Transfusion Reaction Algorithm Clinical

Management of a
Severe Transfusion
Immediate Management Symptoms Of Acute Reaction
Transfusion Reaction Include
• Stop Transfusion Maintain Airway, Breathing,
• Chills Circulation (A, B, C)
• Call a MET if necessary
• Collapse
• Check the blood pack, patient ID, • Flushing Take down unit and giving
set, return intact with any
labels and forms for discrepancies • Hypo/Hypertension
other units to the blood
• Nausea/Vomiting
• Inform medical staff • Pain – Loin,Back,
bank.
• Vital signs every 15 minutes until Chest, IV site Commence IV 0.9% Normal
stable • Rigors Saline Infusion
• Tachycardia
• Keep IV line open with normal saline • Unexplained bleeding Inform Transfusion Medicine
e.g. haematuria (x 834018)
• Do not discard blood product
• Urticaria
• Call Transfusion Medicine Unit (TMU) Proceed with transfusion
• Fever
medicine investigation
on extension 834018 • Dysnoea
Monitor FBC, Urea &
Electrolytes, Coagulation
Predominant Sign/Symptom Profile and Haemolytic
Markers (Bilirubin, LDH,
DAT, Haptoglobins)

Seek Urgent Haematologist

Fever and ICU Advice
Dyspnoea OR
T >1°C from Urticaria
Hypoxia Monitor Urine Output –
baseline Aim >100ml/hr, consider
diuretics

If hypotensive, inotropes
Consider maybe required
Observations resuming If bacterial contamination is
Stable transfusion at Anaphylaxis suspected, institute broad
Patient slower rate spectrum antibiotics and
otherwise well Anti-histamine blood cultures

If DIC use appropriate blood

products to correct.

YES NO YES NO Assisted ventilation maybe

required in respiratory
distress.

ABO
Incompatibility
Febrile Non Circulatory Transfusion
Bacterial Treat for
Haemolytic Overload Medicine
Contamination Anaphylaxis
Transfusion TRALI Investigations
Haemolytic
Reaction
Tranfusion
Reaction Transfusion Reaction
Form: (Take the following
and send to Transfusion
Oxygen Medicine)
Slow rate of Diuretic
Severe Transfusion Sit upright
1 x EDTA
transfusion
Reaction CXR 1 x clotted
Paracetamol
Observe Protocol
frequently (See clinical management of a severe
transfusion reaction section) Suspect TRALI,
If non- responsive North Metropolitan Health Service

AVPUSCGH Ref No: 1208-15