emDocs - March 6, 2017 - Authors: Wroblewski R and Repanshek Z
Edited by: Koyfman A and Long B
"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."