The clinical use of blood: handbook by World Health Organization

By World Health Organization

Summarizes the knowledge supplied within the module, The scientific Use of Blood, and has been produced for speedy reference via clinicians who have the desire to make pressing judgements on transfusion.

summary: Summarizes the data supplied within the module, The scientific Use of Blood, and has been produced for fast reference via clinicians who intend to make pressing judgements on transfusion

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See pages 62–65 for the signs and symptoms, possible causes and management of the three broad categories of acute transfusion reaction to aid in immediate management. Page 66 summarizes the drugs and dosages that may be needed in managing acute transfusion reactions. 61 Adverse effects of transfusion Guidelines for the recognition and management of acute transfusion reactions CATEGORY 1: MILD REACTIONS Signs Symptoms ■ Localized cutaneous ■ Pruritus reactions: (itching) — Urticaria — Rash Possible cause ■ Hypersensitivity (mild) CATEGORY 2: MODERATELY SEVERE REACTIONS Signs ■ Flushing ■ Urticaria ■ Rigors ■ Fever ■ Restlessness ■ Tachycardia 62 Symptoms ■ Anxiety ■ Pruritus ■ Palpitations ■ Mild dyspnoea ■ Headache Possible cause ■ Hypersensitivity (moderate–severe) ■ Febrile non-haemolytic transfusion reactions: — Antibodies to white blood cells, platelets — Antibodies to proteins, including IgA ■ Possible contamination with pyrogens and/or bacteria Immediate management 1 Slow the transfusion.

Obstetrics, elective surgery Urgently request ABO and RhD compatible units. Blood bank may select group O Request ABO and RhD compatible units to be available at stated time Request group, antibody screen and hold Clinical transfusion procedures Ordering blood Ordering blood for elective surgery The timing of requests for blood for elective surgery should comply with local rules and the quantity requested should be guided by the local blood ordering schedule. Blood ordering schedule Each hospital should develop a blood ordering schedule, which is a guide to normal transfusion requirements for common surgical procedures.

Look for blood here Look for haemolysis in the plasma. Is the plasma pink? Look for haemolysis on the line between the red cells and plasma Look for large clots in the plasma Plasma Red cells Look at the red cells. Are they normal or are they purple or black? Do not administer the transfusion if the blood pack appears abnormal or damaged or it has been (or may have been) out of the refrigerator for longer than 30 minutes. Inform the blood bank immediately. 52 Before starting the infusion, it is vital to make the final identity check in accordance with your hospital’s standard operating procedure.

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