Vasovagal Reactions Research Articles

Adverse events after colonoscopy in a randomised colorectal cancer screening trial

ObjectiveColonoscopy-related adverse events increase the burden of colorectal cancer (CRC) screening. This cross-sectional study evaluates adverse events during and after colonoscopy in a large, randomised CRC screening trial in Norway...

Tips and Tricks for Image-Guided Breast Biopsies: Technical Factors for Success.

Image-guided biopsy is an integral step in the diagnosis and management of suspicious image-detected breast or axillary lesions, allowing for accurate diagnosis and, if indicated, treatment planning. Tissue sampling can be performed under guidance of a full spectrum of breast imaging modalities, including stereotactic, tomosynthesis, sonographic, and MRI, each with its own set of advantages and limitations. Procedural planning, which includes consideration of technical, patient, and lesion factors, is vital for diagnostic accuracy and limitation of complications. The purpose of this paper is to review and provide guidance for breast imaging radiologists in selecting the best procedural approach for the individual patient to ensure accurate diagnosis and optimal patient outcomes. Common patient and lesion factors that may affect successful sampling and contribute to postbiopsy complications are reviewed and include obesity, limited patient mobility, patient motion, patients prone to vasovagal reactions, history of anticoagulation, and lesion location, such as proximity to vital structures or breast implant.

Penetrating cardiac injury after percutaneous breast core-needle biopsy, unusual life-threatening complication: a case report

BackgroundComplications after percutaneous breast biopsy are infrequent but may include hematoma, pseudoaneurysm formation, persistent pain, infection, delayed wound healing, vasovagal reaction, hemothorax, pneumothorax, and neoplastic seeding. The risk factors include tumor factors (size, location, vascularity), procedure-related factors (needle diameter, number of biopsies), and interventionist experience. There has been no previous report of a fatal complication resulting from percutaneous breast biopsy.Case presentationWe report a 54-year-old Asian woman with a 3 cm BI-RADS® 4B left breast mass in the lower-inner quadrant who was biopsied by a 16 G needle under ultrasound guidance at a province hospital. She experienced dizziness and near-syncope afterward. The initial evaluation showed evidence of cardiac tamponade with hemodynamic instability. She underwent urgent subxiphoid pericardial window and was transferred to our facility. We brought her directly to the operating room to perform an explorative median sternotomy and found a 0.2 cm hole in the right ventricle. The injured site was successfully repaired without cardiopulmonary bypass. Postoperative echocardiography demonstrated mild right ventricular dysfunction without evidence of septal or valvular injury. She survived with no significant complications.DiscussionThis case might be the first report of a life-threatening complication related to percutaneous breast core-needle biopsy. The rapid pericardial release is key to the survival of cardiac tamponade. The patient subsequently required cardiac repair and monitoring to avoid long-term complications. In this report, we suggested a safe biopsy method, complications recognition, and appropriate management of penetrating cardiac injury.ConclusionPenetrating cardiac injury resulting from percutaneous breast biopsy is extremely rare but can occur. A biopsy must be done cautiously, and worst-case management should promptly be considered.

Stratified analysis of risk factors affecting vasovagal reactions in first-time whole blood donors: A regional multi-center donor hemovigilance data study

Background and objectivesVasovagal reactions (VVR) are the most common adverse reactions in blood donation. This study aimed to provide and analyze the data of the regional hemovigilance system in Chongqing, China from 2020 to 2022, report the prevalence and explore the risk factors of VVR. Materials and methodsR software (version 4.2.3) was used for all statistical analyses. Frequency and composition rates were used to describe the data of total donation, as well as data on the different types of ADR. The Chi-square test was used to analyze risk factors for VVR and inter-group comparisons of VVR stratified by gender (female/male), age (18–22; 23–29; 30–39; 40–49; 50–60) and season(Spring (Mar.-May.); Summer (Jun.-Aug.); Autumn (sep.-Nov.); Winter (Dec.-Feb.)). ResultsThe reported incidence rate of VVR was 8.69‰ during whole blood donations and 1.02‰ during platelet-apheresis donations.The stratified analysis revealed that female donors aged 18–22 years old and 30–39 years old were reported to have lower VVR rates than male donors, oppositely, higher in females in 50–60 years old. Statistically significant differences in the incidence rate of VVR were observed between winter and summer, and between winter and spring in 18–49 years old. No seasonal variation was found in 50–60 years old. ConclusionsThe reported incidence rate of VVR related to blood donation was very low and varied from those calculated by other haemovigilance systems. The higher prevalence of VVR in young, first-time donors, college students, donating in mobile vehicles, males and in spring. Among first-time donors, the prevalence of VVR was higher in males than in females; and stratified analysis revealed there were seasonal variation and gender differences within a same age group.

The association between attitude towards facemasks, quality of donation experience and relationship with healthcare providers: A cross-sectional exploratory study.

Facemasks represent an essential measure of prevention against the spread of infectious diseases; however, they lessen the ability to convey and understand emotions through facial expressions. In blood donation settings, facemask wearing could interfere with professionals' tasks, reduce the satisfaction of blood donors and affect their future blood donation behaviour. This preliminary cross-sectional study explored the association of mandatory facemask wearing with the quality of the blood donation process at the end of the coronavirus 2019 (COVID-19) pandemic. A sample of 615 voluntary unpaid Italian blood and plasma donors completed an online survey assessing their attitude towards facemask wearing, the perceived distress due to facemasks in the different steps of the donation process, self-reported vasovagal reactions after donation and the intention to donate again. Nearly 24% of donors reported a worsened quality of the donation process due to facemask wearing, and 36% reported moderate to severe distress during the donation itself. Donors with a more negative attitude towards facemasks reported a worse donation experience, mainly related to the interactions and the communication with physicians and nurses, and a higher probability of experiencing vasovagal reactions at their last donation. No significant correlations were observed between negative facemask attitudes towards facemask wearing, distress or future intention to donate blood/plasma. Facemasks have worsened the quality of blood and plasma donations for one fourth of donors, confirming the interference with the quality of communications and relationships with healthcare professionals.

A risk prediction model for vasovagal reactions in whole blood donors including the physical and psychological factors: Results from a case–control study done in a regional blood transfusion center

Abstract: BACKGROUND AND OBJECTIVES: Blood centers strive to maintain a safe and adequate supply of blood products from healthy volunteer donors. Primary responsibility of a medical officer is to assess donor risk for vasovagal reaction (VVR) and alert the phlebotomist. The study attempts to identify the significant risk factors of VVR which may help in decision-making. METHODS: This was a case–control study including blood donors donating 350 ml Whole blood in Department of Transfusion Medicine, Medical College, Thiruvananthapuram from December 19, 2017 to June 31, 2018. Donors who suffered VVRs during or after blood donation were considered as cases and compared with controls. The prevalence of risk factors such as age, sex, number of previous donations, body mass index (BMI), blood volume, sleep duration, food intake, fear and anxiety, and pain perception was compared between the groups. RESULTS: 174 cases and 348 controls were studied. Most of the donors were < 35 years of age (63.2%) younger age groups (18–25 year) had a higher odds of VVR (5.54 with 95% confidence interval [CI] 2.4–12.5). First time donations carried an increased risk of VVR with an ODDs ratio of 5.8 (3.81–9.131) compared to repeat donors. Around 45% of cases were first timers whereas only 12% of controls were first time donors. There was a significantly higher rate of reactions in donors who had episodes of VVRs in the previous donations. Odds 1.99 (CI 1.09–3.74) other risk factors identified were female gender (6.3, 95% CI 2–20), lack of sleep at previous night (32.9; CI 16.17–67.18), and high BMI > 27.5/m2 with odds ratio 2.5 (1.4–4.3). Having an estimated blood volume < 3500 ml also was associated with higher odds of VVRs. CONCLUSION: In spite of having a strict criteria for donor deferral based on risk factors, vasovagal reactions still occur and risk factors are prevalent in blood donor population. Special attention should be given to donors having one more of such risk factors and attempts should be made to avert VVRs.

A follow-up study of blood donors with vasovagal reaction – Three years’ experience

Abstract: AIM: The aim of this study was to find out the incidence of seizure recurrence among blood donors who developed vasovagal reaction (VVR). SETTINGS AND DESIGN: A prospective survey-based study conducted at the department of transfusion medicine of a tertiary care referral hospital in southern India. SUBJECTS AND METHODS: All donors who were diagnosed with VVR and loss of consciousness with or without convulsions during 3½ years study period were telephonically contacted to a maximum of 3 times. Whether they experienced a repeat episode of convulsions during 6-month follow-up period irrespective of blood donation was enquired. RESULTS: Out of 66 donors who were included in the study, 45 (68%) donors could be successfully contacted. One donor out of 45 (2.22%) had developed a repeat episode of seizure 5 months postdonation. However, she also had a previous history of seizures which was not revealed during the medical examination. CONCLUSIONS: Our study shows that the VVR with convulsions during blood donation can trigger a secondary episode if the donor had convulsions in their past before donation. We did not find any donor who developed a new seizure episode without a past history of seizure. However, more studies are needed to confirm the same.

The role of blood donation on wheels in the blood collection chain operational logistics during the first wave of coronavirus disease 2019 pandemic

Abstract: BACKGROUND AND OBJECTIVES: The blood collection agencies (BCAs) employ two major logistical modes of conduct for outdoor blood collection. First, the collection agency walks to the donor’s preferred location for routine blood donation drives. Second, the drive is conducted using a heavy-duty vehicle having all the facilities for blood donation in it – Blood Donation on Wheels – hereinafter referred to as mobile blood drive (MBD). The study aimed to review the role of MBDs during the coronavirus disease 2019 (COVID-19) pandemic. MATERIALS AND METHODS: This was a retrospective analysis of data concerning the blood collection at the outdoor blood donation drives such as the number of drives, blood donations in voluntary (total outdoor), routine blood drive (RBD), and MBDs during the COVID-19 pandemic with respect to referent data. RESULTS: There was a trend in the increase in MBDs (43.3% in 2020 vs. 35.6% in 2019), with odds of 1.38 (confidence interval [CI]: 0.99–1.9), P = 0.05, during the pandemic. There was a statistically significant increase in contribution in terms of blood donations from MBDs (25.8% in 2020 vs. 19.5% in 2019), with odds of 1.43 (CI: 1.4–1.5), P < 0.05, during the pandemic. There was a statistically significant reduction in the rates of vasovagal reactions in blood donors donating blood at voluntary blood drives, RBD, and MBDs during the pandemic, in comparison with the referent data. CONCLUSION: The blood donation on wheels compliments the public outreach efforts of the BCAs, both in terms of the organization of the outdoor blood donation drives and the blood donations obtained thereof.

The influence of the frequency of donor plasmapheresis on the concentration of ions and proteins in the blood of donors

Introduction. Plasmapheresis is a routine procedure in many blood centers. The most common complications in plasma donors are vasovagal and citrate reactions. The effects of citrate exposure, repeated with different frequency over a long period of time, have not been sufficiently studied.Aim. to research the effect of the frequency of plasmapheresis on the concentration of ionic and protein composition in donor blood.Materials and methods. The concentration of protein in blood serum was measured using a biochemical method. The concentration of ions was carried out using an automatic blood electrolyte analyzer. Plasma donors were divided into groups depending on gender and frequency of plasmapheresis (1–5 times a year; 6–10 times a year; 11–26 times a year). The total number of donors involved in the study was 274 (155 men and 119 women).Results. A significant decrease in the concentration of bound calcium was revealed in the group of female donors who donated plasma 11–26 times compared to the group who donated plasma 1–5 times a year. A significant decrease in the concentration of iron ions was revealed in the group of female donors who donated plasma 11–26 times compared to the group who donated plasma 1–5 times a year. Statistically significant differences in the concentrations of total protein were revealed between all three groups of male donors, and between groups of female donors who donated plasma 1–5 times and 6–10 times a year; 1–5 times and 11–26 times a year.Conclusion. The use of data on changes in the parameters of ion and protein metabolism in donors of different sexes and different donation frequencies reduces the risk of developing a citrate reaction due to the selective selection of plasma donors.

The factors determining motivation of blood plasma donorship, including conditions of COVID-19 pandemic

The article analyzes publications considering motivation of plasma donors by factors related to ethical and socio-economic aspects. Their detailed analysis and systematical consideration in the work contributes into more effective informing of new potential donors, improving recruitment and retention of donors. The detailed analysis established among causes of negative beliefs and negative experiences regarding donorship such factors as increased risk of infectious diseases, decreased vitality, vaso-vagal reactions and reduced iron content. It is demonstrated that experienced plasma donors try to maintain practice of donorship in conditions of intensive life activity, often applying flexible approach to frequency of plasma donation. Their knowledge about contribution that their donation makes is key factor in continuing donation. However, the COVID-19 pandemic developed additional obstacles to donorship due to state preventive measures and increased personal health risks. In order to develop donorship policy during pandemic in the future, it is important to study changes in motivation of donors during pandemic.

Adverse effects of therapeutic phlebotomies: Prospective study of 587 procedures.

Therapeutic phlebotomy (TP), a widely used medical procedure, can be performed on diverse patients with iron overload or polyglobulia. However, its adverse events are not well known as most of the information on phlebotomy is derived from healthy blood donors (0.1%-5.3%). In contrast, TP is applicable to a broader, more complex population with comorbidities and old age. To ascertain the incidence of adverse events in phlebotomies, we conducted a prospective study on patients who attended our Unit. We prospectively gathered data from patients referred to our Unit for TP. Data regarding demographics, health status, and adverse events within at least 24 h of phlebotomy were gathered via a structured questionnaire during each visit. Between August 2021 and September 2022, 189 patients underwent 587 procedures. Most patients were men, over 60 (57.3%) had comorbidities, and 93% underwent at least two procedures during the study period. Twenty patients (10.8%) presented 25 adverse events (4.3% of phlebotomies), usually vasovagal reactions, none of which were clinically relevant, and all were managed by nursing staff on site, with full patient recovery. The rate of adverse events (<5%) in patients undergoing TP was low and comparable to that seen in healthy blood donors. Consequently, even old patients and those with some comorbidities can safely undergo TP when the process is carefully managed.

Abstract PO3-28-05: Therapeutic Plasmapheresis as a Symptomatic Treatment for Paclitaxel-Associated Peripheral Polyneuropathy

Abstract Relevance: Paclitaxel-associated peripheral polyneuropathy (PIPN) is one of the most common side effects that develop during treatment with drugs of the taxane group. In the treatment of early breast cancer with paclitaxel 80 mg/m2 weekly, 12 injections, PINP develops in 90% of patients of varying severity. The main symptoms are pain and numbness in the arms and legs, which is associated with the accumulation of paclitaxel in the ganglia of the spinal cord, as well as increased expression in the ganglia of the spinal cord of chemokines and cytokines, such as IL-1β, IL-8 and TNF-α, as well as CXCR4, RAGE, CXCL1, CXCL12, CX3CL1 and C3. We hypothesized that the severity of PIPN symptoms can be reduced by lowering the concentration of chemokines and cytokines in the blood by performing plasmapheresis sessions. Research methods: An open prospective study was carried out, the protocol of which was approved by the ethical committee. The study included 30 patients (100% women) aged 30 to 60 years (mean age 45 years) who developed PIPN during paclitaxel therapy 80 mg/m2, weekly, 12 injections. The severity of PIPN symptoms was assessed using a “visual analogue scale” (VAS). The results of the VAS evaluation varied from 6 to 8 points. Patients underwent 5 courses of membrane plasmapheresis with exfusion of 400-500 ml of plasma per session (20 ml per 1 kg of body weight), plasma loss was compensated with saline. Repeated procedures were performed once every two months for 6 months. Results: 30 patients underwent 15 procedures of therapeutic plasmapheresis within 6 months. In 21 patients (70%) there was a pronounced decrease in PIPN symptoms (VAS - 2-3 points), in 3 patients (10%) a moderate decrease in symptoms (VAS -5-6 points), in 6 (20%) no effect of plasmapheresis (VAS - 7-8 points). Approximately 15% of procedures were associated with adverse events, the most common of which were vasovagal reactions; 20% of patients had at least one adverse event. Conclusions: Given the subjective reduction in the severity of PIPN symptoms during courses of therapeutic plasmapheresis in more than 70% of cases, therapeutic plasmapheresis can be used as a symptomatic therapy for PIPN, however, taking into account the subjective assessment of the results by patients, there may be a risk of developing cognitive errors. Therefore, this method of therapy requires more thorough study. Citation Format: Sardor Abdugafforov, Vladimir Vorotnikov, Alexander Soynov, Tornike Mchedlidze, Igor Kopytich, Sofia Kim. Therapeutic Plasmapheresis as a Symptomatic Treatment for Paclitaxel-Associated Peripheral Polyneuropathy [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-28-05.

Meteorological factors associated with the occurrence of the vasovagal reflex during blood donation

Internal factors such as young age, female sex, and first-time blood donation are implicated as risk factors for vasovagal reaction (VVR) associated with blood donation for blood donors. However, the involvement of external factors has not yet been clarified. This study explored the effects of meteorological conditions as external factors on the onset of blood donation-associated VVR. Meteorological conditions were compared between days when blood donation-associated VVR occurred and days when it did not. During the 3-year period from April 1, 2020, 1 092 days during which at least one of the fixed facilities or mobile blood drives was operational were examined for the VVR cases. For meteorological conditions, we used meteorological data published on the website of the Nara Local Meteorological Observatory, located in the northern part of Nara Prefecture. Occurrence and non-occurrence groups included the days when VVR occurred and did not occur among blood donors, respectively. Days of VVR occurrence only in the southern part of the prefecture, which is a mountainous area with different meteorological conditions, were excluded from the occurrence group. A multivariate logistic regression analysis was conducted to identify meteorological variables associated with VVR occurrence. The occurrence and non-occurrence groups included data from 348 and 744 days, respectively. The regression analysis indicated that a large diurnal temperature range, low minimum temperature, and low wind speed were risk factors. The meteorological conditions may play a role in VVR onset.

Prospective evaluation of the safety of ultrasound-guided cervical medial branch blocks using the in-plane technique

BackgroundWhile fluoroscopic guidance is currently the imaging standard for cervical medial branch blocks (CMBBs), ultrasound guidance (USG) offers several potential safety advantages such as real-time needle visualization and the ability...

Donor Haemovigilance: A South Indian experience

Blood Donation from healthy screened donors is a well-tolerated procedure. However a small percentage may experience adverse donor reactions. Donor haemovigilance aims at identifying and documenting these reactions for donor safety.: This prospective cross-sectional study conducted at the Department of Transfusion Medicine &amp; Immunohaematology, Govt. Medical College, Kozhikode, Kerala for a one year study period from January 1st 2018 to December 31st 2018 included all adverse donor reactions and donor determinants in vasovagal reactions in allogenic whole blood donors. Donors were assessed as per the Standard Operating Procedure (S.O.P) based on national guidelines. 350ml collection bags were used. Vasovagal reactions were also graded as per the Blood Donation Reactions Inventory scale (B.D.R.I).: During the 1 year study period, 1.79% of 27,800 donors experienced adverse reactions. The most common symptoms were pre-syncopal 1.33% with syncope forming only 0.3% and local reactions 0.16%. Correlation with donor characteristics using Pearsons chi square test showed significance for female gender, first timers and lack of adequate sleep (&amp;#60;5 hrs). In our study there was no association with age (S.O.P guidelines) or food intake &amp;#60;4hrs.Our study reinforces the safety of blood donation with a very low prevalence of adverse reactions. Proper donor counseling and examination noting donor characteristics like adequate sleep, food intake and alleviation of fears and doubts of first timers can play a major role in further reducing the reaction rate and ensuring repeat donors, the need of the hour.

A Review of 1228 In-Office Hand Surgery Procedures With Wide Awake Local Anesthesia No Tourniquet (WALANT) at a Single Private Practice.

This study examined the complication rate of Wide Awake Local Anesthesia No Tourniquet (WALANT) technique in the clinic setting with field sterility at a single private practice. We hypothesized that WALANT is safe and effective with a low complication rate. This retrospective chart review included 1228 patients who underwent in-office WALANT hand procedures at a single private practice between 2015 and 2022. Patients were divided into groups based on type of procedure: carpal tunnel release, A1 pulley release, first dorsal compartment release, extensor tendon repair, mass excision, foreign body removal, and needle aponeurotomy. Patient demographics and complications were recorded; statistical comparisons of cohort demographics and risk factors for complications were completed, and P < .05 was considered significant for all statistical comparisons. The overall complication rate for all procedures was 2.77% for 1228 patients including A1 pulley release (n = 962, 2.7%), mass excision (n = 137, 3.7%), extensor tendon repair (n = 23, 4.3%), and first dorsal compartment release (n = 22, 8.3%). Carpal tunnel release, foreign body removal, and needle aponeurotomy groups experienced no complications. No adverse events (e.g. vasovagal reactions, digital ischemia, local anesthetic toxicity, inadequate vasoconstriction) were observed in any group. Patients with known autoimmune disorders and those who were currently smoking had a statistically significant higher complication rate. Office-based WALANT procedures with field sterility are safe and effective for treating common hand maladies and have a similar complication profile when compared to historical controls from the standard operating room in an ambulatory center or hospital.

Migration of Intra-Uterine Devices.

Intrauterine devices (IUDs) are a widely used contraceptive. Possible complications from IUDs include failed insertion, pain, vasovagal reaction, infection, abnormal bleeding, and expulsion. Uterine perforation and migration of the IUD are rare complications occurring in approximately 1-2 per 1000 insertions. We executed a systematic review by reviewing all case reports and case series on IUD migration, published between December 2002 and December 2022. Our review indicates that about half of these patients present with pain and that a third are completely asymptomatic. The most common sites of migration are the intestine, bladder, and omentum. We found that the preferred method for removing the migrated IUD is laparoscopy. Generally, there are no lasting injuries after the removal of the migrated IUD, but occasionally, severe complications have been reported. Healthcare providers should be vigilant about this rare complication, especially in cases of painful insertion or the presence of other risk factors for perforation. When uterine perforation is diagnosed, it is advisable to remove the IUD to prevent severe complications.

Donor complication rates in whole blood, plasma and platelet donors: Age versus experience.

Many blood banks use upper age limits for donors out of concern for a higher donor complication rate in older donors. Experienced donors are known to have lower donor complication rates, and older donors are often more experienced, confounding the effect of age on donor complication rate. We studied donor complication rates in whole blood, plasma, and plateletpheresis donors from 2012 to 2022. Donor complication rates were compared between age groups in inexperienced (<20th donation) and experienced (≥20th donation) donors. In addition to this direct comparison, we made use of logistic regression with finer-grained experience groups, to further quantify the effects of age, experience and other factors on donor complication rate. While overall rate of vasovagal reaction was lower, rate of moderate/severe vasovagal syncope was highest in 70-79 year donors, however, only reached significance for plasma donors. Furthermore, rates of failed stab were highest in this age group. Hematoma rate showed a U-shaped pattern with regard to age, where the rate was not higher in the 70-79 year age group than in the 18-23 year age group. Pain decreased with age, however, rates were higher in the 70-79 year age group than in the 65-69 year age group. When properly accounting for donor experience, donor complication rate profiles clearly change with age. The increased risk for moderate/severe vasovagal syncope in older donors should be clearly communicated. Extra caution is needed if these donors are accepted for first-time donations.

Needle size for thyroid fine needle aspiration cytology. A single institution experience.

Fine needle aspiration cytology (FNAC) is an invasive diagnostic technique which is widely used for the cytological diagnosis of thyroid nodules. This procedure is generally widely tolerated by patients, albeit often accompanied by local pain and discomfort. Despite various proposals of execution methods, no approach is universally accepted,especially regarding the size of the needle to be used for sampling. Needle gauge preferences vary across regions, with 25-gauge needles more common in Western countries and 22-gauge needles favored in Asian countries. Complications associated with larger needles have been studied but remain inconclusive. Over one year, we conducted 300 FNAC procedures under ultrasound guidance, employing both 22-gauge and 25-gauge needles. In no patient was local anesthesia performed before starting the procedure, which in all was performed by the same operator. Similarly the cytological examination of the material taken was performed by a single operator. Patients, 105 males and 195 females, were divided into two groups of 150 each based on the needle size used. Patients treated with 22-gauge needles reported higher levels of pain during the procedure and increased discomfort afterward. Similarly, a greater incidence of hematomas and vasovagal reactions was noted in this group. However, the cell sample obtained and diagnostic response rates were consistent across both groups. On the basis of our observations we concluded that the size of the needle used is irrelevant for the purposes of the diagnostic result, as long as the procedure is performed by expert personnel. However, the 25-gauge needle is preferable because it's more tolerated and accepted by patients. Our results do not represent a single and conclusive verdict, but they could represent the starting point for further research.

Pre-donation Hydration and Muscle Tensing exercises to Reduce Donor adverse Reactions due to Blood Donation.

Introduction: Blood Donors are the backbone of a Blood Transfusion service.Since blood donors are considerate volunteers, they should be encouraged , motivated and should be safe without any adverse reactions. As the quote says , people who have not donated have never been asked for .Post donation well being and donors being fine fettle will definitely have implications on blood donor return rate .voluntary repeat donations should be encouraged. If the donors are ensured of a pleasant experience, they will be motivated to become regular repeat donors. This can be accomplished by preventing adverse reactions during and post donation. Objectives: 1.To study the frequency of occurrence of adverse reactions in voluntary whole blood donors. 2. To evaluate the efficacy of pre dontion hydration and muscle tensing exercises in preventing Adverse donar reactions 3. To look for associated factors like age, sex,mental status in the causation of donor adverse reactions Methodology: Study duration : 3 months . Total of 800 donors will be included in the present study , of which 200 will in the standard group and 600 ( 200 each) in intervention group. Randomly donors were assigned to one of four groups: 1) standard donation, 2) Leg exercise prior to Donation (venipuncture/Phlebotomy) 3) Pre-donation water (500 ml of bottled water consumed 20 to 30 minutes before donation), 4) Pre-donation water combined with leg exercise during donation Statistical analysis: Analysis :using SPSS 19.0 software. All data will be entered in Excel and further analysed. Results : There was significant reduction in the VVR in group 3 and 4 when compared to group 1 and 2.Anxiety was more in group 1 and 2.we found that pre donation exercise was not acceptable/ tolerated by many donors and they became more restless / showed anxiety when compared to group 3 .there was no much difference between group 3 and group 4 with respect to VVR.Pre donation hydration and muscle exercise were associated with significantly lower VVR. Implications : Pre Donation Hydration ( 500 ml of water 15 to 20 minute before donating) and leg exercises will help reduce vasovagal reactions specially in Novice donors, thus adding them to the Donor Pool. Hilights : Pre donation Hydration and Muscle tensing exercise to reduce the Adverse donor reactions Increase the Donor Pool Key words : Predonation Hydration, Muscle tensing exercise, donor adverse reaction.