Tagreed Alkaltham: Transfusion Reaction – Understanding Risk and Acting Early
Tagreed Alkaltham, Transfusion Medicine Lab Supervisor at KSMC, shared a post on LinkedIn:
”Transfusion Reaction
Understanding the Risk. Acting Early. Protecting Patients.
A transfusion reaction is any unexpected sign or symptom occurring during or shortly after the administration of blood or blood components, and temporally related to transfusion.
- It may be mild and self-limited.
- It may also be life-threatening.
Early recognition is a patient safety priority.
What are the main types
Acute Hemolytic Transfusion Reaction (AHTR):
- Usually due to ABO incompatibility, often related to identification error.
- Symptoms may include chills, back pain, hypotension, dark urine, fever and shock.
- This is a medical emergency.
Febrile Non-Hemolytic Transfusion Reaction (FNHTR):
- Characterized by fever (≥1°C rise) and chills.
- Common and usually not life threatening, but requires evaluation.
Allergic Reaction:
- Ranges from mild urticaria and itching.
- to severe anaphylaxis with hypotension and airway compromise.
TRALI (Transfusion-Related Acute Lung Injury):
- Acute respiratory distress within 6 hours of transfusion.
- Hypoxia and bilateral pulmonary infiltrates without circulatory overload.
TACO (Transfusion-Associated Circulatory Overload):
- Volume overload presenting with dyspnea, hypertension, and pulmonary edema.
- More common in elderly or cardiac patients.
Delayed Hemolytic Transfusion Reaction (DHTR):
- Occurs days after transfusion.
- Presents as an unexpected drop in hemoglobin and sometimes mild jaundice.
What should be done immediately if a reaction is suspected
When a reaction is suspected:
- Stop the transfusion immediately
- Maintain IV access with normal saline
- Stabilize the patient
- Recheck patient identity and blood unit details
- Monitor vital signs
- Inform the physician
- Notify the blood bank immediately
Never ignore new symptoms during transfusion.
The first minutes determine the trajectory.
What should be done after stabilization
After stabilization comes responsibility:
- Proper documentation
- Completion of transfusion reaction report
- Communication with blood bank for post transfusion work up
- Clinical follow up planning
- Review of transfusion indication and future precautions
A transfusion reaction is not only a clinical event. It is a system signal.
A transfusion reaction is not merely an adverse event.
It is a moment that tests identification systems, communication pathways, and clinical vigilance.
In transfusion medicine,
- precision protects.
- Governance prevents.
- And vigilance saves lives.
We should build systems designed to reduce the probability of harm.
Strong systems prevent recurrence.
Vigilance protects patients.”
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