ADVERSE EVENTS IN BLOOD DONORS AT TRANSFUSION CENTER IN GENERAL HOSPITAL CELJE FROM 2014 TO 2017

Transcription

1 ADVERSE EVENTS IN BLOOD DONORS AT TRANSFUSION CENTER IN GENERAL HOSPITAL CELJE FROM 2014 TO 2017 JANJA PAJK, dr. med. spec. transf. med. SLOVENIA

2 SLOVENIA ON THE MAP

3 CELJE CASTLE

4 GENERAL HOSPITAL CELJE

5 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

6 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 % Veldhuizen I, et al. Transfusion 2012;52:

7 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 donations Wiltbank TB et al.transfusion 2008;48:

8 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):

9 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

10 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

11 DATEC

12 AE TRACKING FORM

13 RESULTS Celje region has a population of Donors: male female years 87,3% regular donors Self-sufficient in blood supply

14 RESULTS Between 2014 and 2017, 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%)

15 RESULTS Avarage : all donors new donors number of donations donors/year 746 new donors/year (12,7%) units of blood/year

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18 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

19 RESULTS donations ( ) 331 AE or 0.95%

20 45 Number of adverse events 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

21 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

22 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: , Veldhuizen I, et al. Transfusion 2012; 52:

23 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)

24 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

25 success is not final, failure is not fatal: it is the courage to continue that counts Winston Churchill

26 I AM ALWAYS OPEN My contact data: Janja Pajk, dr. med. spec. transf. med. Center of Transfusion Medicine, Oblakova 5 SI Celje, Slovenia janja.pajk@guest.arnes.si