The effects of leg crossing and applied tension on blood donor return

Prevention of Blood Donation-related Vasovagal Response by Applied Muscle Tension: a Meta-analysis

Objective

Vasovagal reaction (VVR) is an adverse reaction to blood donation. Applied muscle tension (AMT) has been reported to reduce the probability of VVR during blood donation; however, the results have been controversial. We therefore conducted a meta-analysis to systematically evaluate the effect of AMT in reducing VVR.

Methods

We searched six major databases using “applied muscle tension” and “blood donation-related vasovagal response” as keywords. Relevant articles published in English or Chinese between 1 January 2000 and 30 June 2021 were included in the analysis. The quality of the included articles was evaluated and publication bias was assessed by forest and funnel plots and by Egger's test.

Results

Fifty-one articles were identified, of which six were included according to the pre-defined inclusion and exclusion criteria. A fixed-effects model was adopted for effect size combination and revealed a relative risk of 0.52 (95% confidence interval 0.40 to 0.67). The AMT group was superior to the control in terms of VVR prevention. A funnel plot and Egger's test suggested that the findings were accurate and reliable with low publication bias.

Conclusion

AMT could effectively reduce VVR during blood donation. Further multicenter studies with large sample sizes are needed to confirm these results.

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

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, post-donation 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.

Management of young blood donors

The emphasis on high-school blood drives and acceptance of 16-year-old blood donors led to more research on physiologic and psychological ways to decrease vasovagal reaction rates in young blood donors and to increase donor retention. Research on how to accomplish this has been advantageous for the blood collection industry and blood donors. This review discussed the current situation and what can be done psychologically, physiologically, and via process improvements to decrease vasovagal reaction rates and increase donor retention. The donation process can be significantly improved. Future interventions may include more dietary salt, a shorter muscle tension program to make it more feasible, recommendations for post-donation muscle tension / squatting / laying down for lightheadedness, more donor education by the staff at the collection site, more staff attention to donors with fear or higher risk for a vasovagal reaction (e.g. estimated blood volume near 3.5 l, first-time donor), and a more focused donation process to ensure a pleasant and safer procedure.