Analysis of vasovagal syncope in the blood collection room in patients undergoing phlebotomy.

Vasovagal syncope (VVS) is well-known to occur in patients undergoing phlebotomy, however, there have been no large-scale studies of the incidence of VVS in the blood collection room. The aim of our present retrospective study was to investigate the conditions of phlebotomy and determine the incidence/factors predisposing to the development of VVS. We investigated 677,956 phlebotomies performed in outpatients in the blood collection room, to explore factors predisposing to the development of VVS. Our analysis revealed an overall incidence of VVS of 0.004% and suggested that use of more than 5 blood collection tubes and a waiting time of more than 15 min were associated with a higher risk of VVS. The odds ratios of these factors were 8.10 (95% CI 3.76-17.50) and 3.69 (95% CI 0.87-15.60), respectively. This is the large-scale study to analyze factors of the development of VVS in the blood collection room, and according to our results, use of a large number of blood collection tubes and a prolonged waiting time for phlebotomy may be risk factors for the development of VVS.

Establishment of a stable sampling method to assay mercaptoalbumin/non-mercaptoalbumin and reference ranges.

Oxidative stress is reportedly associated with many diseases such as cancer, arteriosclerosis, diabetes and aging, but no practical biomarkers are currently available in actual clinical practice. Human mercaptoalbumin (HMA) and human non-mercaptoalbumin (HNA) are expected to become markers of oxidative stress, but the stability of HMA/HNA has been problematic. We investigated the conditions for stabilizing HMA/HNA and found that HMA/HNA was stable at room temperature for 25 h if whole blood samples were mixed with a citrate buffer so that the citric acid concentration after mixing was 70 mM or higher and the pH of the added buffer was less than pH 6.0. Whole blood samples were then collected under the above conditions, and the reference range for HNA was set at 21.8% ±â€¯7.4% (HMA, 78.2% ±â€¯7.4%) based on samples from 65 volunteers (28 males and 37 females; average age, 55.0 ±â€¯13.8 years). The clinical usefulness of HMA/HNA as an oxidative stress marker should be clarified for specific pathological conditions using the previously reported, highly accurate measurement method under the conditions required for HMA/HNA stability.

[Emergency drills and exercises to prepare the initial response and countermeasures for a disaster: an evacuation simulation for the hospital's outpatient blood collection room in the event of an earthquake].

In case of a disaster, the clinical laboratory's departmental staff is not only responsible for recovery efforts of routine work and the continuation of emergency tests, but also for protecting patients against both dangers and possible risks in the blood collecting room and physiology laboratory. For this reason, we decided to participate in an emergency drill, which focuses on the initial response to a disaster, specifically evacuation procedures and the cessation of phlebotomy operations. Since there were no existing manuals regarding disasters in our blood collection room, we first made a draft disaster plan. Additionally, since we were absolute beginners with regard to training and had inadequate knowledge of disaster countermeasures, we conducted theoretical simulations in advance. We decided to explain the evacuation details and had each participant in the exercise perform their own role in accordance with our scenario. Furthermore, we asked the participants to discuss the effectiveness of the training and seek out ways to improve our manuals. Although this was the first practice for the blood collection room, we were able to achieve our first goal by raising awareness of disaster prevention activities. The precautions against disaster that eliminate accidents require an immense amount of time and effort. Thus, it is necessary to continue training in order to increase the staffs awareness of disaster defense and to continue to improve our skills in the future.