Adverse Reactions to Transfusion

In all suspected transfusion reactions the transfusion should be
immediately discontinued and the IV kept open with saline. For
uncomplicated urticaria, antihistamines (e.g., Benadryl 50 mg IV) can be
administered and the transfusion resumed slowly. If symptoms resolve, the
transfusion may continue at the usual rate.

For all reactions related to Red Blood Cells or Granulocyte transfusions,
except uncomplicated urticaria, the DTM technologist must be notified and
a Lavender top tube of blood should be drawn from the patient and sent promptly to the DTM. The remainder of the blood bag and empty bags from all units transfused within 4 hours of potential reaction should be sent as well. The administration set should remain attached to the bag and clamped to avoid bacterial contamination. If more than one unit is transfused, the blood tags should be numbered in order of transfusion. In addition, a urine sample should be sent to DTM, where it will be examined for free hemoglobin.

Report symptoms in the MIS under the Transfusion Medicine order screen.
Nurses must enter medical orders as an agent of the physician. The
necessary orders for samples required are automatically generated in
phlebotomy and in the DTM.

Reactions to Platelets and Fresh Frozen Plasma should be handled the same way EXCEPT blood and urine samples are not to be collected and sent to the
DTM unless specifically requested by DTM staff. Additional blood
components may be transfused only after the transfusion reaction has been
evaluated and characterized, or with DTM physician's approval.

Click Here for a summary of the therapy for transfusion reactions.