1. acute intravascular hemolytic reaction Stop the transfusion immediately and
begin treatment to support blood pressure and renal circulation. Notify the physician and collect urine and blood specimens to be analyzed for evidence of hemolysis. Continue to check vital signs at least every 15 minutes, observe your patient for signs of bleeding, monitor hourly urinary output, and provide interventions to reverse the symptoms of shock, as ordered. Acute intravascular hemolytic reaction can be avoided with meticulous attention to blood-sample labeling, blood- component labeling, and patient identification. 2. Acute Hemolytic reactions Diuresis induced by an infusion of 500 mL Non-antibody mediated of 0.9 % sodium chloride per hour or as tolerated 3. Febrile non-hemolytic transfusion stop the transfusion and administer fever- reactions reducing (antipyretic) medication. The physician might direct you to resume the transfusion slowly, monitoring the patient for further difficulties. Continue checking the patients vital signs every 4 hours and intervene according to the physicians orders. The use of leukocyte-reduced blood decreases the likelihood of this type of reaction. 4. Allergic reactions Slowed transfusion Administer antihistamine orally or intravenously stop the transfusion and notify the physician and the blood bank. Most of these reactions are mild and subside with antihistamines. Check the patients vital signs every 15 minutes. Once the symptoms resolve, resume the transfusion as per the physicians instructions. With more serious allergic reactions, bronchospasm, laryngeal edema, and shock develop quickly, and the patient requires more aggressive and supportive treatment. For a patient who has previously had allergic reactions to blood transfusions, administering antihistamines before transfusion may prevent future reactions. Future severe reactions can be avoided when the blood bank uses saline washing to remove any remaining plasma proteins from the blood component. 5. Transfusion-transmitted infection Blood culture and treatment started immediately with and iv Broad-spectrum antibiotic combination implicate units should be sealed 6. Transfusion-related acute lung injury Immediately DC the transfusion Oxygen administered via nasal catheter or mask Recognizing these symptoms and aggressively treating the patient with oxygen and airway support is essential. Some laboratories now provide only leukocyte-reduced blood products in an effort to reduce the incidence of TRALI. 7. delayed hemolytic reaction Notify the physician and the blood bank when you suspect this type of reaction. Because an acute hemolytic reaction may develop with future transfusions, a more specific crossmatch process is essential prior to future transfusions. Patients with delayed hemolytic reactions seldom require treatment; however, they should be monitored for worsening anemia. 8. Graft-versus-host disease (GVHD) Irradiating blood components is the only known and approved method of inactivating T lymphocytes. 9. Post-transfusion purpura Patients with severe bleeding are treated with high doses of intravenous immune globulin. 10. circulatory /volume overload Move into a sitting position Administer oxygen Dc the transfusion Remove the excessive fluid Unit of blood component bening transfused may be lowered Infusing the blood component at the prescribed rate (typically no faster than 2 to 4 mL per kilogram of body weight per hour) may reduce the incidence. Older adults, young children, and patients with cardiac or renal conditions are at a higher risk for this complication. If you suspect circulatory overload, stop or slow the transfusion rate, elevate the head of the patients bed, provide supplemental oxygen as needed, and notify the physician. For patients who are predisposed to fluid overload, the physician might prescribe a diuretic between or after each unit is transfused. 11. Hypothermia Warming of blood components must always be done using a device approved by the U.S. Food and Drug Administration. 12. Bacterial contamination Dc the transfusion Blood culture- intravenous broad spectrum antibiotics Reference:
Nursing Education (n.d.) Blood-transfusion reactions. Retrieved October 1, 2017, from
American Association of Blood Banks, Americas Blood Center, and the American Red Cross. (2002). Circular of information for the use of human blood and blood component. Retrieved October 1, 2017, from http://www.fda.gov.