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Global Standard Protocol for Managing Transfusion Reactions
Nov 18, 2025, 02:44

Global Standard Protocol for Managing Transfusion Reactions

Tareq Abadl, Medical Laboratory Specialist and Director of the Blood Bank at Dr. Abdelkader Al-Mutawakkil Hospital, posted on LinkedIn:

”Global Standard Protocol for Managing Transfusion Reactions….

Your Essential Blood Bank Guide

A transfusion reaction is a medical emergency – and every lab professional must know the correct steps to handle it safely and effectively. Here’s your clear, practical guide:

1. STOP the Transfusion Immediately.

  • Disconnect the blood unit right away.
  • Never restart the same unit under any circumstances.

2. Keep the IV Line Open.

  • Run 0.9% Normal Saline through the same cannula.
  • No medications or additives in the same line.

3. Notify the Physician Immediately.

  • The doctor must reassess the patient and provide treatment (antihistamines, antipyretics, steroids, etc., depending on the reaction).

4. Recheck Patient and Blood Unit Identification.

Verify again:
✔ Patient name
✔ File number
✔ Blood unit number
✔ ABO/Rh type
✔ Crossmatch information

More than 60% of severe reactions are due to identification errors.

5. Send the Blood Bag Back to the Blood Bank.

  • Keep the used blood unit, tubing, and leftover saline.
  • Do NOT discard anything – it must be inspected.

6. Collect New Samples From the Patient.

Required tests usually include:

  • CBC
  • Hemolysis markers (bilirubin, LDH, haptoglobin)
  • Direct Coombs Test
  • Urine for hemoglobin
  • Repeat ABO and Rh typing
  • New Crossmatch (Major crossmatch)
  • Antibody screen ± identification

7. Report the Reaction.

  • Complete the official Transfusion Reaction Form and notify the Blood Bank.
  • This is crucial for documentation and Root Cause Analysis.

8. Monitor Vital Signs Closely.

Every 15 minutes during the first hour:

  • Temperature
  • Blood pressure
  • Heart rate
  • Respiratory rate

9. Do NOT resume transfusion until evaluation is complete.

The Blood Bank will determine whether to:
✔ Release a new unit
✔ Select a more compatible component
✔ Or stop transfusion entirely.

Global Guidelines Confirm This Protocol

The following international authorities endorse these same steps:

International Sources:

✔ AABB – American Association of Blood Banks
Standards for Blood Banks and Transfusion Services

✔ CDC – Centers for Disease Control and Prevention
Guidelines for Transfusion-Associated Adverse Events

✔ WHO – World Health Organization
Blood Transfusion Safety Guidelines

✔ SHOT – UK Serious Hazards of Transfusion Scheme
National Hemovigilance Guidelines

✔ European Blood Alliance (EBA)
Standards for Transfusion Safety and Hemovigilance

✔ Canadian Blood Services
Clinical Guide to Transfusion

Quick Golden Rule

> STOP the transfusion → Maintain saline → Inform doctor → Recheck ID → Send unit → New samples → New crossmatch → Monitor vitals.”

Transfusion Reactions

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Blood Bank Guide Dr. Abdelkader Al-Mutawakkil Hospital Health Hematology Hemostasis Hemostasis Today Medicine Tareq Abadl thrombosis Transfusion Medicine Transfusion Reactions
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