Does using applied muscle tension at strategic time points during donation reduce phlebotomist‐ and donor‐reported vasovagal reaction rates? A three‐armed randomized controlled trial

Thijsen, Amanda; Gemelli, Carley N.; Davison, Tanya E.; O’Donovan, Justine; Bell, Barbara; Masser, Barbara M.

doi:10.1111/trf.14940

Cited by 15 publications

(22 citation statements)

References 25 publications

(48 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, reviewing the literature, we felt that there was encouraging data to support the implementation of water and salt loading and AMT from both clinical trials and operational implementation studies. Randomized trials with positive outcomes include the French study of pre‐donation water, isotonic fluids, and AMT (EVASION), Australian studies of AMT and pre‐donation water loading, and the Dutch study of pre‐donation water loading (EPISoDe) 14–16 . National implementation of pre‐donation water loading and AMT in Australia resulted in an 8% decline in total vasovagal reactions 11 .…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

View full text Add to dashboard Cite

show abstract

“…For example, four of five plasma donors who returned after experiencing presyncopal symptoms had an uncomplicated next donation, with none of the plasma donors experiencing recurrent syncope. The risk of a recurrent event in WB donors may be potentially reduced through educating donors in the use of water loading and applied muscle tension, with evidence supporting the effectiveness of these strategies in preventing VVRs . However, what is not yet clear is how effective these strategies are in reducing VVRs in plasma donors .…”

Section: Discussionmentioning

confidence: 99%

Trends in return behavior after an adverse event in Australian whole blood and plasma donors

et al. 2019

Self Cite

View full text Add to dashboard Cite

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.

show abstract

“…Meta-analytic evidence shows that while AMT did not reduce vasovagal reactions as reported by the phlebotomist, it did result in a reduction in vasovagal symptoms (Mean Difference = -0.07, p = .02) (Fisher et al, 2016). Furthermore, AMT is effective when performed at key points across the donation process (when the needle is inserted, the needle is removed, and getting up from the chair) (Thijsen et al, 2018). There is some evidence that AMT increases intentions to return (Mean Difference = 2.87, p = .004), but not actual return behaviour (RR = 1.02, p = .64).…”

Section: Blood and Organ Donation 32mentioning

confidence: 97%

Blood and organ donation: health impact, prevalence, correlates, and interventions

Ferguson

Murray

O’Carroll

2019

Psychology & Health

View full text Add to dashboard Cite

Objective: Without a supply of blood, health services could not meet their clinical needs. Similarly, organs for transplantation save and transform lives. Donations are acts of generosity that are traditionally seen as altruistic, and accordingly, interventions to recruit and retain blood and organ donors have focused on altruism. We review the predictors, prevalence and correlates of these two behaviours, how effective interventions have been, and draw common themes. Design: Narrative review. Results: We highlight that both recipients and donors benefit, and as such neither blood nor organ donation is purely altruistic. We also highlight health problems associated with both types of donation. In evaluating interventions, we highlight that a move to an opt-out default for organ donation may not be the simple fix it is believed to be and propose effective interventions to enhance the opt-in default (e.g. social media updates). We show that incentives, text messaging, feedback and a focus on prosocial emotions (e.g., 'warm-glow', 'gratitude') may be effective interventions for both blood and organ donation. Interventions designed to reduce fainting (e.g., water pre-loading) are also effective for blood donation. Conclusions: We conclude that affect is key to understanding both types of donation and in designing effective interventions.

show abstract

Does using applied muscle tension at strategic time points during donation reduce phlebotomist‐ and donor‐reported vasovagal reaction rates? A three‐armed randomized controlled trial

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

Cited by 15 publications

References 25 publications

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

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

Trends in return behavior after an adverse event in Australian whole blood and plasma donors

Blood and organ donation: health impact, prevalence, correlates, and interventions

Contact Info

Product

Resources

About