Managing Donors with Iodine Sensitivity

On Monday, 29 May 2000, the CBBS e-network was polled regarding what donor centers were using as alternative arm scrubs for donors who have iodine sensitivity. In addition, the network was asked about the frequency of iodine sensitivity problems and what was done to avoid these problems, if an alternative scrub was not used?

The following replies were received:

1. For iodine sensitive donors, we use "Tincture of Green Soap," manufactured by CLINISWAB, (which, not surprisingly, contains a green soap tincture in aqueous solution) for the initial scrub, and follow it up with a 70% isopropyl alcohol final arm prep (using a swab stick that also is manufactured by CLINISWAB).
   
   
2. American Red Cross in San Diego uses a green soap scrub, followed by alcohol wipe - these come in swab sticks like the iodine ones.
   
   
3. We use green soap and alcohol and yes we do ask donors if they are allergic to iodine.
   
   
4. We currently use soap and alcohol, but I am trying to get some Exidine® scrub.
   
   
5. In Sacramento, we are using Green Soap and Alcohol.
   
   
6. Blood Centers of the Pacific uses green soap followed by alcohol. Both of these come as swabs.
   
   
7. If the donor is allergic to iodine, we use a 'green soap scrub' to scrub the selected area for venipuncture for 30 seconds. Then we use an alcohol swab to 'rinse' the area and begin at the entry site with the alcohol swab and move outward in a concentric circle.
   
   
8. Our incidence of iodine sensitivity is extremely low, and has been seen only as a rash resembling prickly heat in the scrubbed area. We ask donors if they are allergic to iodine as part of the donor room process. We stock Tincture of Green Soap swab sticks (CLINISWAB) as the alternative scrub, and Acetone/Alcohol swab sticks (70% Isopropyl Alcohol, 10% Acetone, PDI) as the alternative prep. We also remove iodine from the donor's arm prior to bandaging, using Io-Gone™ Iodine Remover Pads (Isopropyl Alcohol 50%, Sodium Thiosulfate 3%, PDI).

Interestingly, no reply suggested that a donor center lacked an alternative scrub for donors with iodine sensitivity. It sounds like the community standard is to use an alternative scrub.

ADDENDA Feb. 15, 2010

Editors' Note: Readers of this archived discussion should note that AABB Standard 5.6.2 Protection Against Contamination reads "The venipuncture site shall be prepared so as to minimize risk of bacterial contamination. Green soap (USP) shall not be used." (AABB Standards for Blood Banks and Transfusion Services, 26th edition, 2009).

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Ira A. Shulman, MD
CBBS e-Network Forum Senior Editor & Moderator

W. Tait Stevens, MD
CBBS e-Network Forum Editor & Moderator

Elizabeth M. St. Lezin, MD
CBBS e-Network Forum Associate Editor & Moderator