Precautions to minimize the adverse effects of blood transfusion.

blood transfusion

Now a day the blood transfusion has become very common. People receive them for various reasons. For instance, if a person has a bleeding disorder, he will go with blood transfusion. Or, if a person had a severe accident and lost blood, he will prefer doing a blood transfusion. Some people may go with blood transfusion if they have an infection which makes it difficult to make blood to their body.

Usually, before starting transfusion the technicians inject a few drops of blood to the recipient body to make sure they are compatible. This type of procedure is called as cross matching. For double checking, the technician will increase the units of blood gradually as the most adverse effects occur in the first 15 minutes of transfusion. This ensures the safe blood transfusion. In this situation, the recipient is closely observed and later on nurse will take care to find out the adverse effects.

Most transfusions are safe and successful till now, but sometimes the mild reactions may take place. The most common reactions that occur during blood transfusions are Fever and chills, Allergic reactions and bacterial contamination. The major reactions that takes place are Fluid volume overload, Transfusion-related lung injury, Breakdown of red blood cells due to the incompatibility of blood type, citrate toxicity, Potassium effects, Hypothermia and much more.

During the initial stage, it might be difficult to find out the diverse effects. However, the immediate action to be taken after observing the effect is stopping the transfusion, cross checking the documents, offering immediate patient care and contacting the doctor for further help.

Here are some of the reactions and precautions that have to be noticed during a blood transfusion.

Fever and chills:

Fever and chills are the most common reactions observed in more transfusions and these are caused by a reaction of white cell antigens, white cell fragments or cytokines in the blood. So, it is better to remove white blood cells before transfusion.

Fever occurs usually with platelet transfusion than red cell transfusion. The increase in temperature can cause chills, headache and back pain to the recipient. In some cases, the person also feels some kind of allergic reactions such as itching and rashes.

If a person is suffering from fever and chills and in need of other transfusion, acetaminophen to be given for reducing the fever. This is the only treatment needed to get down the temperature.

Allergic reactions:

Loss of consciousness, swelling, dizziness, itching, wide spread of rash, difficulty in breathing and incontinence of urine are some allergic reactions occur during transfusion. If the patient has severe allergic reaction, he/she may suffer with low blood pressure and shock.

As soon the allergic reaction is observed, the transfusion has to be stopped and antihistamine to be given. In severe cases hydrocortisone and epinephrine is suggested.

If the person has continuous allergic reaction better to wash out the red blood cells. Though this can remove the allergic components from the donor blood.

Fluid volume overload:

Transfusing a larger amount of fluid than the body capacity is known as fluid over load. Transfusion of more fluid may cause diverse effects to the patients such as body swelling, breathing difficulty and fast heartbeat. Patients and infants with cardiopulmonary diseases are at risk.

In case of fluid overload, immediately stop the transfusion and control the breathing by offering required oxygen. To avoid this better to use appropriate infusion rates.

Lung allergy:

This is one of the rare and serious reaction occurred 2 to 8 hours after blood transfusion. It mainly caused due to the presence of antibodies in the donor’s plasma. This allergy may cause serious breathing difficulty which leads to death some times.

In case of lung allergy, the patient may require intubation and mechanical ventilation. This should be continued till the lungs get healed. Using Men blood will minimize the adverse effects.

Break down of red blood cells:

Incompatibility in blood groups of donor and recipient causes this breakdown of red blood cells. This is a very rare condition, to avoid this situation check the type of blood carefully before transfusion. When mismatch occurs the patient body will destroy the red blood cells that are transfused from the donor blood.

Difficulty in breathing, pressure in chest, severe back pain and headache, low blood pressure, cold and moist skin are some of the symptoms. In case of this situation, the doctors will stop the transfusion and will give a treatment for breath adjustment. To find out the destroy level perform urine and blood test.

This situation is less noticed as it is identified only when the blood test is done for the illness.

Infections:

During blood transfusion, a few infectious organisms will get transmitted even if the blood is stored in a special care. Testing the donor’s blood carefully will lower the infection cases. However, some may not be detected if the donor is infected recently.

Graft Versus Host Disease (GVHD):

GVHD is an unusual complication that occurs when the donor immune system is diminished by the drugs. In case of transfusion, the transfused white blood cells will attack the patient’s tissues and this may lead to damage of bone marrow and liver. Fever, abnormal liver function, diarrhea, skin rash, pancytopenia, low blood pressure, fatal, tissue destruction and shock are some of the symptoms of this disease.

To eliminate GVHD disease, weakened immune system red blood cells and platelets have to be given.

Massive transfusion:

Transfusing a massive quantity of blood to the patient within 24 hours or less is known as massive transfusion. This happens mainly when the patient undergoes surgery. Poor blood clotting and hypothermia are some of the complications arises during the transfusion. This poor blood clotting happens because the donor blood does not have enough amount of substances that required for clotting. In this situation, fresh frozen plasma has to be transfused. Usually, this massive transfusion results low body temperature, to avoid this, make use of blood that is refrigerated in special devices by the doctors.

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