1- Disseminated intravascular coagulation (DIC) → cyanosis and massive
bleeding.
2- Major miss match → skin rash, dyspnea, restlessness, headache, vomiting, bleeding due to
DIC and renal failure (tubal necrosis).
Treatment of 1 and 2:
1- Stop blood transfusion.
2- Immediate IV Solu cortef vial + Avil (antihistaminic) ampoule.
3- IV fluids to maintain blood volume.
4- Lasix ampoule → repeated if the urine output does not increase.
5- Sodium bicarbonate 8.4% 50 ml IV to alkalinize the urine.
NB: Excess glucose 5% is harmful to red cells.
3- Hypersensitivity to donor plasma proteins (early or may be delayed) →
urticaria, rigors and pyrexia.
bleeding.
2- Major miss match → skin rash, dyspnea, restlessness, headache, vomiting, bleeding due to
DIC and renal failure (tubal necrosis).
Treatment of 1 and 2:
1- Stop blood transfusion.
2- Immediate IV Solu cortef vial + Avil (antihistaminic) ampoule.
3- IV fluids to maintain blood volume.
4- Lasix ampoule → repeated if the urine output does not increase.
5- Sodium bicarbonate 8.4% 50 ml IV to alkalinize the urine.
NB: Excess glucose 5% is harmful to red cells.
3- Hypersensitivity to donor plasma proteins (early or may be delayed) →
urticaria, rigors and pyrexia.
Treatment:
R/ IV solu cortef vial.
R/ IV avil ampoule.
4- Hyperkalemia → increased myocardial excitability.
- ECG is important → high T wave.
Treatment: R/ Calcium Chloride 10 ml ampoule IV very slowly and IV Calcium Chloride is considered a routine after transfusion of 4 units (bags) of blood.
5- Hypocalcemia → citrate toxicity.
Treatment: routine infusion of Calcium Chloride or Calcium Gluconate 10% ampoule IV slowly.
6- Diseases transmission: diseases may be discovered late.
7- Air embolism: rare.
Prophylaxis: good observation of IV route.
8- Acidosis → increased myocardial excitability (due to lactic acid production in stored blood (glycolysis) ).
Treatment: R/ Sodium bicarbonate 8.4% 100 - 200 ml for each unit (bag) of stored blood after the forth unit.
4- Hyperkalemia → increased myocardial excitability.
- ECG is important → high T wave.
Treatment: R/ Calcium Chloride 10 ml ampoule IV very slowly and IV Calcium Chloride is considered a routine after transfusion of 4 units (bags) of blood.
5- Hypocalcemia → citrate toxicity.
Treatment: routine infusion of Calcium Chloride or Calcium Gluconate 10% ampoule IV slowly.
6- Diseases transmission: diseases may be discovered late.
7- Air embolism: rare.
Prophylaxis: good observation of IV route.
8- Acidosis → increased myocardial excitability (due to lactic acid production in stored blood (glycolysis) ).
Treatment: R/ Sodium bicarbonate 8.4% 100 - 200 ml for each unit (bag) of stored blood after the forth unit.
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