Transfusion Reactions Management

1. acute intravascular hemolytic reaction Stop the transfusion immediately and

begin treatment to support blood
pressure and renal circulation.
Notify the physician and collect urine
and blood specimens to be analyzed for
evidence of hemolysis.
Continue to check vital signs at least
every 15 minutes, observe your patient
for signs of bleeding, monitor hourly
urinary output, and provide interventions
to reverse the symptoms of shock, as
ordered.
Acute intravascular hemolytic reaction
can be avoided with meticulous attention
to blood-sample labeling, blood-
component labeling, and patient
identification.
2. Acute Hemolytic reactions Diuresis induced by an infusion of 500 mL
Non-antibody mediated of 0.9 % sodium chloride per hour or as
tolerated
3. Febrile non-hemolytic transfusion stop the transfusion and administer fever-
reactions reducing (antipyretic) medication. The physician
might direct you to
resume the transfusion slowly, monitoring the
patient for further difficulties.
Continue checking the patients vital signs every
4 hours and intervene according to the
physicians orders.
The use of leukocyte-reduced blood decreases
the likelihood of this type of reaction.
4. Allergic reactions Slowed transfusion
Administer antihistamine orally or
intravenously
stop the transfusion and notify the
physician and the blood bank. Most of
these reactions are mild and subside with
antihistamines. Check the patients vital
signs every 15 minutes. Once the
symptoms resolve, resume the
transfusion as per the physicians
instructions. With more serious allergic
reactions, bronchospasm, laryngeal
edema, and shock develop quickly, and
the patient requires more aggressive and
supportive treatment. For a patient who
has previously had allergic reactions to
blood transfusions, administering

5. Transfusion-transmitted infection
6. Transfusion-related acute lung injury
7. delayed hemolytic reaction
8. Graft-versus-host disease (GVHD)
9. Post-transfusion purpura
10. circulatory /volume overload
antihistamines before transfusion may
prevent future reactions. Future severe
reactions can be avoided when the blood
bank uses saline washing to remove any
remaining plasma proteins from the
blood component.
Blood culture and treatment started
immediately with and iv
Broad-spectrum antibiotic combination
implicate units should be sealed
Immediately DC the transfusion
Oxygen administered via nasal catheter
or mask
Recognizing these symptoms and
aggressively treating the patient with
oxygen and airway support is essential.
Some laboratories now provide only
leukocyte-reduced blood products in an
effort to reduce the incidence of TRALI.
Notify the physician and the blood bank
when you suspect this type of reaction.
Because an acute hemolytic reaction may
develop with future transfusions, a more
specific crossmatch process is essential
prior to future transfusions. Patients with
delayed hemolytic reactions seldom
require treatment; however, they should
be monitored for worsening anemia.
Irradiating blood components is the only
known and approved method of
inactivating T lymphocytes.
Patients with severe bleeding are treated
with high doses of intravenous immune
globulin.
Move into a sitting position
Administer oxygen
Dc the transfusion
Remove the excessive fluid
Unit of blood component bening
transfused may be lowered
Infusing the blood component at the
prescribed rate (typically no faster than 2
to 4 mL per kilogram of body weight per
hour) may reduce the incidence. Older
adults, young children, and patients with
cardiac or renal conditions are at a higher
risk for this complication. If you suspect
 circulatory overload, stop or slow the
transfusion rate, elevate the head of the
patients bed, provide supplemental
oxygen as needed, and notify the
physician. For patients who are
predisposed to fluid overload, the
physician might prescribe a diuretic
between or after each unit is transfused.
11. Hypothermia Warming of blood components must
always be done using a device approved
by the U.S. Food and Drug
Administration.
12. Bacterial contamination Dc the transfusion
Blood culture- intravenous broad
spectrum antibiotics
Reference:

Nursing Education (n.d.) Blood-transfusion reactions. Retrieved October 1, 2017, from

http://www.atitesting.com/ati_next_gen/skillsmodules/content/blood-
administration/equipment/blood_tranfusion_reations.html

American Association of Blood Banks, Americas Blood Center, and the American Red Cross. (2002).
Circular of information for the use of human blood and blood component. Retrieved October 1, 2017,
from http://www.fda.gov.