Acute Transfusion Reactions

You know your patient is having an acute transfusion reaction when you see these manifestations. What do you do?

1. Acute Hemolytic Reactions

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Their heart is racing!

Reactions develop in first 15 min. Chills, fever, low back pain, flushing, tachycardia, dyspnea, tachypnea, hypotension, vascular collapse, hemoglobinuria

2.

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Also watch for actute jaundice, dark urine, bleeding, acute kidney injury, shock, cardiac arrest, DIC, death

3. Febrile, Nonhemolytic Reaction

They're suddenly hot, cold, headache, flushing, or anxious

4.

Their muscles ache or they start vomiting

5. Mild Allergic Reaction

They may break out in hives.

pruitis, uticaria (hives), flushing, itching

6. Anaphylactic and Severe Allergic Reactions

They can barely breathe, going into shock, and possible cardiac arrest.

Anxiety, urticaria, dyspnea, wheezing, progressing to cyanosis, bronchospasm, hypotension,shock, and possible cardiac arrest

7. Circulatory overload Reactions

You see distended neck veins

Cough, dyspnea, pulmonary congestion, adventious breath sounds, headache, hypertension, tachycardia,

8. Sepsis

They are in shock

Rapid onset of chills, high fever, vomiting, diarrhea, makred hypotension, or shock

9. Transfusion-Related Acute Lung Injury (TRALI) Reaction

They find it hard to breath

Nancardiogenic pulmonary edema, fever, hypotension, tachypnea, frothy sputum, dyspnea, hypoxemia, respiratory failure

10. Massive Blood Tranfsusion Reaction

They are going into cardiac arrest!!

S/S:Hypothermia, cardiac dysrhythmias, citrate toxicity, hypocalcemia, hyperkalemia