(3) The fall of peripheral resistance in the normal individual results in
adrenergic stimulation, an increase in heart rate, and increases in peripheral resistance
(skin, muscles, kidney, and gut). In the donor reaction, circulating blood volume loss
results in a fall of peripheral resistance, which appears to be related to a sudden
dilatation of the vascular beds in widespread areas of the body, particularly the
b. Treatment. The blood bank physician must provide written instructions for
handling donor reactions. This must include a procedure for obtaining emergency
Immediate action is needed if the donor has a reaction.
(a) At the first sign of reaction during the phlebotomy, REMOVE THE
TOURNIQUET AND WITHDRAW THE NEEDLE FROM THE ARM.
(b) If the treatment listed in the items below does not result in rapid
recovery, call the blood bank physician or the physician designated for such purposes.
(a) Place the donor on his back and raise his feet above the level of his
(b) Loosen tight clothing.
Be sure the donor has an adequate airway.
(d) Administer aromatic spirits of ammonia by inhalation. Test the
ammonia on yourself before passing it under the donor's nose, as it may be too strong
or too weak. Strong ammonia may injure the nasal membranes; weak ammonia is not
effective. The donor should respond by coughing, which rapidly elevates the blood
(e) Check and record the blood pressure, pulse, and respiration
periodically until the donor recovers.
(f) Apply cold compresses to the donor's forehead or the back of his
neck if this seems desirable.
Nausea and vomiting.
(a) Make the donor as comfortable as possible.