Resultsmentioning

confidence: 97%

Improving the donation experience and reducing venipuncture pain by addressing fears among whole‐blood and plasma donors

et al. 2021

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Background: Fear of blood donation is implicated in vasovagal reactions, donor recruitment, and retention. This study examined the extent to which fear among donors is associated with various donor outcomes in an Australian sample, and whether fear can be addressed on-site to reduce adverse reactions and improve the donation experience. Study design and methods: Six hundred and sixty-four donors (age M = 33.4, SD = 12.7; 55% female) participated in a two-center, pragmatic, parallel group, individually randomized controlled trial. Following donor registration and consent, whole-blood (n = 539) and plasma (n = 125) donors were assigned to one of four Conditions: control; fear assessment; fear assessment + brochure; fear assessment + brochure + tailored conversation focused on any self-reported fear and coping strategies. Post-donation questionnaires assessed the donors' experience including positive support, donor self-efficacy, anxiety, fear, venipuncture pain, and vasovagal reactions. Results: Fear among donors predicted higher venipuncture pain, postdonation anxiety, and vasovagal reactions and remained significant after controlling for other established predictors (i.e., total estimated blood volume, age, sex, and donation experience). Mediational analyses showed that exposure to brochures (with or without the tailored conversation) was associated with less pain, with this effect mediated by donor perceptions of more positive support.Venipuncture pain was also associated with vasovagal reactions, reduced likelihood of return within 6 months, and less satisfaction with the donation experience. Conclusion:The current results underline the importance of interventions to address fear among both whole-blood and plasma donors to secure the safety and well-being of donors and the blood supply.

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“…To prevent VVS, it is also recommended that measures should be taken to optimize patient's baseline blood pressure. Fluid and salt intake should be increased in the lead up to the appointment 11–13 . Manoeuvres such as isometric contractions of large muscle groups may also transiently increase blood pressure and prevent VVS 14 .…”

Section: Discussionmentioning

confidence: 99%

Prospective analysis of syncope/pre‐syncope in a tertiary paediatric orthopaedic fracture outpatient clinic

Davies

MacDonald

Sivakumar

et al. 2021

ANZ Journal of Surgery

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Reduced risk of vasovagal reactions in Australian whole blood donors after national implementation of applied muscle tension and water loading

Cited by 17 publications

References 13 publications

Implementation of measures to reduce vasovagal reactions: Donor participation and results

Implementation of measures to reduce vasovagal reactions: Donor participation and results

Improving the donation experience and reducing venipuncture pain by addressing fears among whole‐blood and plasma donors

Prospective analysis of syncope/pre‐syncope in a tertiary paediatric orthopaedic fracture outpatient clinic

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