Sunday, December 25, 2011

Dangers with blood transfusion

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.


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.

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