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Transfusion medicine

Transfusion reaction - general

Reviewer: Huy Phu Pham, M.D. (see Reviewers page)
Revised: 4 November 2011, last major update September 2011
Copyright: (c) 2007-2011, PathologyOutlines.com, Inc.

General
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● Can be identified during or after the transfusion
● The goal is to rule out hemolytic transfusion reaction

During the transfusion:
● Stop the transfusion
● Keep IV line open with saline
● Contact the physician on-call for immediate assessment of the patient
● Monitor vital signs closely
● Report to blood bank/transfusion service
● Should provide the on-call transfusion medicine physician with:
-Patient’s name, medical record number
-Blood type and history of antibody
-Transfusion history, including pregnancy, history of transfusions, and transfusion in the past 3 months
-Type of product transfused
-Amount of product transfused
-Patient’s symptoms and the temporal relationship to transfusion
-Pre and post transfusion vital signs
-Pre-medication and treatment for the transfusion reaction (if any)
● Blood bank should also perform clerical check, visual check for hemoglobinemia (comparing to pre-transfusion sample), and DAT (direct antiglobulin test, also comparing to the pre-transfusion sample)
● Check patient and unit information for clerical errors
● Send hemolysis labs, including post-transfusion CBC, total and direct bilirubin, LDH, haptoglobin, and UA with microscopic for hemoglobinuria
● Document the transfusion reaction in the medical chart
● Contact transfusion medicine physician on-call regarding further release of blood products
● Continue to observe the patient carefully

After the transfusion:
● Contact the blood bank/transfusion medicine service to report possible delayed transfusion reaction
● Determine the cause of the reaction
● Document the transfusion reaction in the medical chart
● Continue to observe the patient carefully

● Algorithm for working up a transfusion reaction: #1, #2
● Incidence of tranfusion reactions (pages 30-33)

Mortality due to transfusion reactions
● Need to report to the FDA as soon as possible (link)
● Incidence of transfusion-related mortality (link)

End of Transfusion Medicine > Tranfusion reaction > Transfusion reaction - general

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