The first steps in dealing with a potential transfusion reaction are:
- Stop the transfusion.
- Verify patient and unit identification.
- Inform the patient's physician.
- Provide supportive care to the patient.
- Inform the blood bank and send any requested specimens.
Management involves the treatment of hypotension and disseminated intravascular coagulation (DIC). It is essential to maintain blood volume and adequate renal blood flow. Diuretics (substances that increase urine output) may be administered. If the patient enters renal failure, dialysis must be initiated rapidly.
It is impossible to prevent all hemolytic transfusion reactions. The purpose of pre-transfusion compatibility testing is to decrease the probability of a hemolytic transfusion reaction by performing ABO/Rh testing, detecting and identifying alloantibodies, and crossmatching compatible blood. Steps must be taken to reduce the possibility of human error in identifying patient samples, donor units, and recipients. Each person involved in the transfusion process, from blood sample collection to administration of the donor unit, must carefully adhere to each step outlined in the standard operating procedures. All appropriate protocols must be followed. Some examples are:
- Laboratory professional checks blood sample to ensure proper labeling.
- Patient's previous transfusion records are examined, and all transfusion testing is performed correctly and accurately.
- Laboratory professional ensures the correct unit is released from the blood bank.
- Transfusionist ensures the recipient is correctly identified.
There must be a mechanism to train and assess all personnel involved in the transfusion process.
