Paediatric Nursing (PAED)
MANAGEMENT OF AN ADVERSE REACTION TO BLOOD TRANSFUSION IN CHILDREN
This is the immediate recognition and management of adverse reactions during or after blood transfusion.
Purpose
- Stop harmful reaction
- Maintain patient safety
- Provide supportive care
- Prevent future reactions
Indications
- Signs of transfusion reaction during or after blood administration
Equipment
- Normal saline and administration set
- Emergency medications (antihistamines, steroids, epinephrine)
- Oxygen and resuscitation equipment
- Blood culture bottles
- Specimen collection supplies
Preparation
- Know signs of transfusion reactions
- Have emergency medications available
- Understand hospital protocol
Procedure steps
- STOP transfusion immediately
- Keep IV line open with normal saline
- Assess ABCs and vital signs
- Notify physician and blood bank
- Recheck patient and blood product identification
- Monitor for severity of reaction
- Administer prescribed medications
- Collect required specimens
- Send blood bag and tubing to blood bank
- Document reaction thoroughly
- Complete transfusion reaction report
Precautions
- Do not discard blood bag
- Save all equipment for investigation
- Monitor continuously
- Be prepared for anaphylaxis
Aftercare
- Continue monitoring
- Provide supportive care
- Educate family about reaction
- Document for future reference
Nursing considerations
- Differentiate reaction types
- Consider psychological impact
- Plan for future transfusions
Patient education
- Explain what happened
- Importance of reporting future reactions
- Documentation for medical records
Documentation
- Type of reaction observed
- Time of onset
- Vital signs
- Interventions and response
- Physician notification
- Specimens sent
References and further reading
Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.
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