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Blood and Tissue Resources

Guidelines For Monitoring Transfusion Recipients

New York State Council on Human Blood and Transfusion Services
New York State Department of Health
Wadsworth Center
Empire State Plaza - P.O. Box 509
Albany, New York 12201-0509
Committee Members.

Guidelines (.pdf - 63.8KB)

Second Edition
2004

• Guidelines for Monitoring Transfusion Recipients
• Pertinent Literature
• Committee Members

1. The patient's vital signs (temperature, pulse, respirations, and blood pressure) should be recorded shortly before transfusion and after the first 15 minutes, and compared to baseline values. Some patients' history or clinical condition may indicate a need for more frequent monitoring.
2. After the transfusion is initiated, the rate of flow should be observed and regulated, according to the physician's orders.
3. During the transfusion, the patient should be observed periodically, especially during the first 10 to 15 minutes, for signs and symptoms of transfusion reaction.

   a. Hives
   b. Wheezing
   c. Fever
   d. Chills
   e. Shortness of breath
   f. Chest pressure
   g. Back pain
   h. Change in vital signs

   If any of the above occurs, the transfusion should be STOPPED, and the responsible physician notified.

4. If in a medical facility, the patient should be instructed, prior to transfusion, to alert a health care provider of any discomfort or unusual sensations.
5. Upon completion of the transfusion, the patient's vital signs (temperature, pulse, respirations, and blood pressure) should be recorded, and compared with the previous values.
6. The ordering physician/designee should be available to handle any complications. In an ambulatory setting, it is important that the patient be given instructions on potential problems following transfusion and the telephone number to call in the event of a reaction.
7. Monitoring of red cell and platelet increments is essential post-transfusion. However, the timing may depend on the clinical condition of the patient.

PERTINENT LITERATURE

McCallum JL, Pinkerton PH. Blood transfusions, blood alternatives and transfusion reactions: a guide to transfusion medicine. Ontario: Sunnybrook and Women's College Health Sciences Center, 2003.

Popovsky MA, ed. Transfusion reactions. 2nd ed. Bethesda: American Association of Blood Banks Press, 2001.

Triulzi DJ, ed. Blood transfusion therapy: a physician's handbook. 7th ed. Bethesda: American Association of Blood Banks Press, 2002.

COMMITTEE MEMBERS

NEW YORK STATE
COUNCIL ON HUMAN BLOOD AND TRANSFUSION SERVICES

Membership Roster - 2004

NEW YORK STATE
COUNCIL ON HUMAN BLOOD AND TRANSFUSION SERVICES

BLOOD SERVICES COMMITTEE

Membership Roster - 2004

Lazaro Rosales, M.D., Chairperson
Deputy Director, Blood Bank
SUNY Health Science Center at Syracuse
Syracuse, New York

Visalam Chandrasekaran, M.D.
Chief, Division of Blood Banking
Long Island Jewish Medical Center
New Hyde Park, New York

William Fricke, M.D.*
Director, Transfusion Service
Director, Hematology Laboratory
Rochester General Hospital
Rochester, New York

Elizabeth S. Gloster, M.D.
Director, Blood Bank
Kings County Hospital Center, and
SUNY Health Science Center at Brooklyn
Brooklyn, New York

Kathleen Grima, M.D.
Director, Clinical Services
New York Blood Center
White Plains, New York

Joanna Heal, M.D.*
Associate Medical Director
American Red Cross Blood Services
Rochester, New York

Randy Levine, M.D.
Director, Blood Bank
Lenox Hill Hospital
New York, New York

Jeanne V. Linden, M.D., M.P.H.
Director, Blood and Tissue Resources
New York State Department of Health
Wadsworth Center
Albany, New York

Helen Richards, M.D. ^†*
Director of Laboratories
Harlem Hospital Center
New York, New York

Joan Uehlinger, M.D.
Director, Blood Bank
Montefiore Medical Center
Bronx, New York

^† Guideline Working Group Chairperson

* Member, Guideline Working Group

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Requests for copies of this publication may be directed to:
Blood and Tissue Resources Program
New York State Department of Health
Wadsworth Center
Empire State Plaza
P.O. Box 509
Albany, New York 12201-0509
Telephone: (518) 485-5341
Fax: (518) 485-5342
E-mail: btraxess@health.state.ny.us.
Website:www.wadsworth.org/labcert/blood_tissue.