adverse events in blood donors at ......donation of blood is one of the most appreciated...

Transfuzijski center

ADVERSE EVENTS IN BLOOD DONORS

AT TRANSFUSION CENTER IN

GENERAL HOSPITAL CELJE FROM 2014 TO 2017

JANJA PAJK, dr. med. spec. transf. med.

SLOVENIA


SLOVENIA ON THE MAP


CELJE CASTLE


GENERAL HOSPITAL CELJE


INTRODUCTION

Donation of blood is one of the most appreciated contributions in society

Although the blood donation procedure is relatively safe, there is a certain risk of adverse events (AEs)

AEs may deter blood donors from further donations

In order to avoid a decrease in the number of blood donors due to AEs, we must constantly monitor their occurrence and improve preventative measures


TYPES OF AEs

AEs during blood donation can be systemic or local

Systemic symptoms primarily occur due to a vasovagal reaction (VVR)

Local side effects are associated with phlebotomy:

hematoma

bruising

arm pain and stiffness

arterial puncture

The incidence of AEs varies between 0.37-2.5%

Veldhuizen I, et al. Transfusion 2012;52:1871-79


VASOVAGAL REACTIONS

The most common systemic reactions

Caused by reflex bradycardia and arteriolar vasodilatation

Symptoms consist of: sweating,

nausea,

dizziness,

vomiting,

pallor,

hypotension,

bradycardia

loss of consciousness

The most common reason for cessation of further blood donationsWiltbank TB et al.Transfusion 2008;48:1799-808.


TRIGGERS FOR VVR

Age <50 years

Female sex

BMI <25

Pulse >90/min

<8 hours of sleep

Time interval from last meal >4 hours

First donation

Circulating volume <4.3 L

Takanashi M, er al. Transfusion and Apheresis Science 2012; 47 (3): 319-25.


AIM OF THE STUDY

To collect information on AEs during blood donations at the Transfusion Center in Celje(secondary level)

Get an insight into the number and causes of AEs

On the basis of the results, prepare a strategy to prevent future AEs


METHODS

Analysis of data from the Datec information system

Additional analysis of internal AE tracking forms

Analysis of AE data on all donations in the years 2014-2017


DATEC


AE TRACKING FORM


RESULTS

Celje region has a population of 300.000

Donors: male › female

18 – 65 years

87,3% regular donors

Self-sufficient in blood supply


RESULTS

Between 2014 and 2017,

34.548 blood donations were made

We recorded 331 AEs (0.95%)

By frequency they are as follows:

- the most common AE was nausea (42% of all AEs)

- collapse post donation (21.45%)

- collapse during donation (16.31%)


RESULTS

Avarage 2014 - 2017:

5.856 donors/year

746 new donors/year (12,7%)

8.637 units of blood/year

2014 2015 2016 2017

all donors 6.094 5.937 5.691 5.702

new donors 841 778 658 709

number of donations 8.834 8.226 8.662 8.726


RESULTS

A1: Collapse before donation, without loss of consciousness; A2: Collapse before donation, with partial loss of consciousness; A3: Collapse before donation, with spasms

P1: Collapse after donation, without loss of consciousness; P2: Collapse after donation, with partial loss of consciousness; P3: Collapse after donation, with spasms

I1: Collapse at donation, without loss of consciousness; I2: Collapse at donation, with partial loss of consciousness; I3: Collapse at donation, with spasms


RESULTS

34.548 donations (2014 – 2017)

331 AE or 0.95%


0

5

10

15

20

25

30

35

40

45

2014 2015 2016 2017

Nu

mb

er

of

ad

ve

rse

ev

en

ts

Hemathoma

Nausea

Collapse A1

Collapse A2

Collapse A3

Collapse I1

Collapse I2

Collapse I3

Collapse P1

Collapse P2

Collapse P3

Arm pain after don.

Hyperventilation

Fall injury

Artery punction

Nerve damage

A1: Collapse before donation, without loss of consciousness; A2: Collapse before donation, with partial loss of consciousness; A3: Collapse before donation, with spasms

P1: Collapse after donation, without loss of consciousness; P2: Collapse after donation, with partial loss of consciousness; P3: Collapse after donation, with spasms

I1: Collapse at donation, without loss of consciousness; I2: Collapse at donation, with partial loss of consciousness; I3: Collapse at donation, with spasms


DISCUSSION

In our study, the incidence of AEs is comparable to that in other centers

The incidence of nausea far exceeds other symptoms at 42% (141)

If we reclassify nausea as one of the symptoms of VVR, the majority of AEs are VVR at 90.63% (300)

Incidence of local reactions is 9.37% (31), which confirms good technical skills of phlebotomists


STRATEGIES FOR REDUCING VVR

Excluding people with an estimated low blood volume for full donation

Providing education before donation

Drinking water before donation

Use of muscle tension elements

Introduction of a questionnaire based on Theory of Planned Behavior (TPB)

Masser B. Transfusion 2012; 52: 1844-48, Veldhuizen I, et al. Transfusion 2012; 52: 1871-79


STRATEGIES FOR REDUCING VVR USED

AT TC/MOBILES

Providing education before donation

in secondary schools (20 years),

at doctor’s office

Drinking water before donation (30 years)

Use of muscle tension elements (5 years)


CONCLUSIONS

Blood donation is safe, but AEs are possible

Serious AEs, especially VVR, have a negative impact on subsequent donor behavior

Regular monitoring of incidence of AEs is necessary, reporting in HVS

On the basis of monitoring, strategies for reducing AEs can be adopted


„ success is not final,

failure is not fatal:

it is the courage to continue

that counts „Winston Churchill


I AM ALWAYS OPEN

My contact data:

Janja Pajk, dr. med. spec. transf. med.

Center of TransfusionMedicine,

Oblakova 5 SI - 3000 Celje,

Slovenia

[email protected]

adverse events in blood donors at ......donation of blood is one of the most appreciated...

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