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The most common cause of an acute intravascular hemolytic transfusion reaction is ABO incompatibility. The ABO blood group antigens are densely expressed on the RBC surface, and most people have adequate amounts of preformed antibodies that can not only bind to the RBCs but can also activate complement.
The most common symptoms of transfusion reactions are chills, rigor, fever, dyspnea, light-headedness, urticaria, itching, and flank pain. If any of these symptoms (other than localized urticaria and itching) occur, the transfusion should be stopped immediately and the IV line kept open with normal saline.
Causes of Blood Transfusion Errors Administration Errors. Improper administration errors concern mistakes in the process of administering the blood transfusion. Communication and Staff Errors. Patient Assessment Errors. Storage Errors.
The most common signs and symptoms include fever, chills, urticaria (hives), and itching. Some symptoms resolve with little or no treatment. However, respiratory distress, high fever, hypotension (low blood pressure), and red urine (hemoglobinuria) can indicate a more serious reaction.
If you receive blood that is even partially not compatible with your blood, your body produces antibodies to destroy the donors blood cells. This process causes the transfusion reaction. Blood that you receive in a transfusion must be compatible with your own blood.
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The risks of blood transfusions include: An allergic reaction. This can be mild or severe. Fever. Destruction of red blood cells by the body (hemolytic reaction). Too much blood in the body (transfusion overload). Too much iron in the body (iron overload). Viruses being transmitted. Graft versus host disease.
Management: Immediately stop transfusion. Notify hospital blood bank urgently (another patient may also have been given the wrong blood!). These patients usually require ICU support and therapy includes vigorous treatment of hypotension and maintenance of renal blood flow.
The most frequent error leading to transfusion of ABO-incompatible blood occurs during patient identification/verification at the bedside; as a result, although the blood is labeled appropriately, it is transfused to someone other than the correct recipient.