Daily QC (again)

[jojo808 45]

Hi all,

I am trying to overhaul our policy for transfusion reactions as recommended by our last CAP inspector. We were basically culturing all reactions except urticaria and the inspector said we were wasting time and energy and I agree but I need more assurance for the definite criteria so I want to know what are your criteria for culture and gram stain for blood products that are in question. I've looked online and found some use only temperature increase while others use temp increase with or without other symptoms What my research has found is the following: Most call febrile reactions bet 38-40C, or an increase in temp bet 1-2C from the baseline (pre-transfusion). The ones that use other symptoms use tachycardia and/or hypotension.

Just want a poll for several things:

1. At what temp do you call it a Febrile reaction?

2. Do you also use temp increase from the baseline? If so what is?

3. Do you use other criteria with Temp increase for culture? If so what are they?

4. If you do have one, what is your definition for tachycardia (eg =>100 bpm?)

5. Same with Hypotension, any numerical definition?

I know there are threads on this but I don't want to sort through it all. Please, I would love as much input as possible. Add any advice or other pertinent information is greatly appreciated. Thank you all in advance. 

[carolyn swickard 212]

. At what temp do you call it a Febrile reaction?  we use temp increase - unless the pt is already hot and they had to transfuse anyway - then we would still look for temp rise beyond start point

2. Do you also use temp increase from the baseline? If so what is?  start temp with 2F/ 1C temp rise

3. Do you use other criteria with Temp increase for culture? If so what are they?  any symptoms that indicated bacterial contamination - shock, hypotension (significant drop from start point),  high fever (from start point), chills, vomiting, diarrhea - are what we list for RN

4. If you do have one, what is your definition for tachycardia (eg =>100 bpm?) - no definition

5. Same with Hypotension, any numerical definition? - no - significant/noticeable drop from start point

[pinktoptube 47]

9 hours ago, cswickard said:

. At what temp do you call it a Febrile reaction?  we use temp increase - unless the pt is already hot and they had to transfuse anyway - then we would still look for temp rise beyond start point

2. Do you also use temp increase from the baseline? If so what is?  start temp with 2F/ 1C temp rise

3. Do you use other criteria with Temp increase for culture? If so what are they?  any symptoms that indicated bacterial contamination - shock, hypotension (significant drop from start point),  high fever (from start point), chills, vomiting, diarrhea - are what we list for RN

4. If you do have one, what is your definition for tachycardia (eg =>100 bpm?) - no definition

5. Same with Hypotension, any numerical definition? - no - significant/noticeable drop from start point

Same as cswickard, except for temp increase, we use an increase greater than 38C