Need help!

[Animor]

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Hello everyone,

I have graduated medical school some months ago and I have just started to work in a blood donation center in Albania. Till now I have seen several cases of vasovagal syncope after blood donation. What the older doctors mostly do here, when this happens is a subluxassion of the mandibular joint which provokes a lot of pain and kind of wakes the donor up.
Can someone tell me if there is a simple manner to manage this kind of situation or can send me any videos to see closely and better step by step how it is done?

Thank you!

 

[Apollyon]

subluxassion of the mandibular joint which provokes a lot of pain and kind of wakes the donor up.

So the donor has vasovagal syncope after blood donation, and the docs grab onto the patient's jaw and wrench on it? Seriously?

All that happens in the US is making the donor supine and observation for a bit. We don't assault or batter the patients here (at least that much).

 

[danzman]

Hello everyone,

I have graduated medical school some months ago and I have just started to work in a blood donation center in Albania. Till now I have seen several cases of vasovagal syncope after blood donation. What the older doctors mostly do here, when this happens is a subluxassion of the mandibular joint which provokes a lot of pain and kind of wakes the donor up.
Can someone tell me if there is a simple manner to manage this kind of situation or can send me any videos to see closely and better step by step how it is done?

Thank you!

Cranial Osteopathy at its finest.

 

[wook]

Hello everyone,

I have graduated medical school some months ago and I have just started to work in a blood donation center in Albania. Till now I have seen several cases of vasovagal syncope after blood donation. What the older doctors mostly do here, when this happens is a subluxassion of the mandibular joint which provokes a lot of pain and kind of wakes the donor up.
Can someone tell me if there is a simple manner to manage this kind of situation or can send me any videos to see closely and better step by step how it is done?

Thank you!

I think what you are referring to is the the "laryngospasm notch" http://anesthesiology.med.miami.edu/documents/mm_articles/93.pdf. It is a painful stimulus that works very well.

Thanks.


Wook

 

[Animor]

Maybe I didn't explain myself quite clearly. Of course that we don't use this method every time. Only when the donor has a syncope, so the donor is not concious for some seconds. I have seen that after applying these method they gain their selfs immediately. I guess it is the same method although I don't think that it is for the same purpose.
"I think what you are referring to is the the "laryngospasm notch" http://anesthesiology.med.miami.edu/...rticles/93.pdf. It is a painful stimulus that works very well."
I thought maybe there is any other easier method to use, becouse I think it wont be easy for me to do this to robust donors.

Thank you very much for the answers doctors! 🙂

 

[dchristismi]

You shouldn't have to *do* anything. Just lie them flat and give them a few seconds. A gentle shake is usually enough - when people have syncope from blood donation it is brief and resolves pretty quickly without painful stimuli.

 

[WilcoWorld]

Agree with above - lay them flat and check a pulse. If it's a little brady or normal - you're fine. If it's very fast or weak, only then might you want to start doing something.

 

[EctopicFetus]

Lay em down and lift their legs.. works well.

 

[EM_Rebuilder]

Lay em down and lift their legs.. works well.

I can think of many "questions" that this could serve as a great answer.

 

[Animor]

Lay em down and lift their legs.. works well.

Of course we do that. What we do is that we immediatly suspend the donation. We lay them in Trendelenburg position, and give them coton with alcohol. But sometimes this is no use. I guess our donors have a more important reactions than yours, maybe due to the psychological factors. Most of them are family members who donate for their relatives.

 

[danzman]

Of course we do that. What we do is that we immediatly suspend the donation. We lay them in Trendelenburg position, and give them coton with alcohol. But sometimes this is no use. I guess our donors have a more important reactions than yours, maybe due to the psychological factors. Most of them are family members who donate for their relatives.

Just how much blood are you taking?

 

[Animor]

Just how much blood are you taking?

450 ml, considering even the "container" (I'm sorry I don't know the right term.) But this is flexible. Sometimes when it is too hot or the donor donates for the first time we accept 400 ml.

 

[Rendar5]

I think you're right that it is likely a cultural/psychological phenomenon. Because for what you describe to be a fairly common occurence is not common here.


In the US, I'd be concerned that it's something other than a vasovagal response if they were to syncopize wihtout a rapid return to baseline from trendelenberg position.

 

[dchristismi]

Before I went to med school I worked for the Red Cross and did 2 years worth of mobile blood drives. Syncope is actually very common, and sometimes it takes a little bit, but they all wake up. You may be right that there is a cultural element, but there is some of that here as well. If you donors are properly screened and healthy, I still would err on giving them a little more time. Having a syncopal or near-syncopal event makes you feel pretty awful for a bit.

 

[Animor]

Yes, it really makes them feel bad. I don't think they would ever donate again as voluntary donors after such experience.
While reading a transfusion medicine book, I came across a internet url. It was a list of medications that suspend the donor from the donation, from the US Army blood service, but I couldn't open this page online. Can someone help me find this list?