| ID | 155 |
|---|---|
| Name | BLOOD TRANSFUSION REACTIONS |
| Cause | |
| Signs Symptoms | |
| Diagnosis | |
| Investigations | |
| Management | |
| Introduction | It is one of the complications of blood transfusion Incompatibility: The patient develops extremely a rigor, temperature, pain in the loin and may become extremely alarmed. |
| History | |
| Etiology | |
| Clinical Features | |
| Preventions | |
| Treatment | Treatment: 1. Stop transfusion immediately. 2. Send fresh venous blood and urine from patient together with residue of the used blood of donor for laboratory checking. 3. Watch patient’s pulse, B.P, temperature, urinary output & hematuria. 4. Treatment of shock if present (see above under anaphylactic shock). 5. Frusemide 80-120mg i.v given to provoke diuresis and repeated if the urine output falls below 30ml/hour. 2. Simple pyrexial reactions: Pyrexia, rigor, increase pulse rate. Treatment: 1. Paracetamol orally. 2. Inj. Oradexon 1 amp. i.m or i.v stat. 3. Inj. Avil 1 amp i.m or i.v stat. 3. Allergic reactions: Mild tachycardia with urticarial rash. Treatment: 1. Stop transfusion. 2. Inj. Oradexon 1 amp i.m or i.v. 3. Inj. Avil 1 amp i.m or i.v. 4. Antibody production: Occurs in the patient who recieved blood transfusions several times. Treatment: 1. Minimised by using packed or washed cell. 2. Inj. Oradexon 1 amp i.m or i.v. 3. Inj. Avil 1 amp i.m or i.v. 5. Citrate toxicity: Treatment: Inj. Calcium gluconate 10ml i.m per 1000ml blood. 6. Potassium toxicity: Treatment: Fresh blood and diuretics should be given. Other complications include: 1. Congestive cardiac failure: Cause: i. rapid transfusion, ii. anemic patient, iii. cardiac insufficiency. Treatment: a. Slow transfusion (1 unit over 4-6 hours) b. Packed cell c. Diuretic 8. Infection: a. Viral hepatitis b. Bacterial infection. Treatment: Bacterial infection- proper antibiotic. Viral hepatitis- treatment as appropriate. 9. Thrombophlebitis: Treatment: Antibiotic and analgesic. 10. Air embolism: Cyanosis, venous pressure increases, B.P falls, pulse thready, syncope, respiratory failure death. Treatment: Foot end raised with head down & left lateral position. 11. Hemosiderosis: Treatment: Desferioxamine (dosage, see in the text book). |
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