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During the
Transfusion
Monitor the patients vital signs.
Vital signs need to be obtained
before starting the transfusion so that there is a baseline for comparison. The
vital signs should be measured again at 5 and 30 minutes after the transfusion
begins.
Monitor the patient during the first 5 minutes of the
transfusion.
When initiating the infusion, the rate should be no
more than 120 cc/hr for the first 15 minutes. You need to remain with the
patient for the first 5 minutes to observe for symptoms of transfusion
reaction. If after 15 minutes the patient has not displayed any signs of a
transfusion reaction, the rate may be increased to that ordered by the
physician.
Monitor the patient's intake and output measurements.
Any patient receiving parenteral therapy is at risk for fluid
volume excess and should be monitored.
If adverse symptoms are noted,
such as temperature spikes, rigors,
and/or increased respiratory rate, stop the infusion immediately. A 0.9% saline
infusion should be started to keep the IV access patent and the physician
notified. The physician will determine if the transfusion will be discontinued
or if medication should be administered and the transfusion restarted based on
the following criteria:
Mild allergic reactions:
If the patient is experiencing signs of a mild allergic reaction, such as urticaria, and pruitis, the physician may decide to treat the patient with
diphenhydramine (Benadryl) and/or steroids. If the symptoms resolve, the
transfusion may be restarted. You should complete the transfusion reaction
section of the blood bag tag indicating symptoms and return the second copy to
the Blood Bank.
Severe
reactions:
When a patient experiences a severe reaction such as confluent urticaria,
laryngeal edema, shock, hemolytic reaction or unexplained fever, the transfusion
needs to be stopped and a transfusion reaction work-up initiated
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