Intravascular Transfusion Reaction

• Stop blood component infusion immediately
• Maintain IV access with suitable crystalloid or colloid solution
• Maintain BP, heart rate
• Maintain adequate airway
• Give a diuretic and/or institute fluid diuresis
• Obtain blood/urine for transfusion reaction work-up
• If only mild allergic-type reaction, consider giving diphenhydramine and restarting transfusion
• Blood Bank work-up
• Check paperwork to ensure correct blood component was transfused to proper patient
• Observe plasma for hemoglobinemia
• Perform diagnostic direct antiglobin test
• Repeat compatibility testing (crossmatch)
• Repeat other serological testing as needed (ABO, Rh, etc.)
• Analyze urine for hemoglobinuria
• If intravascular hemolytic reaction is confirmed
• monitor renal status (BUN, creatinine)
• Monitor coagulation status (PT, PTT, fibrinogen)
• Monitor for signs of hemolysis (LDH, bilirubin)
• If sepsis is suspected, culture as appropriate