Blood Reaction Management

  1. Remove tubing containing blood product, and replace it with new tubing, except as noted below, in the case of a mild allergic reaction.
  2. Maintain patent IV line using 0.9% normal saline solution.
  3. Notify physician.
  4. Notify blood bank.
  5. Obtain blood samples (if needed) from arm opposite transfusion. Check institution policy regarding number and type of tubes to be used.
  6. Complete Transfusion Reaction Investigation form.
  7. Return remainder of blood component and attached blood tubing to the blood bank according to institution policy. (Blood will not usually need to be returned in the case of circulatory overload.)
  8. Monitor and document patients vital signs every 15 minutes or more frequently, if needed or as ordered. 
  9. Administer prescribed medications according to type and severity of transfusion reaction.

  a.  Epinephrine
  b.  Antihistamine
  c.  Antibiotics
  d.  Antipyretics/analgesics
  e.  Diuretics/morphine
  f.  Corticosteroids

Administer IV fluids.
In the event of cardiac arrest, initiate cardiopulmonary resuscitation.
Obtain first voided urine sample and send to laboratory/blood bank (per facility-specific policy). A catheter may need to be inserted to obtain the urine.

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