Those providing direct patient care are responsible for monitoring the transfusion and reporting any signs or symptoms that might indicate a transfusion-associated adverse event. Policies and procedures should include definitions of signs and symptoms and instructions regarding actions to be taken, including discontinuation of the transfusion. AABB Standards require that the following steps be followed when a transfusion is discontinued and an adverse reaction is suspected:
- Check all labels and records to detect identification or transfusion errors.
- Notify the transfusion service and the patient’s physician.
- Send the blood container (even if empty), transfusion set, and IV fluids to the transfusion service.
- Draw the patient's post-transfusion blood sample(s) and send it to the transfusion service.
Required procedures for suspected hemolytic transfusion reactions (AABB Standards):
- Inspect the patient's serum/plasma for signs of hemolysis using a pretransfusion sample for comparison.
- Repeat the patient's ABO grouping using a post-transfusion sample.
- Perform a direct antiglobulin test (DAT) on a post-transfusion sample using the most recent pretransfusion specimen for comparison.
- Submit serologic findings to the Medical Director for review and interpretation.
