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Increasing donor adherence to pre-donation water loading and applied muscle tension

What was the question?

Some donors react to the sight of blood or a needle by feeling dizzy, becoming sweaty or feeling nauseous. This is known as a vasovagal reaction, and the symptoms are caused by a sudden drop in blood pressure and heart rate. Research has found two simple ways to reduce these symptoms. One is to drink 300ml of water ten minutes before the donation (known as water loading), and the other is a set of simple exercises during donation. If a person crosses their legs and tenses their inner thigh and abdominal muscles for five seconds while maintaining steady breathing (known as applied muscle tension), their blood pressure increases within two to three seconds.
The exercise is repeated at various times while donating.

Many donors are not aware of these two techniques. We wanted to test different educational materials for whole blood donors to increase the use of water loading and applied muscle tension.

Why is it important?

Vasovagal reactions (VVR) are one of the biggest deterrents to repeat blood donation. Donors who have
a VVR are at a higher risk of sustaining an injury and often feel embarrassed or anxious. VVRs disrupt the flow within a donor centre and can prolong donor wait times. It is therefore important to educate donors on how to prevent these reactions from occurring.

What did we do?

We selected donors with a whole blood appointment at one of two donor centres (Liverpool or Parramatta) and two days before their appointment, we sent each of them an email to help them prepare for their donation. The donors were randomised into one of four groups:

  • Group 1 received a link in their preparation email to an online instruction video
  • Group 2 received a link in their preparation email to a webpage with VVR prevention information
  • Group 3 received an instruction card at the donor centre
  • Group 4 was a “business as usual” group.

When the donor arrived at the donor centre, we invited them to participate in the study and asked them to complete a survey after their donation in refreshments.
We successfully recruited 600 donors into the study.

What did we find out?

Donors who received the onsite instruction card reported greater use of water loading, awareness and use of applied muscle tension, and had a higher collected blood volume. We also had positive feedback from participants: “I enjoy giving blood, this was my 85th donation and I have not had any problems in that time. I have not heard of muscle tension exercises but if they help, very good”.

The findings of this study highlighted the important role that donor centre staff play in providing donor education on VVR prevention. In our follow-up study, we are working with donor centre staff to develop new training materials for staff to improve the routine use of VVR prevention techniques. If you would like more information please contact Amanda Thijsen (athijsen@redcrossblood.org.au)

We would like to thank the staff at the two donor centres, the data collection staff from Medical Services, the study material designers from Business Improvement and Marketing, and the donors who participated in this study.

The study would not have been possible without you.