Swelling after blood donation

Swelling after blood donation DEFAULT

Annex 2Bruising: information for blood donors

Although it is hoped that no donor will have any ill-effects from giving blood, occasionally bruising of the arm may develop at the venepuncture site. The bruise can look dramatic and some people may find this worrying, but it is usually harmless and recovers within a few days.

Bruising is caused by bleeding under the skin, which occurs due to injury to blood vessels. These injured blood vessels leak a small amount of blood, which collects in the area as a bruise. If a bruise occurs during blood donation, the process may be discontinued to prevent it from worsening. With time, the familiar blue-black discolouration changes to green, then yellow and eventually fades and disappears. This may take two to three weeks if the bruise is large. It is normal for bruises to spread out before fading.

During or after blood donation, the following may happen:

  • The vein is pierced during blood donation, causing some blood to leak into the surrounding tissue. The donor is more likely to develop a bruise if the venepuncture procedure was more difficult than usual.

  • There are tiny fragile blood vessels running just under the skin, as well as the larger veins from which the blood donation is obtained. When the donation needle is inserted into the arm, one of these small vessels may be injured and bleeding occurs.

  • Inadequate pressure placed on the venepuncture site after removal of the needle may allow blood to leak in the surrounding tissues.

  • Lifting heavy objects after blood donation could put pressure on the venepuncture site and dislodge the clot formed.

Prevention and management of bruising following blood donation

  • Wear clothes with loose fitting sleeves when donating blood. A tight sleeve can act as a tourniquet and cause congestion in the vein, increasing the chance of bruising.

  • Apply firm pressure to the venepuncture site after donation, as advised by the BTS staff member, until the bleeding has stopped. A plaster will be applied to cover the venepuncture site; this should be kept on for a minimum of six hours.

  • Avoid lifting heavy objects for a few days as this could aggravate the bruising. However, gentle movements are recommended whilst the bruise is healing.

  • If bruising has developed, applying cold compresses to the area can also help to relieve any pain or discomfort.

  • If you require more pain relief, it is recommended to take paracetamol (according to the manufacturer's instructions); avoid taking aspirin or ibuprofen for the first 24 hours.

  • If you experience any of the following, seek further help or call the BTS for advice:

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    Severe pain

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    Numbness or persistent pins and needles in the arm, hand or fingers

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    Swelling which is large or increasing in size

    &#x;

    Painful redness and inflammation.

Sours: https://www.ncbi.nlm.nih.gov/books/NBK/

Bruising and arm pain

Although we hope that no one will have any ill effects from giving blood, occasionally bruising of the arm and some arm pain may develop.

Does it hurt to give blood?

Following needle insertion you should be comfortable during your donation. If your arm hurts or feels sore while giving blood please alert a member of staff.

Will giving blood bruise my arm?

Occasionally, bruising of the arm may develop. The bruise may look dramatic and some people can find this worrying, especially if it appears away from the donation area. Bruises are usually harmless and will disappear with time and it is normal for them to spread out before fading.

If you do develop a bruise the following R.I.C.E advice may also help.

What if you can't find a suitable vein?

Although you may have been able to have blood tests taken easily at your doctors or the hospital, we use a larger needle which is in the vein for longer to obtain a full donation and this may mean your veins aren’t suitable for blood donation.

Sometimes it is necessary to advise donors that they should not become a blood donor or to no longer give blood. We would like to stress this decision is not taken lightly and is made after considering all factors involved. Thank you for giving up your time to come along. You could still support us by encouraging others to donate.

Why is my arm painful after giving blood?

If, during your donation, you informed staff of pain or discomfort in your donation arm, hand or fingers, this may be related to possible tendon/nerve injury. These are uncommon risks associated with venepuncture and there is more information about this in our donor consent booklet.

We advise that you avoid heavy lifting and strenuous activity. DO NOT immobilise your arm as this could cause further complications – gentle exercise will aid your recovery.

If you experience any of the following please contact us, visit your GP or attend a walk-in centre to gain medical assistance as early as possible:

  • stiffness, weakness or a dull ache in the arm
  • pain that gets significantly worse when you move the affected arm
  • severe or worsening pins and needles
  • severe or worsening swelling or the development of a lump in the arm
  • redness and/or inflammation of the donation arm
  • change of skin temperature or colour to your donation arm or hand.

 Treat your bruise with R.I.C.E

Rest – allow time for the arm to heal, avoid heavy lifting, e.g. at the gym or carrying heavy shopping. Light gentle movement is recommended. After 36 hours, return to normal activity.

Ice – This is most effective immediately for swelling of the bruise and surrounding area. Do not place directly onto the skin; use a cloth to act as a barrier to prevent freezeburns, e.g. pack of frozen vegetables or an ice pack.

Compression – pressing on the point where the needle was inserted.

Elevation – If possible, when resting elevate your arm on a pillow.

Treatment for the bruise is most effective whilst the bruise is still reddish, however after 36 hours – heat in the form of a warm cloth to be applied to the bruise for approximately 10 minutes, times a day may increase blood flow to the bruised area allowing the skin to reabsorb the bruise more quickly – ultimately the bruise will fade in colour.

Further information

If you are worried or require further information you can obtain advice by:

  • ringing our donor helpline on 23 23
  • calling the NHS helpline on
  • contacting your GP.

Register today to be a blood donor

Sours: https://www.blood.co.uk/the-donation-process/further-information/bruising-and-arm-pain/
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 Table of Contents 
CASE REPORT
Year :   |  Volume : 5  |  Issue : 3  |  Page :

A rare complication after blood donation: Brachial artery pseudoaneurysm

Lokesh Shekher Jaiswal, Tanveer Khan, Narendra Pandit
Department of Surgery, B. P. Koirala Institute of Health Sciences, Dharan, Nepal

Date of Web Publication8-Aug

Correspondence Address:
Dr. Lokesh Shekher Jaiswal
Department of Surgery, B. P. Koirala Institute of Health Sciences, Dharan
Nepal
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Source of Support: None, Conflict of Interest: None

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DOI: /ijves.ijves_6_18

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  Abstract 


Pseudoaneurysm of brachial artery following whole blood donation is a very rare complication due to inadvertent arterial puncture. There are only a few cases reported in literature. Here, we describe this rare event in a young male whole blood donor presenting 2 months after blood donation with pulsatile swelling in the right antecubital fossa and paresthesia of hand. He was successfully managed with surgical intervention.

Keywords: Blood donation, brachial artery, complication, pseudoaneurysm


How to cite this article:
Jaiswal LS, Khan T, Pandit N. A rare complication after blood donation: Brachial artery pseudoaneurysm. Indian J Vasc Endovasc Surg ;

How to cite this URL:
Jaiswal LS, Khan T, Pandit N. A rare complication after blood donation: Brachial artery pseudoaneurysm. Indian J Vasc Endovasc Surg [serial online] [cited  Oct 13]; Available from: https://www.indjvascsurg.org/text.asp?/5/3//




  Introduction Top


Minor complications such as bruise and local pain can occur after whole blood donation. Inadvertent arterial puncture during whole blood donation is very rare and can lead to serious complications such as arterial pseudoaneurysm, arteriovenous fistula, and compartment syndrome. There are three reported cases of brachial artery pseudoaneurysm[1],[2],[3] and only one case of brachial artery true aneurysm[4] due to arterial puncture during blood donation. Here, we discuss this rare event during blood donation and its preventive measures.


  Case Report Top


A year-old male presented with a history of progressively increasing swelling in the right antecubital fossa of 2 months duration. It was associated with tingling sensation in hand and constant aching pain aggravated by movement of elbow joint. He gives a history of blood donation 2 months back following which he developed bruise and swelling which was managed conservatively with local compression; however, it progressively increased in size. It was his first blood donation. On examination, there was 6 cm &#; 6 cm tense pulsatile swelling in the medial aspect of the right antecubital fossa [Figure 1]a. Duplex examination showed large hematoma with Ying&#;Yang flow in central zone arising from brachial artery suggestive of pseudoaneurysm [Figure 1]b. Ultrasound-guided compression was attempted; however, it was unsuccessful. Surgical repair was planned, as hematoma was large and tense causing pain and paresthesia due to local nerve compression. He was operated under local anesthesia with 1% lignocaine. Proximally brachial artery was dissected, and control was taken with arterial sling after heparinization. Horizontal incision was made over the swelling in antecubital fossa and deep fascia (bicipital aponeurosis) was incised, releasing the tense hematoma lying below it [Figure 2]a. After the evacuation of hematoma, a 2 mm hole in brachial artery above the bifurcation was visualized [Figure 2]b, there was no other superficial artery, and course of brachial artery was normal. The hole was repaired primarily by oversewing with polypropylene suture [Figure 3]. Postoperatively, his pain and paresthesia subsided and is on regular follow-up without any complaints.
Figure 1: (a) Large and pulsatile swelling in the right antecubital fossa. (b) Duplex scan showing pseudoaneurysm arising from brachial artery

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Figure 2: (a) Large hematoma below the deep fascia. (b) Hole in the brachial artery (arrow) just above the bifurcation showing spurt of blood coming out

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Figure 3: Primary repair of brachial artery hole after evacuation of hematoma

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  Discussion Top


Arm complications after whole blood donation occur in 30% of the donors. Most commonly, it occurs as minor complication in the form of simple contusion or hematoma (23%) and arm pain (10%); however, major complications can occur due to inadvertent arterial puncture (pseudoaneurysm, arteriovenous fistula, and compartment syndrome) and nerve injury. The reported incidence of arterial puncture during whole blood donation is around %, more commonly in men and first time donor.[5] Almost one-third of the arterial puncture results in hematoma formation. However, pseudoaneurysm develops only in %&#;% of all arterial punctures following blood donation.[1],[6]

Arterial puncture should be suspected whenever there is shorter blood collection time of <3 min, collection of bright red blood, pulsating needle or tubing system, difficult venipuncture or manipulation of needle, and development of large hematoma after donation. In our case, the patient gives a history of blood collection in shorter time than other donors of the day; however, he could not recall the color of blood and manipulation of needle. Once arterial puncture is suspected needle should be removed, and firm pressure should be applied for 10 min followed by bandage application for 5 h.[6] Before asking the donor to leave, sealing of puncture site should be ensured as most of the arterial puncture can be managed with this conservative management, thus avoiding the future pseudoaneurysm.

Complications due to arterial puncture should be minimized in this noble cause, as it can demotivate the donor for future blood donation. This can be prevented by venipuncture by experienced phlebotomist, use of lateral veins, minimizing needle manipulation and discontinuation of the process, and application of local compression once arterial puncture is suspected. Routine follow-up of donor is advised in suspected arterial puncture for early detection and treatment of complication.


  Conclusion Top


Arterial puncture during whole blood donation is rare and brachial artery pseudoaneurysm is even rarer. This can be further minimized by extra vigilance and ensuring immediate measures to seal the puncture site in case of inadvertent arterial puncture.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Popovsky MA, McCarthy S, Hawkins RE. Pseudoaneurysm of the brachial artery: A rare complication of blood donation. Transfusion ;  Back to cited text no. 1
    
2.
Kumar S, Agnihotri SK, Khanna SK. Brachial artery pseudoaneurysm following blood donation. Transfusion ;  Back to cited text no. 2
    
3.
Newman B, Popovsky M. Pseudoaneurysm after blood donation. Transfusion ;  Back to cited text no. 3
    
4.
Bhatti K, Ali S, Shamugan SK, Ward AS. True brachial artery aneurysm following blood donation: A case report of a rare complication. EJVES Extra ;  Back to cited text no. 4
    
5.
Newman B. Arm complications after manual whole blood donation and their impact. Transfus Med Rev ;  Back to cited text no. 5
    
6.
Newman BH. Arterial puncture phlebotomy in whole-blood donors. Transfusion ;  Back to cited text no. 6
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]

This article has been cited by
1Risk mitigation in blood transfusion services – A practical approach at the blood center level
Shivaram Chandrashekar,Ambuja Kantharaj
Global Journal of Transfusion Medicine. ; 4(2):
[Pubmed] | [DOI]

 
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Sours: https://www.indjvascsurg.org/article.asp?issn=;year=;volume=5;issue=3;spage=;epage=;aulast=Jaiswal
Blood Donation – Precautions and Care - Aarogyamastu - 18th March 2020 - ETV Life

Keeping you safe

Possible side-effects

Bruising

Small bruises around where the needle was inserted are pretty normal and nothing to worry about. Much more rarely, larger bruises or pain may occur. They might look scary, but they’re usually harmless and all bruises will go away in a couple of days. 

It can’t always be prevented, but you can reduce the risk of bruising by keeping the bandage on your arm for 4 hours after donating, and by avoiding heavy lifting and strenuous use of your arm for the next 24 hours. 

If your bruise is causing any kind of discomfort: 

  • Hold a cold pack wrapped in a clean cloth over the bruise. Only do this for 15 minutes at a time, times in the first 24 hours. 
  • After 24 hours, apply a hot pack wrapped in a clean cloth. Do this for 15 minutes at a time, times a day. 
  • Use mild pain relievers like paracetamol (not aspirin or anti-inflammatory medications like ibuprofen). 

If your bruise is causing severe pain, numbness, inflammation, stiffness or swelling, call us on 13 14 95 to talk to one of our medical officers. 

Feeling unwell

It’s really rare, but some people feel unwell during or after a donation. If you do, or if you experience any pain, it’s really important that you tell a staff member immediately. 

If you feel unwell while donating, our team members will be with you every step of the way, making sure you’re feeling great. They’ll make a note and follow-up if you were uncomfortable or unwell at any point, so don’t be afraid to speak up. 

Your health is very important to us. If you feel unwell at any time before, during or after your donation, or you experience pain, it is very important to tell a staff member immediately.

If you feel unwell after you’ve left the donor centre, give us a call on 13 14 95 and we can let you know what to do and record what happened. 

That information will also help next time you come in. We'll look into what happened and, where possible, improve things for next time. 

Any complications

There can be complications, but they’re extremely rare and usually resolve completely. You may need medical treatment, or to restrict your normal activities while they do. 

This may include damage to an artery, nerve or tendon and local swelling or infection at the needle site. This sort of problem occurs in less than 5 in every 10, donations. 

Even more rarely, some donors experience tightness in the chest, chest pain or a rapid pulse. It only happens to a really small number of people (less than %), but if it happens to you while you’re still in the donor centre, please tell a member of staff immediately. If you have these symptoms after you leave, call  

Sours: https://www.lifeblood.com.au/blood/safety/keeping-you-safe

Blood donation after swelling

Why You Can Get a Bruise After a Blood Draw

After having your blood drawn, it’s fairly normal to have a small bruise. A bruise usually appears because small blood vessels are accidentally damaged as your healthcare provider inserts the needle. A bruise might also form if there wasn’t enough pressure applied after the needle is removed.

Bruising after a blood draw is typically harmless and doesn’t require treatment. But, if your bruises are large or accompanied by bleeding elsewhere, it could be a sign of a more serious condition.

Causes of bruises after a blood draw

Bruising, also known as ecchymosis, happens when capillaries located just under the skin are damaged, leading to bleeding just underneath the skin. The bruise itself is discoloration from the blood trapped under the skin’s surface.

Damaging blood vessels

During a blood draw, a healthcare provider specially trained to collect blood — most likely a phlebotomist or a nurse — inserts a needle into a vein, usually on the inside of your elbow or wrist.

As the needle is inserted, it may damage a few capillaries, leading to the formation of a bruise. This isn’t necessarily the fault of the person drawing the blood as it’s not always possible to see these small blood vessels.

It’s also possible that the needle needs to be repositioned after the initial placement. The person drawing the blood may also insert the needle too far beyond the vein.

Small and hard-to-find veins

If the person drawing blood has any difficulty locating a vein — for example, if your arm is swollen or your veins are less visible — it makes it more likely that blood vessels will be damaged. This may be referred to as “a difficult stick.”

The person drawing the blood will usually take the time to locate the best vein, but sometimes they aren’t successful on the first try.

Not enough pressure after

Another reason a bruise may form is if the person drawing the blood doesn’t apply enough pressure on the puncture site once the needle is removed. In this case, there’s more of a chance that blood will leak into the surrounding tissues.

Other causes of bruising after blood draws

You might be more prone to bruising during or after a blood draw if you:

  • take medications called anticoagulants that reduce blood clotting, such as aspirin, warfarin (Coumadin), and clopidogrel (Plavix)
  • take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) or naproxen (Aleve), for pain relief
  • take herbs and supplements, such as fish oil, ginger, or garlic, which may also reduce your body’s ability to clot
  • have another medical condition that makes you bruise easily, including Cushing syndrome, kidney or liver disease, hemophilia, von Willebrand disease, or thrombocytopenia

Older adults may also bruise more easily as their skin is thinner and has less fat to guard the blood vessels from injury.

If a bruise forms after a blood draw, it’s usually not a cause for concern. However, if you notice bruising on other parts of your body or the bruise is very large, you may have another condition that could explain the bruising.

How to avoid bruising after a blood draw

You can’t always avoid bruising after a blood draw. Some people just tend to bruise more easily than others.

If you’re scheduled to have blood drawn, there are a few steps you can try to prevent a bruise:

  • Avoid taking anything that can cause blood thinning in the days before your appointment and 24 hours after the blood draw, including over-the-counter NSAIDs.
  • Don’t carry anything heavy, including a handbag, using that arm for several hours after the blood draw, since lifting heavy objects can put pressure on the needle site and displace your blood clot.
  • Wear a top with loose-fitting sleeves during the blood draw.
  • Apply firm pressure once the needle is removed and keep your bandage on for a few hours after the blood draw.
  • If you notice a bruise forming, apply a cold compress to the area of injection and elevate your arm to help speed up the healing process.

You should tell your doctor and the person drawing blood if you bruise frequently from having blood taken. Be sure to also tell them if you have any medical conditions or you’re taking any medications known to cause issues with clotting.

Butterfly needles for blood collection

If you notice that the person drawing the blood is having a difficult time locating a good vein for a blood draw, you can request the use of another type of needle called a butterfly needle, also known as a winged infusion set or a scalp vein set.

Butterfly needles are often used to draw blood in infants, children, and older adults. A butterfly needle requires a shallower angle and is a shorter-length, making it easier to place in small or fragile veins. This reduces the likelihood you’ll bleed and bruise after a blood draw.

It’s important to know, however, that healthcare providers who draw blood are encouraged to use traditional methods before the use of butterfly needles, due to the risk of clotting.

If you ask for a butterfly needle, there’s a chance your request may not be granted. It may also take longer to draw blood using a butterfly needle because it’s smaller or finer than the standard needle.

When to see a doctor

If the bruise is large, or you notice that you bruise easily, it could indicate an underlying condition, such as a clotting problem or a blood disease. On top of bruising after a blood draw, you should see your doctor if you:

  • often experience large bruises that can’t be explained
  • have a history of significant bleeding, such as during surgery
  • suddenly begin bruising after you start a new medication
  • have a family history of bruising or bleeding episodes
  • are experiencing unusual bleeding in other places, such as your nose, gums, urine, or stool
  • have severe pain, inflammation, or swelling at the site of the blood draw
  • develop a lump at the site where blood was drawn

The bottom line

Bruises after a blood draw are fairly common and will go away on their own as the body reabsorbs the blood. The bruise is caused by damage to a few small blood vessels during the blood draw process, and is usually not the fault of your healthcare provider.

The bruise may change in color from dark blue-purple, to green, and then brown to light yellow over the course of a week or two before it goes away completely.

Sours: https://www.healthline.com/health/bruising-after-blood-draw
Blood Donation – Precautions and Care - Aarogyamastu - 18th March 2020 - ETV Life

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