Management of Transfusion Reaction

Blood Transfusion Reaction:

Any adverse effect caused by transfusion may be considered a transfusion reaction. Some are mild, others are life threatening All reactions should be documented and reported. Guidelines for the recognition of transfusion reactions are:
Mild Reaction
Sign
Symptoms
Possible cause
Localized urticaria / rashes
Itching
Hypersensitivity( mild)


Moderately severe
Flushing, urticaria, rigor, , fever, restlessness, tachycardia
Anxiety, pruritus(itching),
palpitations, mild dyspnoea,
Headache
Hypersensutivity . febrile non haemolytic transfusion reaction: Antibodies to WBC, platelict/ proteins Possible contamination with pyrogens and bacteria.


Life threatening

Rigor, fever, restlessness, tachycardia, haemoglobinourea, unexplained bleeding
Anxiety, chest pain, pain near infusion site respiratory distress/ shortness of breath , loin/back pain, headache, dyspnoea
Acute intravascular haemolysis, Bacterial contamination and septic shock, Fluid overload Anaphylaxis - Transfusion associated lung injury



If an acute transfusion reaction occurs, first check the blood pack labels and the patient's identity. If there is any discrepancy, stop the transfusion immediately and consult the blood bank.

 In an unconscious or anaesthetized patient, hypotension and uncontrolled bleeding may be the only signs of and incomplete transfusion.

 In a conscious patient undergoing a severe haemolytic transfusion reaction, signs and symptoms may appear quickly- within minutes of infusing only 5-10 ml of blood. Close observation at the start of the infusion of each unit is essential.

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