What are the initial steps taken when a transfusion reaction is suspected?

Updated: Jan 12, 2021
  • Author: S Gerald Sandler, MD, FCAP, FACP; Chief Editor: Emmanuel C Besa, MD  more...
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Transfusion reactions require immediate recognition, laboratory investigation, and clinical management. If a transfusion reaction is suspected during blood administration, the safest practice is to stop the transfusion and keep the intravenous line open with 0.9% sodium chloride (normal saline). A clerical check of the information on the blood unit label and the patient's identification should be performed to ensure that the "right" blood unit was administered to the "right" patient. In most cases, the residual contents of the blood component container should be returned the blood bank, together with a freshly collected blood sample from the patient, and a transfusion reaction investigation should be initiated.

Acute transfusion reactions may present in complex clinical situations when the diagnosis requires distinguishing between a reaction to the transfused blood product and a coincidental complication of the illness being treated that occurs during or immediately after a blood transfusion.

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