Transfusing Tina — Blood Transfusion Reactions
Fever, flank pain, hives within minutes — STOP the transfusion first
Ten minutes into her second unit of blood, Tina says her back hurts and she feels flushed. Her temperature has jumped 1.8°F since baseline.
Tina is receiving a unit of packed red blood cells for symptomatic anemia. Most fatal transfusion reactions happen in the first 15 minutes, which is why the nurse stays at the bedside and vital signs are checked frequently early on. Any new fever, chills, back pain, hives, itching, or shortness of breath means one action comes before all others: stop the transfusion and keep the IV line open with normal saline. Only after the transfusion is stopped does the nurse notify the provider and blood bank.
Read Transfusing Tina's full story →The story arc
The setup
Tina's hemoglobin is 6.8 g/dL from chronic GI bleeding, and she is typed, crossmatched, and started on packed red blood cells with a second nurse verifying at the bedside.
The turn
The first 15 minutes pass with the nurse staying in the room, running the infusion slowly and checking vitals closely.
The crisis
Tina reports flank pain and flushing, her temperature rises from 98.6°F to 100.4°F, and hives appear on her chest.
The save
The nurse stops the transfusion immediately, keeps the IV open with a new tubing set of normal saline, stays with Tina, and then notifies the provider and blood bank while sending the remaining blood and tubing for analysis.
NCLEX study section — Blood Transfusion Reactions
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Safety & Infection Control
Take this chapter into practice questions on the same topic.