hematology medication: transfusion reaction

What if there is a transfusion reaction?

step 1

Stop infusion and notify HCP immediately

Step 2

Switch out blood tubing to a new tubing with 0.9% saline only for a bolus

step 3

Document start & stop times of transfusion, & client response to it

step 4

Stay with client, monitor VS & urinary output

step 5

Notify blood bank, recheck information, send blood bags with all tubings, to the blood bank

step 6

Obtain a urine specimen for testing

step 7

Repeat type & cross & draw a CBC & bilirubin to determine hemolysis

step 8

Complete transfusion log sheet

Special Considerations

older clients

• Transfuse with caution to prevent overload

• Take v/s q 15 mins throughout the procedure & frequently after

special considerations

• For Massive Transfusions: greater or equal to replacement of total blood volume in 24 hr, about 10 units in adults or 5 units in a 4 hour period:

• Monitor platelets, PT, & aPTT every 5 units, replace as needed

• Monitor potassium & calcium levels

• Monitor ECG for changes

• Use a blood warmer

Special considerations

Autologous transfusion

• Donation of blood several weeks prior to elective surgery to be used for that specific case

• Fresh blood can be saved up to 40 days, blood 10 years for a client who has a rare blood type

• Can prevent some transfusion reactions but client is still at risk for circulatory overload & sepsis