The last edition of the Patrika laid the prelude to understanding and handling adverse events in outdoor voluntary blood donation drives. Like mentioned last time, Sankalp India Foundation has designed a protocol for handling such events. In this edition of the Patrika, we shall focus on identification of Adverse events in blood donation drives. A problem well stated is like a problem half solved.
Standard for Surveillance of Complications Related to Blood Donation(Working Group on Donation(Working Complications Related to Blood Donation, 2007) is the most widely accepted and scientifically acknowledged document. The standard is to present an internationally accepted description of the complications, including severity and imputability grade. The document is the benchmark for capturing and reporting complications (adverse events or reactions). The document does not cover all of the possible complication. It attempts to categorize the complications into 16 categories which in all cover 99% of the complications which are reported.
Definition of Adverse Events
Adverse Event: Any untoward occurrence of any sort faced by the donor either before, during or after the completion of phlebotomy which could be associated with blood donation is classified as an adverse event.(Domaine, 2010)
Adverse Reaction: Any unexpected reaction of any sort faced by the donor either before, during or after the completion of phlebotomy which could have could be associated with blood donation is classified as an adverse reaction. reaction.(Domaine, 2010)
Complication related to blood donation: Adverse reactions or incidents related in time to a blood donation are defined as 'complication related to blood donation'.(Working Group on Complications Related to Blood Donation, 2007)
It also becomes very essential that the severity of the complication is thoroughly assessed. While severe complications could mean hospitalization, damage to body parts (permanent) or death, non severe complications generally include cases of hematoma, arterial puncture, arm injury and vasovagal reactions. A full blown categorization along with specification (localized or general symptoms) is mentioned in the following series of tables.
Perhaps we tend to neglect some of these occurrences. For example, blood oozing out of the phlebotomy site after the donor has left the donation area is considered "normal and acceptable". It could be the donor's or technical staff's carelessness. However, it is still an adverse event as it is not a normal occurrence. Identifying, treating and documenting it is important as it shall help us realize what could have caused this. This shall help in capacity building to avoid repeated instances thereby automatically improving quality in blood donation drives.
We request blood bank medical officers to capture details in the tables mentioned above and educate all members of the team that attend blood donation drives. For example, in blood donation drives organized by Sankalp, a quick reference card containing the classification and grading of adverse reaction is a part of the standard equipment.
The next issue shall carry details on prevention of adverse reactions.
Through the Patrika an appeal is made to all Blood Bankers to put in practice the methods and tools as mentioned in the protocol.
This protocol is a sincere effort from Sankalp India Foundation to make blood donation drives a pleasurable and awesome experience for blood donors. Readers are encouraged to bring forth queries, suggestions and ambiguities by writing to sankalp.admin@gmail.com
Lets walk together to make voluntary blood donation in India safer.
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References:
(Domaine 2010) Domaine, “Donor Management Manual,” 2010. [Online].
(Domaine 2007) Working Group on Complications Related to Blood Donation, “Standard for Surveillance of Complications Related to Blood Donation,” 2007. [Online].