Mikael Häggström: Expanded

2022-10-26T23:34:49Z

Expanded

← Older revision		Revision as of 19:34, 26 October 2022
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	==Workup==		==Workup==
	Even for unspecific symptoms, it is essentially never wrong to take blood samples for direct antiglobulin test (DAT) and hemolysis, as well as a urine sample for hemolysis.		Even for unspecific symptoms, it is essentially never wrong to take blood samples for '''direct antiglobulin test''' (DAT) and '''hemolysis''', as well as a '''urine''' sample for hemolysis.

	Generally request temperature and blood pressure if not already available, and compare with measurements before the transfusion.		Generally request '''temperature''' and '''blood pressure''' if not already available, and compare with measurements before the transfusion.

	~~Reactions~~ can ~~broadly~~ be ~~classified as follows, where additional symptoms and parameters may point in a different direction~~:		The '''most probable''' reaction can often be appreciated with the following algorithm:
	[[File:Transfusion reaction algorithm.jpg\|400px\|center]]		[[File:Transfusion reaction algorithm.jpg\|400px\|center]]
			Look up the most probable reaction in the hemovigilance protocol of NHSN, and check whether the patient fulfills its criteria:
			*[https://www.cdc.gov/nhsn/pdfs/biovigilance/bv-hv-protocol-current.pdf NHSN Hemovigilance Module Surveillance Protocol v2.6]
			If the condition fulfills the criteria, classify it as such. Otherwise, you may look in the left column of each reaction type in that protocol to see if the patient fulfills any of them. In case blood cultures are pending, you may generally still classify the current condition as if it was negative, and change the classification if cultures points towards a transfusion-transmitted infection. Non-severe symptoms that don't fill any criteria can generally be classified as "non-specific symptoms". In such cases where there are other conditions of the patient that likely have caused the symptoms, consider "no evidence of transfusion reaction".

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Mikael Häggström: Started

2020-12-24T19:51:17Z

Started

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==Immediate management==
*Check if transfusion is ongoing, and if so, '''stop''' it until resolution.

==Workup==
Even for unspecific symptoms, it is essentially never wrong to take blood samples for direct antiglobulin test (DAT) and hemolysis, as well as a urine sample for hemolysis.

Generally request temperature and blood pressure if not already available, and compare with measurements before the transfusion.

Reactions can broadly be classified as follows, where additional symptoms and parameters may point in a different direction:
[[File:Transfusion reaction algorithm.jpg|400px|center]]

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Transfusion reaction - Revision history

Mikael Häggström: Expanded

Mikael Häggström: Started