Transfusion Reactions Flashcards
What to do if a reaction is suspected?
STOP
What do you do with the IV if a reaction is suspected?
Maintain a new IV line with NS in same site with surgical asepsis
NC for suspected transfusion reaction?
- ask questions
- VS
- contact HCP and blood bank
- recheck equipment
- monitor urine output
- save blood bag and tube for blood bank
- report
- collected specimens for hemolysis
Acute hemolytic reaction
- most life-threatening
- incompatible blood products
Febrile, non-hemolytic reaction
Fever develops during infusion but hemolysis does not occur
mild allergic reaction to transfusion
sensitization to donor WBCs (often), platelets, or plasma proteins (more common in people with history of allergies)
Anaphylactic/severe allergic reaction
severe sensitization to donor plasma proteins; life-threatening
septic reaction to blood transfusion
Bacteria present in the blood
transfusion-associated circulatory overload
Excess blood volume administered
What population is susceptible to a TACO
Older, heart failure
Leukocyte-reduced blood products
- collected from whole blood
- contaminant of other cell blood components and can cause adverse effects including immune-mediated factors
S/S acute hemolytic rxn
IMMEDIATE flush, fever, low back pain (kidneys), Hgb in urine, dyspnea, HA, tachy, hypoT, cardiac arrest/death
NC for AHTR
PREVENTION IS KEY
- keep BP up with colloids, get blood sample from site, get urine sample for hematuria–send foley and equipment to the lab
Febrile non-hemolytic rxn (FNHTR) s/s
chill and fever, HA, flushing, anxiety, vomit, muscle pain; LESS immediate; no shock or hematuria
FNHTR NC
tell HCP, usually admin Tylenol and restart blood slowly; PREVENT by asking pt about past reactions, try to get leukocyte-reduced products for them
Mild allergic transfusion reaction s/s
urticaria, flushing, itching
mild allergic transfusion reaction NC
STOP - tell HCP; might admin steroid or antihistamine, restart slow (if ordered for mild sx), tx with prophylactic antihistamines and steroids, prevent by asking about previous reactions
What blood product might be ordered for a mild allergic reaction?
Washed RBCs and platelets
Severe anaphylactic rxn s/s
anxiety, urticaria, dyspnea, wheezing, cyanosis, hypotension, bronchospasm, cardiac arrest
NC for severe anaphlaxis
CPR and oxygen, epinephrine, antihistamine, steroids, B2 agonists
What blood products might a patient get for severe anaphylaxis?
very washed RBCs, maybe autologous components
Bacterial/sepsis reaction s/s
fever, chills, V/D, hypotension
Bac/sepsis reaction NC
- get culture
- return bag to bank
- tx septicemia with abx, IVF, vasopressor (inc BP)
PREVENT by admin blood in under 4 hours
TACO s/s
cough, dyspnea, pulmonary congestion, HA, inc VS, distended neck veins
TACO NC
slow OR stop infusion, admin diuretics, oxygen, morphine, CXR STAT - recognize risks and prevent
How to decrease risk of a reaction?
Ask about prior history of reactions, recognize high risk pts (esp TACO), use autologous components
Autologous donation
store your own blood for future and freeze; if not frozen, use within a few weeks
Disadvantages of autologous donations
insurance does not pay, can waste blood products
Autotransfusion
take blood lost in surgery and recycle to put back in the body
