2. Whole Blood Unit
After
centrifugation
whole blood
separates into the
plasma and
platelets on top
and packed red
blood cells on the
bottom.
A plasma expresser is used to literally squeeze the plasma
and platelets off the top and leave only the red blood cells in
the original bag.
3.
4.
5. The risks associated with transfusion can be reduced by:
Effective blood donor selection.
Screening for TTI in the blood donor population.
High quality blood grouping, compatibility testing.
Component separation and storage.
Appropriate clinical use of blood and blood products.
Quality assurance
Donor Patient
6.
7.
8. WHEN WE SHOULD TRANSFUSE BLOOD ?
&
WHAT BLOOD COMPONENT
SHOULD BE TRANSFUSED ?
10. Alternatives to blood transfusion for
patients having surgery.
** Erythropoietin.
** Intravenous and oral iron.
** Cell salvage and tranexamic acid.
11. What about non-blood
alternatives?
Crystalloids
Extensively used.
Large volumes cause haemodilution.
Artificial Colloids
Dextrans, Hetastarch, Gelatin solutions
May cause bleeding problems, allergic
reactions at high doses
THESE ONLY REPLACE VOLUME.
13. Perfluorocarbons
Can carry large amounts of
dissolved O2.
Not H2O soluble, therefore
must be emulsified.
Require high FiO2 to
become oxygenated.
PFC’s carry less O2 under
physiological conditions.
Tend not to release bound
O2 easily.
Difficult to store.
14. Haemoglobin solutions
Haemoglobin is a complex
protein with properties related to
both it‘s a. a. sequence and its
morphology.
micro-encapsulate up to 1 x
106 Hb molecules in artificial red
cells or liposomes.
Free Hb is toxic to the kidneys.
Recombinant human Hb is
the future.
20. Whole blood
Characteristics:
RBC and plasma; WBC and platelets not viable after 24hr
storage. Labile clotting factors significantly decreased
after 2 days of storage.
Hct 35% (dilution by anticoagulant).
Blood 450mL.
CPD or CPDA-1 anticoagulant 63mL.
Approximate Volume :
520mL.
Shelf-Life:
ACD,CPD 21days at 1-6ْC.
CPDA-1 35days at 1-6ْC
Clinical Indications
Most useful in Massive Blood Loss/ Trauma/ Exchange
Transfusion.
21. FRESH WHOLE BLOOD
Less than 5 days old.
Indications:
-Exchange transfusion.
- Major surgery with massive blood loss.
- Liver transplantation.
- Open heart surgery in infants.
22. Contraindications :
Risk of volume overload in patients with:
Chronic anemia
Incipient cardiac failure.
Administration:
Must be ABO and Rh compatible with the recipient.
Transfusion should be completed within 4 hours of
starting.
Use filter as platelets and coagulation factors will not be
active after 3-5 days.
Medication should NEVER be added to unit of blood.
24. RED CELL COMPONENTS
1- Whole blood.
2- Red cell concentrates (Packed RBC)
3- Washed red cells.
4- Leukocyte depleted red cells.
5- Frozen red cells.
25. Packed red blood cells
Characteristics:
Packed RBC with reduced plasma volume; WBC, platelets, and
coagulation factors as for whole blood.
Hct 69%.
Approximate Volume :
260mL.
Shelf-Life:
ACD,CPD 21days at 1-6ْC.
CPDA-1 35days at 1-6ْC
clinical Indications
Most useful for symptomatic anemia is present; chronic anemia,
bleeding.
26. RBC Concentrate
Considerations
Recipient must not have antibodies to donor RBC‘s
(note: patients can develop antibodies over time).
Donor cells and recipient serum are mixed and
evaluated for agglutination.
Usual dose 10 cc/kg (will increase Hb by 2.5 gm/dl).
Usually transfuse over 2-4 hours (slower for chronic
anemia.
NEVER give pRBC with D5W, 1/2NS, TPN, Antibiotics,
Lactate Ringer‘s.
27. Washed Red Blood Cells
Characteristics:
RBC. No plasma, minimal platelets. 70-80% WBC removed if
manual wash . 90% WBC removed if automated wash.
Hct adjustment as per amount of saline added.
5% loss of red cells due to wash procedure.
Approximate Volume :
250mL.
Shelf-Life:
24 hr at 1-6ْC. After wash.
Clinical Indications
Increased red cell mass as for packed red cells.
Most useful for preventing febrile and allergic reactions due to
leukocytes or plasma proteins and for preventing anaphylactic
reaction in IgA- deficient recipients .
Indicated in recurrent an/or sever reactions
28. Frozen deglycerolized red
blood cells.
Characteristics:
RBC, no plasma , no platelets, removal of 95% of WBC.
Hct adjustment as per amount of saline added.
Up to 20% of red cells lost due to procedure.
Approximate Volume :
250mL.
Shelf-Life:
10 years at -65ْC or colder .
24 hr at 1-6ْC. After wash.
Clinical Indications
Most useful for supply of rare blood group, inventory control
and auto-transfusion. Also, as per washed red blood cells.
Storage: Liquid nitrogen or Freezers.
Preparation prior to transfusion: Thawing washing and
addition of glucose.
Transfusion: Within 24 after preparation.
29. Leukocytes-depleted blood components
Leucocytes in the blood units may cause infections and non-
haemolytic transfusion reactions to the recipients.
Therefore, leucocytes are removed from blood components by
filtering through leucocytes specific filters prior to
transfusions.
This process called leucocytes depletion.
Examples of infections transmitted by leucocytes in blood
products: Creutzfeldt-Jakob disease (CJD) and CMV.
Indication:
Non-hemolytic febrile reactions
30. Leuco-reduction of red cells
Pre-storage leucoreduction of RBCs is recommended for critically ill
patients
Lowers transfusion associated immunosuppression
lowers incidence of post-operative infections
Red cells should be <15 days old
- as older blood decreases microcirculatory oxygen delivery.
- decreases red cell 2,3 DPG concentration in old blood.
- increased splanchnic ischemia occurs with old blood.
33. Guidelines for Transfusion of RBCs in Patients Less than 4 Months
of Age:
1. Hemoglobin <7 g/dL with low reticulocyte count and symptoms of anemia.
2. Hemoglobin <10 g/dL with an infant:
On <35% hood O2
On O2 by nasal cannula
On continuous positive airway pressure (CPAP)/intermittent mandatory
ventilation (IMV) with mechanical ventilation with mean airway pressure <6 cm H2O
Significant apnea or bradycardia
Significant tachycardia or tachypnea
Low weight gain
3. Hemoglobin <12 g/dL with an infant:
On >35% hood O2
On CPAP/IMV with mean airway pressure 6 to 8 cm H2O
4. Hemoglobin <15 g/dL with an infant:
On extracorporeal membrane oxygenation (ECMO)
Congenital cyanotic heart disease
34. Guidelines for Neonates RBC transfusion*
Hgb <13g/dl (Hct <40%) with severe
cardiopulmonary disease.
Hgb <10g/dl (Hct <30%) with moderate
cardiopulmonary disease or surgery.
Hgb <8g/dl (Hct <24%) with symptomatic
anemia.
Bleeding or phlebotomy exceeding 25% of red
cell volume.
* from Strauss, Chap 20 Neonatal Transfusion in Anderson, Ness
Scientific Basis of Transfusion Medicine
35. RBC Transfusions
Administration
Dose
Usual dose of 10 cc/kg infused over 2-4 hours.
1 donation( a dose of 10-15 ml/Kg raises venous Hb by
about 1g/dl.
Procedure
Filter use—routinely leukodepleted.
Monitoring—VS q 15 minutes, clinical status.
Do NOT mix with medications.
Complications
Rapid infusion may result in Pulmonary edema.
Transfusion Reaction.
36. platelet concentrate
Characteristics:
Platelets (5.5 ×10); some WBC (i.e., lymphocytes),
50mL of plasma ,few RBC (less than 0.5% Hct).
Approximate Volume: 50mL.
Shelf-Life:
5 Days
at room temperature (20-24ْC) constant, gentle agitation.
Clinical Indications:
Used for quantitative or qualitative platelet disorders. May
be used when bleeding (slow ooze) due to severe
thrombocytopenia.
37. PLATELET CONCENTRATES
(prepared from whole blood donations)
Description
Single donor unit in a volume of 50–60 ml of
plasma should contain: - At least 55 x 109 platelets
- < 1.2 x 109 red cells
- < 0.12 x 109 leucocytes
Unit of issue May be supplied as either
Single donor unit ( Apheresis).
Pooled unit: 4 to 6 donor units ‘pooled’ into
one pack to contain an adult dose of at least
240 x 109 platelets.
Single donor (apheresis) platelets have low risk to
recipients than do pooled platelets.
Apheresis Platelets contains 3 x 10^11 Plts.
Six units of pooled platelet concentrate= 6 ( 5.5 x 10^10)
Plts.
38. Platelets
Storage
Up to 5 days at 20-24°.
Indications
Thrombocytopenia, Platelet <10,000.
Bleeding and Platelet < 20,000.
Invasive procedure and Platelet < 50,000.
Considerations
Contain Leukocytes and cytokines.
1 unit/10 kg of body weight increases Platelet count by 50,000.
Donor and Recipient must be ABO identical.
39.
40. Indications for Plt transfusion
Canadian Blood Services Clinical Guide
There is limited high quality evidence to guide the
use of platelet transfusions to treat bleeding. There
is general agreement that the following patients
should receive platelet transfusions.
Patients with thrombocytopenia or platelet
dysfunction to;
Stop bleeding (therapeutic transfusion)
Prevent bleeding (prophylactic transfusion)
41. Indications for Platelet transfusion
Patients with thrombocytopenia or platelet dysfunction to;
Stop bleeding (therapeutic transfusion);consider cause!
1. Pts with non-immune thrombocytopenia and clinically significant
bleeding with platelet count < 50 x109/L.
2. Immune mediated thrombocytopenia with severely reduced platelet
count (< 20 x 109/L) and significant bleeding.
3. Head trauma or life threatening hemorrhage with a platelet count <100
x 109/L.
4. Platelet dysfunction from congenital or acquired causes (GABG, PHV,
MDS, SLE, HCL) and clinically significant bleeding.
5. As part of a massive transfusion protocol in bleeding patients.
42. Indications for Platelet transfusion
Patients with thrombocytopenia or platelet dysfunction to;
Prevent bleeding (prophylactic transfusion)
1. Hospitalized patients with therapy- induced hypoproliferative
thrombocytopenia with a platelet count of ≤10x109/L.
2.Elective central line with platelet count <20x109/L.
3.Elective LP with platelet count <50x109/L.
4. Major elective non-neuroaxial surgery with a platelet count
<50x109/L.
5.Neuroaxial surgery with a platelet count <100x109/L.
6. Consider transfusion for patients undergoing CABG who exhibit peri-op
bleeding with thrombocytopenia and/or evidence of platelet dysfunction.
43. Indications
Platelet Count
trigger for
transfusion
As prophylaxis in bone marrow failure.< 10 x 109/L
Bone marrow failure in presence of additional risk factors:
fever, antibiotics, evidence of systemic hemostatic failure.< 20 x 109/L
Massive hemorrhage or transfusion.
In patients undergoing surgery or invasive procedures.
Diffuse micro vascular bleeding- DIC.
< 50 x 109/L
Brain or eye surgery.
< 100 x 109/L
Appropriate when thrombocytopenia is considered a
major contributory factor.
Any Bleeding
Patient
In inherited or acquired qualitative platelet function
disorders, depending on clinical features & setting.
Any platelet
count
45. Guidelines for Platelet transfusion*
Platelets <100,000/ul and bleeding or
clinically unstable (inc. IVH).
Platelets <50,000/ul and invasive
procedure.
Platelets < 20,000/ul and no bleeding and
clinically stable
* from Strauss, Chap 20 Neonatal Transfusion in Anderson, Ness Scientific Basis of
Transfusion Medicine
46. Platelet Transfusions
Preparations
ABO antigens are present on platelets
ABO compatible platelets are ideal.
This is not limiting if Platelets indicated and type
specific not available.
Rh antigens are not present on platelets
Note: a few RBC‘s in Platelet unit may sensitize the Rh-
patient.
47. Not indicated in chronic stable sever thrombocytopenia :
Idiopathic autoimmune thrombocytopenic purpura (ITP).
Thrombotic thrombocytopenic purpura (TTP).
Aplastic, myelodysplastic anemia.
Thrombocytopenia associated with septicemia, until
treatment has commenced or in cases of hypersplenism.
Prophylactic transfusion in TTP, HIT, HUS or ITP unless
the patient is suffering a life or organ threatening bleed.
Extrinsic platelet dysfunction such as renal failure,
hyperproteinemia, or von Willebrand disease.
49. Dosage:
1 unit of platelet concentrate/10 kg body weight:
in a 60 or 70 kg adult, 4–6 single donor units
containing at least 240 x 109 platelets should
raise platelet count by 20–40 x 109/L.
Increment will be less if there is:
Splenomegaly.
Disseminated intravascular coagulation.
Septicemia.
50. PLATELET CONCENTRATES
(collected by platelet pheresis)
Description:- Volume 150–300 ml.
- Platelet content 150–500 x 109,
equivalent to 3–10 single donations.
- Platelet content, volume of plasma and
leukocyte contamination depend on the
collection procedure.
Unit of issue:
1 pack containing platelet concentrates collected by
platelet pheresis from a single donor.
51.
52. III- PLASMA DERIVATIVES
Plasma products commonly requested:
1- Fresh Frozen Plasma (FFP)
2- Cryoprecipitate
3- Fibrin Glue
Plasma and its derivatives represent a valuable
source in transfusion practice.
Plasma production: Manually, Aphersis,
Industrial fractionation.
53. Fresh frozen plasma
Characteristics:
Plasma proteins, all coagulation factors, complement.
Approximate Volume :
200 to 260 mL.
Shelf-Life:
1 year at -18ْC , or colder.
Transfusion: Thawed over 20 - 30 min.
Validity: 24 hours after thawing.
Clinical Indications:
1) coagulation deficiencies and hemorrhage conditions
(massive blood loss, infection or surgery of the liver).
2) acquired coagulation factor deficiencies such as DIC.
54. Plasma and FFP
Considerations
Plasma should be recipient RBC ABO compatible.
In children, should also be Rh compatible.
Account for time to thaw.
Usual dose is 20 cc/kg to raise coagulation factors
approx 20%.
Infusion rate typically 10–20 mL/kg/hour although more
rapid transfusion may be appropriate when treating
coagulopathy in major hemorrhage.
FFP should not be used to reverse warfarin (prothrombin
complex is a specific and effective antidote).
55. Indications
Replacement of multiple coagulation factor
deficiencies, e.g.:
Liver disease.
Warfarin anticoagulant overdose.
Depletion of coagulation factors in patients
receiving large volume transfusions.
Disseminated intravascular coagulation (DIC).
Thrombotic thrombocytopenic purpura (TTP)
(plasma exchange is preferred).
Contraindication for FFP:
Volume expansion
Heparin reversal
If specific factor concentrates are available (factor VIII and IX).
56.
57. Indications
FFP trigger for
transfusion
Multiple coagulation deficiencies associated with acute DIC.
Inherited deficiencies of coagulation inhibitors in patients
undergoing high-risk procedures where a specific factor
concentrate is unavailable.
Thrombotic thrombocytopenia purpura (plasma exchange is
preferred)
Replacement of single factor deficiencies where a specific or
combined factor concentrates is unavailable.
Immediate reversal of warfarin effect in the presence or
potentially life-threatening bleeding when used in addition to
Vitamin K & / or Factor Concentrate (Prothrombin concentrate)
The presence of bleeding and abnormal coagulation parameters
following massive transfusion or cardiac bypass surgery or in
patients with liver disease
PT & PTT are
more than 1.5
times the upper
limit of normal
range
Indications
Cryoprecipitate
trigger for
transfusion
Congenital or acquired fibrinogen deficiency including DIC.
Hemophilia A, von Willebrand disease (if the concentrate is not
available).
Factor XIII deficiency.
Fibrinogen<
1gm/L
58. Pediatric plasma transfusion
Most infants have low levels of vitamin K dependant
factors, hence, all infants receive vitamin K at birth.
IM vitamin K is more effective than PO.
Many infants, especially premature normally have
prolonged INR, hence prolongation of INR, in absence of
clinical bleeding or significant risk of bleeding is NOT an
indication for plasma transfusion. Rx is vit K.
Plasma 10-15cc/kg is usual dose.
Cryoprecipitate may be required if treating fibrinogen
level <100.
59. Administration:
Must normally be ABO compatible.
No cross matching needed.
Before use, should be thawed in water which is
between 30°C and 37°C.
Once thawed, should be stored in a refrigerator
at 2°C–6°C: use within 6 hours of thawing.
Precautions
Acute allergic reactions are not uncommon,
especially with rapid infusions.
Severe life-threatening anaphylactic reactions
occasionally occur.
Hypovolaemia alone is not an indication for use.
60. CRYOPRECIPITATE
Description: FFP thawed at 4* C
- Is a cold insoluble fraction of FFP.
- Factor VIII: 80–100 i.u./pack;
- fibrinogen: 150–300 mg/pack
Unit of issue: single donor pack or 6 or more
single donor units ―pooled‖.
ABO compatible preferred (but not limiting).
Usual dose is 1 unit/ 5-10 kg of recipient body
weight.
61. Cryoprecipitate
Characteristics:
80 units of factor VIII, other plasma proteins, von Willebrand factors
XIII, fibrinogen(200mg), fibronectin.
Approximate Volume :
10 to 15 mL.
Shelf-Life:
1 year at -18ْC , or colder .
Clinical Indications
Most useful for von Willebrand disease, Factor XIII deficiency, or
hypofibrinogenemia.
Cryoprecipitate should not be used for a newly diagnosed
hemophilia A case, because there are factor concentrates available
that have been modified to eliminate the AIDS virus and possibly
hepatitis.
62. Cryoprecipitate
Typical adult dose is two - five donor pools (ten single-donor
units).
Will raise fibrinogen concentration by approximately 1 g/L in
average adult.
Typically administered at 10–20 mL/kg/hour (30–60 min per
five-unit pool).
When possible, the patient's coagulation parameters (such
as PT/PTT, fibrinogen, specific coagulation factor assay,
etc.) should be determined prior to transfusion (within 24
hours) and within 24 hours after transfusion if the patient
remains hospitalized.
63. Indications
As an alternative to Factor VIII concentrate in the
treatment of inherited deficiencies of:
- Von Willebrand Factor
- Factor VIII (hemophilia A)
- Factor XIII
As a source of fibrinogen in acquired
coagulopathies: e.g. (DIC).
Administration:
If possible, use ABO-compatible product.
No compatibility testing is needed.
After thawing, infuse within 6 hours of thawing.
64. Transfusion Triggers (in presence of
bleeding)
Platelets < 75 x 109/L = 1 bag of platelets.
Platelets < 50 x 109/L = 2 bags of platelets.
INR > 1.5 = 2 bags FFP.
INR > 2.0 = 4 bags FFP.
Fibrinogen < 1.5g/L = 6 bags of cryoprecipitate.
Fibrinogen < 1.0g/L = 12 bags of cryoprecipitate.
Fibrinogen < 0.5g/L = 18 bags of cryoprecipitate.
RBC’s as guided by blood loss and laboratory values.
65. Fibrin Glue
Topical hemostatic blood product.
Production:
1- Cryoprecipitate
2- Thrombin
Cut , tailored and pasted.
Indication:
Hemostatic and sealant in cardiac, vascular
and other surgical procedures
66. Granulocyte Transfusions
Prepared at the time for immediate transfusion
(no storage available).
Indications– severe neutropenia (less than 0.5 x
109/L) associated with infection unresponsive to
antibiotic therapy and recovery of BM is expected.
Donor is given G-CSF and steroids or Hetastarch.
Complications
Severe allergic reactions.
Can irradiate granulocytes for GVHD prevention.
67. ANC <500
Fever
Documented infection (bacterial or fungal)
for 24-48 hours.
Unresponsive to appropriate antibiotics.
Reasonable hope of marrow recovery.
68. Administering Blood Products-
STEP by STEP
1. Verify Physician Order for Blood Transfusion and Pre medications
2. Verify consent has been signed and on chart.
3. Verify Type and Cross has been Completed.
4. Obtain Vitals Signs prior to Administering Blood.
5. Verify that suctions and oxygen are at patient’s Bedside.
6. Obtain an IV in Patient- 18 or 20 gauge.
7. Start 500ml bag of Normal Saline attached to Y tubing (clamp off
side with filter attached, Will prime when with normal saline once
blood is hung).
8. Obtain Cardiovascular assessment and Initial Vital Sign's.
9. Obtain Blood from the Blood Bank(this task can be delegated,
check with facilities policy)
1. Visually inspect Blood with blood bank for any abnormalities
such as clots, bubbles, or any discoloration.
69. Transfusion Reactions
Most common causes of transfusion related
DEATHS:
1. Improper specimen identification.
2. Improper patient identification.
3. Antibody identification error.
4. Crossmatch procedure error.
Most transfusion reactions (not all) are the result of
human error. As you work through this lecture,
consider what could be done to prevent each
outcome.
70. Complications of BT…
Donated blood is collected and separated into
various components. CPD-A 1 added to whole
blood can be stored for up to 42 days.
Storage changes:
Leakage of intracellular K.
Reduced levels 2,3-DPG.
Degeneration of functional granulocytes and platelets
Deterioration of clotting factors V and VIII.
Ammonia concentration rises.
Decrease in pH.
Decrease in RBC deformability and viability.
72. Introduction
Module 12: Transfusion Reactions and
Adverse Events
Many of the serious adverse events that occur as a result of blood transfusion
are unpredictable. The most important are:
Acute haemolytic
transfusion reactions
Infusion of a bacterially
contaminated unit
Severe allergic reaction
or anaphylaxis
Post-transfusion
purpura (PTP)
Transfusion-associated
Graft-versus-host
disease
Transfusion-related
acute lung injury (TRALI)
It is often difficult to distinguish which type of reaction is taking place as the signs and
symptoms of these reactions are very similar. These are detailed on the next slide. Expert
medical help should be sought from a hematologist and/or microbiologist if a transfusion
reaction is suspected. It is often necessary to treat all possible causes.
West Midlands
73. Module 12: Transfusion Reactions and
Adverse Events
Signs & Symptoms to look out for if a patient is having
a transfusion reaction:
Acute reactions are rare but any new signs or symptoms, which develop during a
transfusion, may be caused by a transfusion reaction. It is therefore important to consider a
transfusion reaction if there is any deterioration in the patient’s condition especially during
the first 15-20 minutes of transfusion of blood / blood product.
Please note: In the following ‗suggested treatments‘ – when returning the unit of blood / blood
component to the hospital blood bank, check if the giving set should also be sent still attached to
the unit
Pyrexia
Tachycardia
Hyper / hypotension
Change in BP
Haemoglobinuria
Vomiting / diarrhoea
Urticaria
Rigors
Collapse
Chest / back pain
Abdominal pain Bone /
muscle pain
Headache
Restlessness / agitation
Flushing Nausea
Breathlessness /
coughing
Generally feeling unwell
West Midlands
74. Transfusion Reaction
STEP to STEP
1. STOP Transfusion IMMEDIATELY, Contact MD
2. Disconnect blood tubing from patient.
3. Start new bag of Normal Saline with new tubing.
4. Obtain Vital signs.
5. Give supportive therapies as needed- suction,
oxygen etc.
6. Recheck Patient Identification, blood unit label,
and compatibility tag with transfusion record sheet
7. Notify Blood Bank.
8. Follow any orders given by the MD post
transfusion reaction- DO NOT RESTART BLOOD
UNLESS ORDERED BY Physician!!
75. Module 12: Transfusion Reactions and
Adverse Events
Actions to take if a serious acute reaction is suspected
Stop the transfusion immediately and keep the IV line open with a slow infusion of
saline (via a new giving set);
Call a doctor to see the patient urgently. It may be necessary to call the crash team
depending on the severity of the reaction; resuscitation may be required.
Check and record the patient’s temperature, pulse and blood pressure;
Check respiratory rate and respiratory signs – dyspnoea, tachypnoea, wheeze, cyanosis;
Re-check the patient’s identity, ensure this corresponds with the unit of blood / blood
Component and re-check all documentation;
Inform the blood bank. Blood and urine samples will be required to investigate the
reaction (blood bank / medical staff will clarify what is required);
Check oxygen saturation and blood gases;
Provide further management depending on the patient’s clinical features.
This may involve transfer to intensive care unit and mechanical ventilatory support.
It is important to document all observations, symptoms, signs, treatments and tests
performed relating to the event.
West Midlands
76. Key PointsModule 12: Transfusion Reactions and
Adverse Events
Remember: Transfusion reactions can be fatal
• Many of the serious adverse events that occur as a result of blood
transfusion are unpredictable.
It is often difficult to distinguish which type of reaction is taking place as the
signs and symptoms of these reactions are very similar.
It is often necessary to treat all possible causes.
If an acute transfusion reaction is suspected, this should be classed as a
medical emergency and prompt action taken.
If a transfusion reaction is suspected, always check that the correct patient
is receiving the correct unit of blood / blood component.
West Midlands
