1. DONOR ROOM EMERGENCIES
a NISANTH MENON presentation
MD (EM), M.Med (FM)
Fellow of Academic College of Emergency Experts (FACEE)

2. PROBLEM STATEMENT
0.6%
1.3%
1.2%
3.2%
1.6%
2.04%
7.9%

4. PHLEBOTOMY WAITING TO DONATE BLOOD TESTING RESTING Seemingly healthy
False sense of pride
Seemingly healthy
Anxiety/ Hyperventilation
BLOOD TESTING
Pain
Diagnosing blood dyscrasias
PHLEBOTOMY
Pain
Bleeding
RESTING

5. CARDIAC ARREST ANAPHYLAXIS SEIZURES ANGINA/ ACS TIA/ STROKE SYNCOPE
UNRESPONSIVENESS
CARDIAC ARREST
ANAPHYLAXIS
SEIZURES
ANGINA/ ACS
TIA/ STROKE
SYNCOPE

6. ECG Rhythm/& Defibrillation SpO2/ BP/ IV cannula
High Quality CPR
ECG Rhythm/& Defibrillation
SpO2/ BP/ IV cannula
Adrenaline or Atropine
Recovery Position
ANTICONVULSANT
IV Crystalloids
Anti-Shock Position
Vasopressors
Reassure/ Refer

7. HIGH QUALITY CPR Start early/ check pulse Call for help
30 compressions : 2 breaths
Barrier device/ mask – if not, CO-CPR
Push Hard/ Push Fast
Do not interrupt
Get an AED/ Defibrillator ready
Early IV line  Adrenaline 1:10000
Defibrillate if pVT/ VF
Transfer to ED/ ICU/ higher centre

8. SEIZURE Left Lateral position Suction n clear airways IV LINE
Inj. MIDAZOLAM/ LORAZEPAM
0.1 mg/ kg
Transfer to ED/ ICU/ higher centre

9. ANAPHYLAXIS Propped-up position Oxygen & clear airways
Adrenaline mg 1:1000 im/ sc
0.01mg/kg paediatric dose
Early IV line  IV crystalloids
Inj. HYDROCORTISONE mg
Defibrillate if pVT/ VF
Transfer to ED/ ICU/ higher centre

10. BLEEDING Compression Ice Pack Limb elevation
Tourniquet/ BP Cuff inflation
Prevent Hematoma
Prevent extravasation  Neurological deficits

11. Prick Hematoma Nerve Injury Tendon Injury
PAIN

12. IV ANALGESIA Ice Pack Reassurance Lignocaine – L/A Analgesic Creams
NSAIDs Vs Opiods
IM Analgesic injections
IV ANALGESIA

13. Nerve injuries Arterial Injuries Vein Injuries
OTHER INJURIES
Nerve injuries
Arterial Injuries
Vein Injuries

14. APHERESIS RELATED TETANY ?HYPOCALCEMIA ? HYPERVENTILATION
Rebreather Mask
Calcium Tablets
Calcium gluconate IV

15. TAKE HOME Low prevalence Emergency – On your toes!
Be confident- keep calm ; Be competent – get trained!
Rule out a Cardiac Arrest in the unresponsive patient
Differentiate Seizure from Syncope
Suspect angina – ACS/ Seizure – TIA
ECG – Rhythms to rule out deadly bradycardias/ arrythmias
Hyperventilation mimics hypocalcemic tetany
Bleeding & Pain – Life > Limb – threatening condition
Hematoma/ Nerve Injuries/ Tendon injuries
Refer appropriately

16. Thanks! Any questions? You can find me at: Nisanth Menon