Blood Transfusion

What is important before starting a blood transfusion

Verify order/consent, blood product, compatibility, patient identity, baseline vitals, prescribed rate, and independent checks under facility policy

What solution is commonly compatible with packed RBCs

0.9% normal saline is the standard compatible crystalloid. Do not add medications or unapproved solutions to blood tubing

What is the first action for a suspected transfusion reaction

Stop the transfusion immediately; maintain IV access with normal saline via appropriate tubing, assess patient, notify provider/blood bank, and follow protocol

What are signs of an acute hemolytic transfusion reaction

Fever, chills, flushing, back/flank pain, hypotension, dark urine, and possible shock; treat as an emergency

How might a febrile transfusion reaction present

A new temperature rise, chills, headache, and malaise during or soon after transfusion; stop and assess for other causes/reactions

How might an allergic transfusion reaction present

Itching, urticaria, flushing, or in severe cases wheezing, airway swelling, and anaphylaxis; stop and assess immediately