Blood Trans. Monitoring & Reactions (ASAN002/19)

Question 1

Monitoring & Reactions of Blood Transfusions

Answer 1

Blood transfusions should be started at a very low rate (0.2 – 0.5ml/kg).\nThe patient must be constantly monitored for any signs of reaction.

Question 2

Monitoring should include:

Answer 2

Patient Demeanour\nHeart Rate\nRespiratory Rate\nBlood Pressure\nTemperature\nPulse Oximtery

Question 3

Monitoring – Patient Demeanour:

Answer 3

Signs of nausea are an indication of a reaction.

Question 4

Monitoring – Heart Rate:

Answer 4

Any dramatic change in HR should be reported to Vet immediately.

Question 5

Monitoring – Respiratory Rate:

Answer 5

Any change in RR – especially if tachypnoeic.

Question 6

Monitoring – Blood Pressure:

Answer 6

BP should be monitored when administering blood or PRBC’s. Any abrupt ↑ in BP should be reported to Vet.

Question 7

Monitoring – Temperature:

Answer 7

An ↑ in temp is indicative of a reaction.

Question 8

Monitoring – Pulse Oximtery

Answer 8

Ensure the patient is adequately oxygenating.\n\n\nA pulse oximeter will give constant HR & SPO² allowing any fluctuations to be recongnised immediately.

Question 9

Recording Vital Signs:

Answer 9

Should be recorded at least every 5 mins for the first 15 – 30 mins.\nMonitoring should be continued until transfusion is complete – even if no signs of reaction are observed during initial stages.

Question 10

Immediate Reactions – Signs:

Answer 10

Tachycarida (↑HR)\nHypotension (sudden ↓ in BP)\nNausea (licking lips, salivating)\nUrtiaria (hives)\nMuscle tremors\nPanting\nPyrexia\nSwelling (face, paws, limbs)

Question 11

If you see or suspect any signs of a reaction…

Answer 11

STOP the transfusion immediately & notify the Vet.\nThe Vet may decide to administer drugs or start the transfusion at a much slower rate.\nAnaphylactic reactions can occure where the patient may go into cardiac arrest.

Question 12

Immune–mediated Reactions:

Answer 12

Acute\nDelayed\nHaemolytic delayed reaction \nNon–haemolytic delayed reaction

Question 13

Acute Immune–mediated reaction:

Answer 13

Quite rare but are the most severe.\nThey result from pre–existing antiboidies (e.g. giving a B type cat, A type blood)\nCan also result from sensitization from a previous transfusion.

Question 14

Acute Immune–mediated reaction – Signs:

Answer 14

Earliest clinical signs are ↑ temp & vomiting.\nOther signs include:\nTachycardia\nTachypnoea\nMuscle tremors\nFacial swelling\nAgitation\nHypotension

Question 15

Delayed Immune–mediated reaction:

Answer 15

Can occur 2 – 21 days after transfusion.\nThese are most common reactions.\nDivided into haemolytic & non–haemolytic reactions.

Question 16

Haemolytic Delayed reaction:

Answer 16

Shortened survival time of transfused RBC’s\nPCV ↓

Question 17

Non–haemolytic Delayed reaction:

Answer 17

Generally a result of antibodies to the RBC’s, leukocytes, platelets or plasma proteins.\nOften transient in nature.

Question 18

Non–haemolytic Delayed reaction – Signs:

Answer 18

Uticaria (hives)\nHyperthermia\nTachypnoea\nDyspnoea\nVomiting\nNeurological signs

Question 19

Non–immune Mediated Reactions:

Answer 19

Asymptomatic haemolysis\nBacterial pyrogens or sepsis\nCitrate toxicosis

Question 20

Asymptomatic Haemolysis:

Answer 20

Caused by trauma to RBC’s\nThe RBC’s start to die due to trauma caused by the transfusion.

Question 21

Bacterial Pyrogens or Sepsis:

Answer 21

Caused by contamination of blood products.\nIf they have not been stored correctly or become contaminated during transfusion.\nSepticaemia can occur.

Question 22

Citrate Toxicosis:

Answer 22

Occurs if patient receives a large transfusion.\nCan occur if citrate to blood ratio is incorrect.