Blood transfusion- reactions

Question 1

Patient has fever + chills 10 mins after transfusion
-what is it and how do you manage?

Answer 1

Non haemolytic febrile reaction

Management:
-slow or stop transfusion (dums pp says its chill to continue it)
-give paracetamol
-observe

(pretty common reaction to have)

Question 2

pruritis + urticaria after transfusion
-what is it and how do you manage?

Answer 2

Minor allergic reaction

-temporarily stop transfusion
-monitor
-ANTIHISTAMINE

Question 3

patient has hypotension, dyspnoea, wheezing and angioedema after transfusion
-what is it and how do you manage?

Answer 3

Anaphylaxis

-STOP transfusion
-IM adrenaline
-ABC support (oxygen + fluids)

Question 4

patient has fever, abdo pain + hypotension after transfusion

What is it and how do you manage?

Answer 4

Acute haemolytic reaction

-stop transfusion
-confirm diagnosis (check identity of patient/name on blood product and send the blood for direct coombs test + cross matching)
-fluid resus (supportive care)

Question 5

what causes an acute haemolytic transfusion reaction

Answer 5

ABO incompatibility of blood
(human error)

Question 6

Patient has pulmonary oedema + HYPERtension after transfusion reaction
-what is it and how is it managed?

Answer 6

Transfusion associated circulatory overload (TACO)

-slow or stop transfusion
-consider IV loop diuretics (e.g. furesomide)
-oxygen

Question 7

what causes a transfusion associated circulatory overload (TACO)?

Answer 7

-excessive rate of transfusion + pre existing heart failure

basically too much fluid getting pumped in for the body to handle

(patient presents with pulmonary oedema + hypertension)

Question 8

patient has a transfusion and presents with hypoxia, pulmonary infiltrates on CXR, fever + HYPOtension

-what have they got and how is it managed

Answer 8

Transsfusion related lung injury (TRALI)

-stop the transfusion
-oxygen + supportive care

(Non cardiogenic pulmonary oedema secondary to increased vascular permeability caused by host neutrophils that become activated by substances in blood)

Question 9

Patient presents with mild jaundice 5-10 days post transfusion
-what have they got?

Answer 9

Delayed haemolytic transfusion reaction

Question 10

what antibody causes a delayed haemolytic transfusion reaction?

Answer 10

IgG