Transfusion Reactions
Blood components injure recipients four separate ways, immune destruction of red cells, plasma-protein allergy, bacterial contamination and sheer transfused volume, and at onset they look alike.
Definition
An adverse event caused by the transfusion of a blood component. Acute reactions occur during the transfusion or within 24 hours of it; delayed reactions occur after 24 hours. Severity is graded on the rise in temperature from baseline, the presence of rigors, and whether the airway, breathing or circulation are compromised.
First principles
Stop the transfusion first, name the reaction afterwards
Fever, rash, breathlessness and hypotension are shared by every serious transfusion reaction, and nothing available at the bedside separates them in the first minutes. Stopping costs a delayed transfusion. Continuing an incompatible unit delivers more incompatible red cells, and the injury is dose-dependent. Keep the cannula open with 0.9% sodium chloride so you can still resuscitate.
This page is exam revision material, not medical advice, and must not be used for patient care. Always check drug doses against the BNF and current guidance. Full disclaimer.