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Recognizing and Responding to a Transfusion-Associated Adverse Event

It is the responsibility of those providing direct patient care to monitor the transfusion and report any signs or symptoms that might be indicative of a transfusion-associated adverse event. Policies and procedures should include definitions of signs and symptoms and instructions regarding action 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 suspected:
  1. Check all labels and records to detect any identification or transfusion errors.
  2. Notify the transfusion service and the patient’s physician.
  3. Send the blood container (even if empty), transfusion set, and IV fluids to the transfusion service.
  4. Draw post-transfusion blood sample(s) from the patient and send to the transfusion service.
Required procedures for suspected hemolytic transfusion reactions (AABB Standards 30th Ed)
  • Inspect 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 Medical Director for review and interpretation.