Canterbury DHB


Mild Transfusion Reaction: Diagnosis and Treatment

Guidelines for Management of Mild Adverse Transfusion Reactions

First Mild Reaction




  • Mild febrile reaction
    • Temperature increase >38°C but <1.5°C from baseline
    • Stable haemodynamics
    • No respiratory distress and no other symptoms


  • Mild allergic reaction
    • Occasional urticarial spots and no other symptoms


  1. Check compatibility label and recipient identity.
  2. Slow transfusion.
  3. Call for medical assessment.
  4. Medical staff may consider the need to prescribe paracetamol for pyrexia or antihistamines for urticaria.
  5. Continue transfusion at a slower rate with increased monitoring, e.g., temp, pulse and BP at 15-30 minute intervals.
  6. 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).
  7. Document in patient's clinical notes.

If symptoms increase treat as a moderate or severe reaction.

Subsequent Transfusions and:

  • Recurrence of mild febrile reactions


  • Recurrence of mild allergic reactions


  1. Febrile reaction: consider giving premedication of an antipyretic (e.g. paracetamol). Note: There is no good evidence for this practice.
  2. Urticarial/allergic reaction: consider giving premedication of an antihistamine (e.g. oral phenergan). Slow transfusion administration rate.

Note: Hydrocortisone is not usually indicated.

About this Canterbury DHB document (5110):

Document Owner:

Steve Gibbons (see Who's Who)

Last Reviewed:

June 2019

Next Review:

June 2022


Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 5110