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Adverse Occurrence type:
Estimated frequency of pain: 4.6/100,000. Estimated frequency of neuropathic pain: possible 1.5/100,000; probable 0.6/100,000.
Time to detection:
immediate - 10 years
Alerting signals, symptoms, evidence of occurrence:
Pain (spontaneous, with motion, daily or constant), hyposensitivity, hypersensitivity. Characterization of pain included accepted descriptors such as "burning," "squeezing," and "painful cold." ISBT definitions: radiating, often 'electrical' sharp pain moving away from the venipuncture site, and/or paraesthesias such as tingling, burning sensations in the hand, wrist or shoulder area but away from the venipuncture site. Symptoms may arise immediately when the needle is inserted or withdrawn: immediate ~50%; delayed (up to 1 week): 39%; duration up to 10 years post injury. Symptoms may be worse in certain positions or with certain arm motions. Rarely, weakness of the arm may develop.
Demonstration of imputability or root cause:
Imputability based on pain immediately upon needle insertion (50%) or development within one week (39%).
Suggest new keywords:
Sorensen, B. S., Jorgensen, J., Jensen, T. S. and Finnerup, N. B. (2015). Pain following blood donation: a questionnaire study of long-term morbidity (LTM) in blood donors. Vox Sang (2015). 109(1):18-24.
we may want to change NPHO wording from needlestick to venipuncture to differentiate from needlestick exposure injuries
Expert comments for publication:
This paper reported the results of a questionnaire designed to characterize pain and estimate the prevalence of neuropathic pain, sent to 152 donors who reported pain during or after donation. Published diagnostic criteria for neuropathic pain together with grading criteria were used to develop the survey tool. While specific details of injuries and imputability were not reported, this report is important as a first study designed to characterize long term morbidity of needle stick nerve injuries based on established signs, symptoms and a grading system. Of note, the lesions were not verfified by use of nerve conduction studies.