Monday, March 6, 2017

Transfusion Reactions

emDocs - March 6, 2017 - Authors: Wroblewski R and Repanshek Z
Edited by: Koyfman A and Long B
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"Pearls and Pitfalls: Approach to Reactions
  • Maintaining high clinical suspicion for reaction will save lives; although rare these are serious reactions.
  • Report any reaction to the blood bank to allow for reporting and monitoring.
  • For any reaction: stop transfusion, call blood bank, and double check that the correct patient received the correct blood.
  • Most reactions with fever will require a full laboratory work-up for signs of hemolysis and infection: CMP, CBC, Haptoglobin, DAT, LDH, PT, PTT, fibrinogen, blood culture, and gram stains from patient and sample, and a type and cross.
  • Any signs of dyspnea require a chest radiograph; if there is a fever and hypotension, it is more likely to be TRALI than TACO.
  • Treatment for all is largely supportive; however, in severe reactions antibiotics can be initiated for any suspicion of septic transfusion."