This is the process of responding to an adverse reaction during and after blood transfusion. Adverse reaction could be mild, moderate or severe. Mild reactions may include fever, chills, vomiting and urticaria rash. Severe reactions include respiratory distress, low blood pressure, facial oedema and haematuria.
Aims
· Stop the progression of adverse reaction
· Prevent complications
Requirements
1. A trolley containing the following:
a. Top shelf:
· Intravenous infusion (0.9 % Normal Saline)
· Sterile gloves
· Examination gloves
· Gallipot
· Receiver for soiled swabs
· Hydrocortisone
· Syringes (2cc, 5cc and 10cc)
· Nasal prongs/face mask
· Intravenous cannula
· Specimen sample bottles
b. Bottom shelf
· Vital signs tray
· Gallipot with cotton wool swabs
· Methylated spirit
· Savlon solution
· Thermometer
· Pulse oximeter
· Pain scale (appropriate)
· Sphygmomanometer (manual/electronic)
· Glucometer with strips
2. Oxygen source
3. Blanket or extra sheet
4. Blood bank issue slip
5. Vomit bowl
6. Intake and output chart
7. Patient chart: vital signs chart, nurses notes and treatment chart
8. Screened blood
9. Cannulae
10. Thermometer
11. Drip Stand
12. Plain Giving set
13. Glucometer with strips
14. Adhesive Plaster
Steps
1. Stop transfusion immediately and set up 0.9% normal saline
2. Establish rapport (refer steps)
3. Explain procedure to child or caregiver/family (refer steps)
4. Allow caregiver to take a decision of either staying or leaving the resuscitation area
5. Administer hydrocortisone if prescribed
6. Reassure caregiver of good management throughout the procedure
7. Perform hand hygiene
8. Gather all equipment needed
9. Ensure a warm environment by wrapping baby or child with blanket or extra sheet
10. Check and record vital signs every 15 mins for 1 hour and 30 mins for the next 2 hours
11. Give oxygen if in respiratory distress
12. Check the blood with the Paediatrician/Nurse to ensure it is the right blood (serial No. expiry date and blood group)
13. Notify the Transfusion Service Providers
14. Send freshly collected blood and urine samples along with the blood pack to the Transfusion Service Providers
15. Fill the blood transfusion reaction form
16. Check blood glucose level and record
17. Note time of commencement, time of withdrawal and the amount of blood transfused
18. Observe for any other adverse reaction
19. Perform the following if it is a baby:
· Nurse baby under phototherapy if haemolysis occurs
· Observe the umbilicus for any bleeding and report (if necessary)
20. Record all procedures in patient’s chart
21. Dispose off and decontaminate used items
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