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At the end of the quoted policy above is this caveat: "Increase in temperature alone should not always constitute justification for a transfusion reaction work up. Nursing judgment should be used in evaluating symptoms and notification of physician." Here, we occasionally have problems with workups not being done, or direction from the blood bank to stop transfusions, against hospital policy. This is because there is sometimes a tendency to excuse reactions, such as a temp increase, to something other than an acute reaction to the transfusion. Now, every facility has to go by their own policy, but I would rephrase this as: "A significant increase in temperature, that may be attributable to some other cause, shall not constitute justification for ignoring what may be a life-threatening acute transfusion reaction. Nursing judgment should be used in evaluating symptoms only after consultation with the Laboratory Blood Bank, and attending physician." Scott

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