Mild Transfusion Reaction: Diagnosis and Treatment


About this Canterbury DHB document (5110):
Document Owner:	Steve Gibbons (see Who's Who)
Last Reviewed:	June 2019
Next Review:	June 2022
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Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer The Haematology Department Protocols and Guidelines (the Red Book) are intended as a guide for registered health professionals to communicate guidelines and share best practices with supporting health professionals within New Zealand district health boards. They are not intended to be provided to or used as a reference for patients or non-registered health professionals. All health professionals must exercise their own clinical judgement and use pertinent clinical data when treating patients. The authors and editors of this publication have checked with sources believed to be reliable in their effort to provide information that is complete and in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical science, neither the authors, editors, publisher, nor any other party who has been involved in preparing or publishing this work warrants that the information contained in it is accurate or complete in every respect. They therefore have no liability (whether in tort (including negligence) or otherwise) for any loss or damage arising out of any reliance on this information. This publication has been compiled by the staff and contractors of Canterbury District Health Board (CDHB) and as such CDHB has copyright for this book. Amendments must be authorised in accordance with the documented process. No release of part of, or all of, this publication to any other party or organisation is permissible without the prior approval of the designated document owner.
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Guidelines for Management of Mild Adverse Transfusion Reactions
First Mild Reaction
Symptoms:
Mild febrile reaction Temperature increase >38°C but <1.5°C from baseline Stable haemodynamics No respiratory distress and no other symptoms	OR	Mild allergic reaction Occasional urticarial spots and no other symptoms
Action: Check compatibility label and recipient identity. Slow transfusion. Call for medical assessment. Medical staff may consider the need to prescribe paracetamol for pyrexia or antihistamines for urticaria. Continue transfusion at a slower rate with increased monitoring, e.g., temp, pulse and BP at 15-30 minute intervals. Discuss with Blood Bank staff – mild febrile and allergic reactions do not routinely warrant blood tests or return of IV set/unit. If there is clinical concern or you are advised, send 1 x group and screen (EDTA) tube to Blood Bank + a completed Adverse Reaction Notification form (111F00901). Document in patient's clinical notes. If symptoms increase treat as a moderate or severe reaction.
Subsequent Transfusions and:
Recurrence of mild febrile reactions	OR	Recurrence of mild allergic reactions
Action: Febrile reaction: consider giving premedication of an antipyretic (e.g. paracetamol). Note: There is no good evidence for this practice. Urticarial/allergic reaction: consider giving premedication of an antihistamine (e.g. oral phenergan). Slow transfusion administration rate. Note: Hydrocortisone is not usually indicated.