Help me not faint when donating blood
July 31, 2014 8:00 AM   Subscribe

Sometimes I have a dramatic vasovagal response (i.e. I pass out) after having blood drawn or donating blood. Sometimes I don't. This means that I donate blood less than I'd like to. Can I condition myself out of this?

This question was prompted by my yearly health screening, which includes taking several vials of blood. This morning I did not feel lightheaded or pass out, no problem. In the past, I have, but there doesn't seem to be any kind of pattern I can discern to fainting vs. not-fainting, i.e. exercise immediately before the draw, food eaten (today I fasted for 12 hours and was fine), time of day, etc.

When I do faint it can be rapid, with only a few seconds between starting to feel off and hitting the floor, and often comes on a while after the needle is out of my arm. Sometimes I've even spent 10-15 minutes sitting around feeling fine, and then as soon as I decide to walk out the door I urgently have to lay down on the sidewalk outside.

This isn't a huge a problem for blood draws, as they're infrequent (once a year, generally) and I'm not generally a squeamish person, so I don't have trouble with anticipatory nervousness or avoidance. However, I do worry that I'm going to injure myself by falling someday, and I avoid donating blood because passing out is, honestly, pretty unpleasant.

I've tried things like drinking salty fluids and clenching muscles but nothing seems to help, and I don't seem to be desensitized by repeated exposure--for a while I was donating blood regularly and still frequently (but not predictably) passed out. I would really like to donate blood regularly. Is there anything else I can try? Does everyone pass out when donating, and they're just toughing it out? Can I eventually manage to desensitize myself?
posted by pullayup to Health & Fitness (20 answers total) 1 user marked this as a favorite
What gender are you? Could this possibly be related to your menstrual cycle?

And no, it isn't normal. Some people are more fainty than others, but certainly the bulk of the population isn't fainting and just toughing it out.

Are you drinking juice and eating a cookie or biscuit after donating but before standing? What position are you in when your blood is being drawn and while in recovery?

If you are seated have you tried completing the donation and then inverting your head?
posted by DarlingBri at 8:09 AM on July 31, 2014

Have you considered that it might be physiological and not psychological? Especially if the fainting occurs when you're moving from laying to sitting, or from sitting to standing?
posted by Gev at 8:10 AM on July 31, 2014

Ugh, I have this problem too, and it started as an adult, too.

Anyway, sometimes telling the tech/nurse that I might get light-headed or pass out helps. They might suggest I lie down rather than sit for the procedure. Then I just stay put for a while afterwards, til I'm pretty sure my head is clear.
posted by bluedaisy at 8:12 AM on July 31, 2014 [3 favorites]

Vasovagal reactions to blood draws are pretty rare. This article has a lot of tips (aimed at blood donation centers) for reducing negative reactions to blood draws.
posted by muddgirl at 8:13 AM on July 31, 2014 [1 favorite]

I have fainted in response to donating blood. I was hungry before I went into donate and, after, I made it across a huge campus before passing out in a McDonald's. Of course I assumed it was low-blood sugar and lack of sleep. (I was a college student, burning the candles at both ends during mid-terms.)

The next time I went into donate, it was a double red cell donation. I made sure I was well hydrated, well rested, and had eaten before going in. I told the nurse about my previous experience and that I was nervous about passing out again. She asked me to tell her if I felt faint during the procedure. I did and she reclined the chair I was in and took out two of those cold packs (the ones you have to break something inside and shake to get the cold going) and put them on my chest. It didn't completely take away the edge of blotto feeling, but it did keep me from fainting.

The most believable explanation I've heard about it is that donating tricks your body into believing that you're bleeding out and responds by dropping your blood pressure to keep you from bleeding to death. I have never tried to combat fainting, but I wonder if the tricks that pilots use to avoid passing out in high G situations would work, the AGSM and "hick maneuver."

My solution, after talking with my doctor, was to stop donating blood.
posted by GoLikeHellMachine at 8:23 AM on July 31, 2014 [1 favorite]

I've done several dozen whole-blood donations, plus another bunch of platelet donations; the rules are always the same:
*Get plenty of rest beforehand: don't go into it already tired. Take a nap afterwards if you need to: it's okay to lay down and rest some more.
*Always have something in your stomach, even if it's just a couple slices of toast; although something more substantial --- even a bowl of cereal --- will be better. And definitely fluids: drink some juice or something beforehand, so you don't go in there dehydrated. (And yeah, this is why blood donation places make you sit and have something to drink and a couple of cookies or something before you leave!)
*Avoid alcohol and exercise for the rest of the day; both can take even more of a toll on your temporarily-depleted body. (And no, even though booze is liquid it doesn't help with dehydration or replacing the lost fluids!) Soda or coffee is better by far than alcohol, but juice or water is best.
*If you're female, yep, menstrual cycle can make a difference: giving blood when you're already at your lowest point of the month for iron- and fluid-loss won't help.

I've been lucky and never yet passed out, but take that with a grain of salt: if you ask, they'll tell you that sooner or later everyone does: it just hasn't been my turn yet. For what it's worth, I find its far easier to not watch them stick that needle in me: I can watch the blood flowing down the tube and filling the bag, I can watch them remove the needle; I can handle all of it except watching the needle actually going in....
posted by easily confused at 8:58 AM on July 31, 2014 [1 favorite]

I've donated blood three times, and passed out three times. It doesn't seem to have anything to do with anything in my control (I also tried eating a lot, drinking a lot beforehand). After discussing with the Red Cross nurse last time, I no longer try to donate blood. She said something along the lines of, "some people just shouldn't donate blood". If it's an important issue to you, perhaps you could volunteer as one of the sign-in desk people? (Not sure if you need a medical background for that sort of thing)

I do OK with blood draws. For me, I think it must have something to do with the volume of blood, since I'm OK for the beginning of the donation, and then it hits me near the end.
posted by chocotaco at 9:00 AM on July 31, 2014

So, looking at what AGSM is, mentioned above by GoLikeHellMachine, I find that this is what they teach pilots:

1. Breathing: Rapid (under 1 sec) exhalation/inspiration cycles every 3-4 seconds. This maintains oxygen content and decreases carbon dioxide in blood, while also relieving increased pressure of chest, and allowing the heart to refill with blood.
2. Isometric Contraction: Flexion of skeletal muscles of legs and abdomen. This step increases pressure in chest and displaces blood away from these contracted muscles into the arms, chest, and brain.

I used to faint in both situations like you. Also when getting shots, so I think it's basically a reaction to needles, not triggered by blood loss but more of a psychological reaction to needles. I have not had this problem since adopting part two of AGSM, though I didn't know what that was at the time. The technician drawing blood would probably not appreciate part one (rapid breathing), and I don't think its necessary.

The basic idea is, you faint because blood is draining out of your brain. You can counteract whatever is causing that by flexing lower body muscles which increases blood pressure. (You mention clenching muscles but it needs to be the right ones.) I find that just wiggling my toes or feet is enough, but you could do more, like alternatively tightening and relaxing your stomach or leg muscles. Since I know it's a needle thing, I also studiously look in the opposite direction from where it's being done, and engage my mind with whatever I see there, like reading a poster or studying a picture or whatever I see.
posted by beagle at 9:03 AM on July 31, 2014

I have the same problem. During a blood donation at work a few years ago, I started having tunnel vision during the middle of the blood draw, almost as if the blood was coming directly from my brain.

My thinking was clear enough though, to debate a critical issue: "Should I tell the nurse I'm about to faint, and suffer through the ribbing I will likely get from my coworkers, or should I just pass out completely and not worry about it?"

I decide to alert the nurse. She immediately tilted me back in the chair, such that my legs were elevated higher than my heart. My vision immediately cleared, and I finished the donation without a problem. From that point on, I just mention "vaso-vagal reaction" to the nurse and ask to have my feet elevated, and there has been no problem.
posted by superelastic at 9:18 AM on July 31, 2014 [1 favorite]

I worked in recruitment at a blood bank and we always insisted that donors ate a good meal within 4 hours of donating (but nothing too greasy or spicy). There's also some newer research indicating that hydration is as important to preventing "reactions." I'd recommend drinking lots of water in the days preceding your donation or blood draw, and also downing a bunch right before.

Tell the donor tech that you've had reactions before. They'll give you ice packs and put your feet up. And if you start to feel faint or see stars or anything, don't be shy about alerting them.

Also depending on your blood type (talk to your blood bank), you might be a good candidate for apheresis platelet and/or plasma donation. Since you're not losing the red cells you have less of a chance of having a reaction. I personally much prefer giving platelets because I don't feel crappy afterwards.
posted by radioamy at 9:29 AM on July 31, 2014

I just went through a blood-draw two weeks ago, and have the exact same problem as you. All I can say is to

1) Hydrate, hydrate, hydrate in the days before the draw.
2) Make sure they know that you will almost certainly pass-out.
3) Ask them to use a pediatric needle.
4) Ask to have a second nurse in the room to hold your hand and talk to you during the procedure and make sure your eyes are on them and not on the nurse doing the needle work.
5) Don't be afraid to make whatever horrible noises you need to make, and even bounce your legs if needed. And squeeze that nurse's hand like you're trying to crush it. Seriously. They don't mind.

I came close to blacking-out, but, thanks to the tiny pediatric needle and the nurse holding my hand and talking to me, I actually got through it. The nurses said I turned a bit pale, but never went out. Got juice and a cookie after, too!

Blood draws suck.

Good luck!
posted by Thorzdad at 9:37 AM on July 31, 2014

I am living proof that it is possible to give over a gallon of blood without once looking at needles or blood. I just studiously look away, like beagle recommends, because I know I could feel faint, though I've never passed out. My regime is to drink a half liter of water just before I sign in for the donation, and always do the double red / ALYX. Since they give you back the fluid, I find I am much less faint and dizzy afterwards.
posted by wnissen at 9:42 AM on July 31, 2014

radioamy and others are right about platelet or plasma donations causing less dehydration and therefore less chance of passing out, but to be honest there are a couple drawbacks to these, too:

When you donate whole blood, they use one needle, usually in the inside of your elbow. Platelets, on the other hand..... that takes two needles, one usually in arm A in the inside of your elbow; and the other in arm B, either in the inside of that elbow or in the back of your hand --- this is because the blood is removed from you through arm A, goes through a machine that centrifuges out the platelets/plasma, then the rest of the fluids are returned to you through arm B. Also, because of the more involved procedure, platelets/plasma takes 2-3 hours, as compared to whole blood rarely taking more than 15 minutes.

So if needles make you freak out, don't donate platelets.
posted by easily confused at 9:57 AM on July 31, 2014

I'm a fainter and I tell the nurses (as part of explaining my actual phobia/PTSD problems), and they always put me horizontal for draws. Being horizontal and staying that way for a few minutes after the draw has always been sufficient for me to recover without fainting either during the draw or when I stand up afterwards.

I'm under a lifetime donation ban for mad cow risk, so I can't help with actual donation.
posted by immlass at 9:58 AM on July 31, 2014

Out of the dozen or so times I've donated blood, I've nearly passed out after about a third of them. I haven't been able to find any rhyme or reason for it related to food/water/etc. One recommendation I'll reiterate: tell the people drawing your blood that you have a history of passing out. They'll take extra precautions, like leaning you all the way back, and making you hang out in the chair to recover for a bit before sending you to the snack table. Sometimes they'll preemptively give you an ice pack and bring drinks over.

Also, try not to feel bad, like you're some pain in the ass donor. Last time I gave blood, there was a guy in there who abruptly passed out and fell out of his chair at the snack table. It was actually really entertaining to watch the employees spring into action, shouting urgently and throwing ice packs across the room to each other. Apparently the guy had been donating regularly for years and had never before had a problem, so it really can happen to anybody.
posted by gueneverey at 10:25 AM on July 31, 2014

I have fainted. The skill of the person doing the draw makes a huge difference, for me; one needle insertion, I'm fine, while several pokes and prods invariably make me clammy and lightheaded. I do have small veins, so now I ask for the pediatric ("butterfly") needle and for someone who'll be fast and accurate.
posted by Iris Gambol at 11:34 AM on July 31, 2014

Also, keep in mind that your reaction to a blood draw for lab testing (when you may have received instructions to fast for the preceding X hours) may be different from your reaction when you give blood (because you can be better prepared nutritionally).
posted by John Borrowman at 11:56 AM on July 31, 2014

i've had the same experience as chocotaco--ok w/minor draws (a couple tubes) but ALWAYS on the verge of passing out by the end of a donation, and fwiw i almost bled out (NOT during a donation) and went into shock and it felt exactly the same. i've just had to get over my embarrassment and let the techd know as soon as i start to feel ooky and they'll tip the chair, give me cold packs, etc. i do avoid donating sometimes b/c of this very issue, though!
posted by oh really at 5:08 PM on July 31, 2014

I fainted once after donating blood (and it put me off enough that I changed from a monthly donation to a couple of times a year afterwards). The things that were different the day I fainted were that it was the first and only time the needle has been painful throughout the procedure (usually I can't feel it while it is in the vein) and it seemed to take a lot less time than usual. I don't know whether those are controllable by the techs, but if you warn them you might faint and they do have control over the speed of the blood draw, etc, they will no doubt go slow.

The other thing that was different that day was that I got on a train right afterwards. (Well, after the mandatory 10 minute recovery period the blood donation centre has you wait for). It was on the train that I fainted. I wonder whether the motion of the train contributed at all. Nowadays I am careful not to go in a moving vehicle for a while after a donation.
posted by lollusc at 7:45 PM on July 31, 2014

I've given blood a bunch of times. Sometimes I ended up fainting. The pattern I eventually discovered was that I never fainted in the winter but sometimes in the summer. Turns out that warm days and blood doning do not go together for me. I stopped giving blood during the summer months.
posted by koahiatamadl at 2:55 AM on August 1, 2014

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