Blood Transfusion Reactions

 REACTION

- Rash (hives)

- Elevated temperature

- Aching

- chills

- tachycardia

increased RR

oliguria (anuria) hemoglobinuria

DIC + renal failure

fever, chills, anxiety, back pain, chest pain, creased heart rate, blood pressure, hemoglobinuria

meds - corticosteroids, fluids, antihistamines, antipyretics, vasopressors, diuretics

labs - clotting, dic, electrolytes, renal blood levels

urine free hemoglobin

Patient had fever of 100.2 prior to transfusion reaction, received tylenol 650mg roughly 1800 and temperature went down to 99.2. Almost 3 hours later blood was almost completed but temperature was 101.4.

Decision was to complete blood. 

Patient had +temperature change > 1 degrees from pretransfusion after tylenol. Patient denies rigors/chills, headache, nausea, vomiting, flank pain, no hypoxemia, no urticaria, no dyspnea, no shortness of breath, no bleeding from site.

Patient had isolated fever

PE: Lungs CTAB, normal RR, no crackles, rhonchi, rales, cvs: nml s1, s2, no mrg, extremities w/o urticaria

- tylenol 650mg

- bcx x2

- v/z am team to decide whether 

- ldh, haptoglobin, fractionated bilirubin

- f/u hemoglobin at __ transfuse goal > 8