Transfusion reactions Flashcards
Haemolytic transfusion reactions
What happens?
What needs to be done?
patients present with a temperature >40’C, signs of shock, chest/abdominal pain and agitation.
The transfusion should be stopped immediately, the patient should be resuscitated, and all blood products returned to the transfusion laboratory.
Febrile non-haemolytic transfusion reactions
What happens?
What needs to be done?
patients present with a temperature (typically <40’C), but are otherwise well
Management: Slow the transfusion and administer 1 gram paracetamol.
Allergic reaction
What happens?
What needs to be done?
patients present with urticaria and itching within minutes of starting the transfusion
Stop/slow transfusion and administer 10 mg intravenous chlorphenamine ± 200mg hydrocortisone
Anaphylaxis reaction
What happens?
What needs to be done?
Patients present with angioedema and breathing difficulty
Management:
- The transfusion should be stopped
- Resuscitation initiated: 500micrograms 1:1000 Adrenaline, 10mg Chlorphenamine, 200mg Hydrocortisone, and the transfusion laboratory should be informed.
Delayed haemolytic transfusion reaction
What happens?
What needs to be done?
Patient presents with jaundice, anaemia, and fever often on day 5 post-transfusion.
Samples should be taken for FBC, LFT, Coombes test, and antibody screening and the transfusion laboratory should be informed.
Bacterial contamination
stop the transfusion
administer intravenous antibiotics
inform the blood bank
Transfusion related acute lung injury (TRALI)
Patients present with:
- non-cardiogenic pulmonary oedema.
- sudden development of dyspnea
- severe hypoxemia (O2 saturation <90% in room air)
- hypotension
- fever
The transfusion should be stopped and senior haematology advice
Fluid overload
this occurs in patients with known/risk factors for heart failure
The transfusion should be stopped and 40 mg intravenous furosemides administered.
