Signs and Symptoms
Signs and symptoms may present during transfusion or in the hours/days post transfusion. The following is a list of possible indicators for transfusion reactions.

  • Fever greater than 1°C (2°F) above pre-transfusion baseline
  • Chills
  • Backache
  • Shortness of breath
  • Respiratory distress
  • Rash, hives, or itching
  • Nausea or vomiting
  • Chest pain
  • Abnormal pain of indeterminate origin
  • Hemoglobinuria (red or dark colored urine)

Immediate Actions
When a transfusion reaction is suspected: (These actions are tailored to LifeShare Compatibility customers. Always follow local procedures for evaluation of suspected transfusion reactions)

  • Stop the transfusion
  • Notify the attending physician
  • Collect and label post-transfusion samples from patient: [One 7-mL EDTA (purple or pink top) sample and a 10-mL clotted (plain red top) sample]
  • Complete LifeShare Form L-49, Record of Transfusion Complication
  • Notify LifeShare of suspected transfusion reaction
  • Send the following to LifeShare:
    - Completed Form L-49
    - EDTA and Red top samples
    - Blood component bag with all attached tubing and fluids

Laboratory Investigation
Laboratory investigation will include:

  • Clerical check of component bag, label, paperwork, and patient sample
  • Repeat of ABO testing on the posttransfusion sample
  • Visual check of Pre- and posttransfusion sample to evaluate for evidence of hemolysis
  • Direct antiglobulin test (DAT) on posttransfusion sample
  • Additional testing based on initial findings

In the event Transfusion Related Acute Lung Injury (TRALI) is suspected, additional information may be requested.

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