Transfusion Reactions in Emergency Medicine Follow-up
- Author: Eric M Kardon, MD, FACEP; Chief Editor: Barry E Brenner, MD, PhD, FACEP more...
Further Inpatient Care
See the list below:
- Continue IV fluids to maintain urine output.
- Monitor urine output.
- Continuous cardiac and blood pressure monitoring for early detection of any hemodynamic instability
- With transfusion-related acute lung injury, intubated patients usually improve quickly with supportive care, and once patients recover, they can safely receive blood products as needed.
See the list below:
- All healthcare personnel should be familiar with the hospital's policy of checks and cross-checks to ensure that donor blood being transfused is administered to the intended patient; this best prevents hemolytic reactions
- Administer leukocyte-poor packed RBCs in patients who have had two previous febrile nonhemolytic reactions and in patients who frequently receive blood products
- If the patient has history of previous anaphylactic reactions to transfused blood, transfuse blood from IgA-deficient donors, or if that is not available, frozen deglycerolized packed RBCs
- Administer cytomegalovirus (CMV)-negative blood to patients who are immunocompromised
- To reduce the risk of graft versus host disease, irradiated blood should be given to immunocompromised patients, those receiving bone marrow transplants, and those receiving blood products from a blood relative donor
- Nonhemolytic febrile reactions recur in 15-20% of patients receiving future transfusions
Intravascular hemolysis may result in the following:
- Cardiovascular collapse
Patients and family members of patients who have any reaction to blood products must be educated about the reaction. They should be instructed to inform healthcare workers about this in order to prevent any future transfusion reactions.
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