steps should be taken when a transfusion reaction occurs?
Whenever a reaction is suspected:
· The transfusion should be immediately
· Intravenous access should be maintained.
· The patient information on the blood product
label should be compared with the information on the patient wristband.
· The blood bank/transfusion service should be
notified and a transfusion investigation should be requested.
· An entry documenting the reaction should be
made in the medical progress notes.
The transfusion protocol for each institution
generally specifies the type of samples needed for the preliminary
investigation. In general, a post-transfusion blood sample (one tube with
anticoagulants and one without) and a post-transfusion urine sample are
requested. Depending on the type of reaction, other samples may be requested.
The laboratory should be provided with a full
and accu-rate description of the reaction. This includes the patient’s
pre-transfusion status including: diagnosis, indication for transfusion,
previous history of transfusion and transfu-sion reactions, pre-transfusion
vital signs, and any changes in signs and symptoms that developed during the
transfu-sion. It is helpful to know how long after the transfusion was
initiated the symptoms developed and how much of the product was transfused. In
addition, the response of the symptoms to discontinuation of the transfusion
and medications given to treat the reaction, as well as the patient’s current
clinical condition, should be provided. Most transfusion investigation forms
are designed to cap-ture this information. The blood bank physician uses the
clinical information, the type of product transfused, and the results of the
preliminary laboratory investigation to develop a differential diagnosis that
guides the laboratory investigation.