Arterial puncture phlebotomy in whole-blood donors

An arterial puncture during whole-blood phlebotomy is a rare event. A series of arterial punctures was evaluated to determine the clinical findings and the incidence of complications.

Arterial punctures reported by staff between January 1, 1999, and February 28, 2001, were evaluated. Follow-up interviews were done with the phlebotomy nurses to determine what the clinical findings were and what the incidence of complications was.

Twelve cases of arterial punctures were identified from 410,000 blood donations (0.0029%; 1/34,000). Eleven cases had a fast blood-flow rate of <4 minutes; 9 units (75%) were bright red; and in 4 cases (33%), the needle was pulsating. One case was diagnosed because the donor developed a brachial artery pseudoaneurysm 3 days after donation. Four hematomas occurred, for an occurence rate of 33 percent (0.35% in the general donor population). There was also an association with newly trained staff.

Fast blood-flow rate is the most common clinical feature after an arterial puncture. Bright red blood is usually, but not always, present, and a pulsating needle is sometimes present. Hematoma is a relatively common complication, and brachial artery pseudoaneurysms are rare, although one case was seen in this study.