| For
Reactions Involving Red Blood Cellsor Granulocytes |
Collect
Red top and Lavender top tubes from patient, being careful
to avoid hemolysis.
Sign
and date the samples. (No Typenex needed)
Send samples to DTM along with blood container and intact
recipient set.
Obtain
urine sample and send to DTM for determination of free hemoglobin.
If laboratory
tests or clinical conditions indicate,
start prophylactic treatment as outlined below.
|
| Shock,
Hemoglobinuria, Oliguria, Bleeding, Lumbar Pain, Dyspnea,Chest
Pain |
STOP
TRANSFUSION but keep IV line open. Notify DTM.
INSTITUTE
PROPHYLACTIC TREATMENT IMMEDIATELY
•Maintain
blood pressure
•Maintain
urine flow over 70 mL/hr
•Push
fluids; keep strict I & O
•IV
diuretic, e.g., furosemide (Lasix)
Collect
Red top and Lavender top tubes, being careful to avoid hemolysis.
Sign and date tubes.
Send Red
top and Lavender top tubes to DTM along with blood container
and intact recipient set.
Obtain
urine sample and send to DTM.
Obtain
specimens for CBC, PT, PTT, TT, fibrinogen, platelet count,
bilirubin, BUN, LDH, creatinine and electrolytes.
Consult
DTM physician about further therapy.
|
| Acute
Anaphylaxis |
STOP
TRANSFUSION but keep IV line open. Notify DTM.
Inject
Epinephrine: 0.4 mL of 1:1000 solution for adults, 0.2 mL
of 1:1000 solution for children SQ (unless severe shock prevents
absorption); then give same dose diluted 10 mL in normal saline
IV over 5minutes.
Collect
Red top and Lavender top tubes, being careful to avoid hemolysis.
Sign and date tubes.
Send tubes
and blood container with intact recipient set to DTM.
Consider
bacterial contamination or antibodies to IgA in further evaluation
and treatment.
|
Clinical
Ordering Guide
