Transfusion Reactions Flashcards
A post- transfusion investigation takes into account the following:
- product transfused
- signs and symptoms
- serological results from a post-transfusion sample
when should patient vital signs be taken? (HR, BP, temp)
- before transfusion
- 15 mins after start
- end of transfusion
first fifteen minutes of transfusion is slow and patient is monitored for any signs or symptoms of reaction. what must be done if there ARE SIGNS of reaction
- STOP transfusion, maintain IV line, run saline
- notify attending physician immediately
- document vital signs and symptoms
- perform bedside clerical check with the unit tag/vs patient (2 identifiers)
- notify blood bank (they ask all of the above)
- return unused product, along with post-transfusion specimen (EDTA) to blood bank
- EVEN minor reaction, must be reported if even if it was resolved within twenty mins **
positive ___ post-transfusion is significant! why?
DAT
- because it can indicate delayed transfusion rxn; depending on time of investigation, DAT may be only indicator
positive ___ post-transfusion is significant! why?
DAT
- because it can indicate delayed transfusion rxn; depending on time of investigation, DAT may be only indicator
other {rare} causes of DAT post-transfusion
- transfusion of passive antibody
- transfusion of IVIg that binds non-specifically to RBC
- donor is DAT pos
T or F. Rh binds complement
F!
Why does complement only bind in vivo?
because in vitro, EDTA chelates Ca 2+ and Mg 2+
indicators of IVH
- visible hemolysis (plasma Hb)
- hemoglobinuria
- markedly decreased haptoglobin (bc it is complexed)
- increased LD (there is so much LD in red cells)
indicators of EVH
- increased bilirubin
- increased LDH
- decreased haptoglobin (or N)
- decreased Hb (or Hb that fails to increase)
transfusion rxn investigation (8)
- clerical check
- review symptoms (documented on tag)
- note product transfused
- time of transfusion to symptoms (week ago = not febrile; minutes = severe allergic)
- volume transfused
- check for visible hemolysis on post-transfusion sample
- serological tests (ABO Rh, Ab screen, DAT, XM)
- non-serological tests (bilirubin, Hb, LDH, haptoglobin)
which products will not get delayed hemolytic rxn
plasma and platelets
in the event of a transfusion rxn, what tests do we run on a pre-transfusion sample
- clerical check ABO Rh, Abscr, serological XM
in the event of a transfusion rxn, what tests do we run on a post-transfusion sample
- clerical check
- check for visible hemolysis
- ABO Rh
- Abscr
- DAT
- serological XM
in the event of a transfusion rxn, what tests do we run on the donor segment
- clerical check
- ABO Rh
- antigen type for any Ab detected in the pre or post antibody screen
