Determining the effect of vein visualization technology on donation success, vasovagal symptoms, anxiety and intention to re-donate in whole blood donors aged 18-30 years: A randomized controlled trial.

BACKGROUND AND OBJECTIVES: Vein visualization technology (VVT) devices use near-infrared light to assist location of peripheral veins. The current study investigated the impact of VVT on donor experience and collection success for young blood donors at the Australian Red Cross Blood Service. MATERIALS AND METHODS: The study in donors aged 18 to 30 years used a two intervention to one control randomized trial design with 285 new and 587 returning donors recruited at two sites. Donors reported presyncopal symptoms, phlebotomy pain, anxiety and intentions to redonate along with other measures. Participating phlebotomists rated usefulness of the technology. Flow rates, collection volumes and other donation information were taken from routine data. RESULTS: No significant differences were found between control and intervention groups on presyncopal symptoms, phlebotomy pain, anxiety, intentions to redonate, flow rates, collection volumes or vasovagal reactions (all P's > 0·05). Phlebotomist ratings of VVT were significantly more positive when they had less than 5 years of experience (P < 0·01) or when the vein was not visible to the naked eye (P < 0·01). CONCLUSIONS: Results suggest that VVT does not improve the donation experience for younger blood donors. Staff reports indicate that VVT may have some utility for assisting with difficult phlebotomies.

[Distorsion of the wrist joint]. / Die Handgelenk-"Distorsion".

Wrist hyperextension is a common injury. However, obvious ligamentous ruptures are apparently seldom. The intracarpal locking phenomenon, allowing for correct load transmission, or overlooked pathology might explain this remarkable discrepancy. If the muscle tension fails, i.e., no locking phenomenon happens, and the ligaments are put under abnormal constraints with a high risk of secondary rupture. Such constraints might also appear secondary to bony alteration or previous ligamentous weakening. Patient history allows to define the pathophysiology of the accident, examination will locate the points of maximal tenderness whereas radiology allows to detect malalignment, step-off or bony anomaly. To be valid, radiology must be standardized. Accordingly we describe the radiological techniques. Scintigraphy will show if the lesion is focal (mainly osseous) or not (dystrophy). Arthrography helps to find out which group of ligaments are torn, whereas arthroscopy will quantify the tears and find out additional chondromalacia or synovitis. Magnetic resonance imaging remains limited to vascular trouble shooting. We propose a diagnostic and therapeutical scheme that will help the physician in advising the patient.