Blood transfusions are much safer these days than they were a few decades ago, however, typing, crossmatching, and screening blood is still of the utmost importance! When you look at blood types and compare donor to recipient, what you will notice is the O- donor can donate to ANY recipient, it’s considered the universal donor. That is because they have no antigens and no Rh factor. There is nothing in that blood that will react with the recipient’s blood. You will also notice that the AB+ recipient is considered the universal recipient. This is because they have ALL of the antigens and therefore haven’t created antibodies to anything! They can literally receive any type of blood and the body will recognize it as normal.
When administering a blood transfusion, we must monitor for transfusion reactions. We take a full set of vital signs before we start, every 15 minutes x 2, every 30 minutes x 1, then hourly until the transfusion ends, at which point we take one final set. Your facility may have different specific policies for this, so just be sure you’re following those as well. Two important notes. First, an LPN can monitor a blood transfusion, but an RN must initiate it. Again, verify these policies with your facility. Second, the most likely time for a transfusion reaction is in the first 30 minutes, so make sure you’re doing this monitoring every time.
There are 4 main types of transfusion reaction. An allergic reaction shows with flushing, itching, hives, fever. Febrile, non-hemolytic reactions include chills, fever, palpitations, tachycardia, and flushing. Hemolytic reactions tend to cause kidney damage and possibly even ischemia, so you’d see chills, fever, chest pain, diaphoresis, acute renal failure, and flank pain. Finally there’s a possibility for a septic reaction in which you’d see chills, a very high fever, and shock symptoms. In ANY case, the moment you suspect a transfusion reaction, you need to STOP THE TRANSFUSION!
Date Published - Jul 9, 2018
Date Modified - May 21, 2018