One Hour posttransfusion temperatures

[David Saikin 1,425]

Nursing has started documenting patient temperatures at one hour after final transfusion.  The question they ask is:  if the temp is elevated at that time should they call a transfusion reaction? 

I will look forward to your responses.

[John C. Staley 1,167]

Personally, I think that is a judgement call to be made by the patient's physician.  Is there some reason this one hour post transfusion temp documentation is being done?  Any new studies I'm not aware of?  There are uncounted reasons for a patient's temp will rise, my favorite was the time the curtains were open and the sun was beating down directly on the patient!  

Just my thoughts.   

[Neil Blumberg 246]

I would not be performing one hour post-transfusion vital signs unless the patient has signs or symptoms that require assessment.  I would not be reacting to one hour post-transfusion data unless they were consonant with a transfusion reaction.  If fever was the only sign or symptom, it's probably not transfusion related in the vast majority of cases.  Routine vital signs in the absence of a clinical rationale are a problem, not a solution.

[Sonya Martinez 31]

I think this came from the AABB Primer for Blood Administration.  We have it in our policy to check all vital signs 1 hour after transfusion and if it meets requirements of a transfusion reaction then they start the transfusion reaction workup.  We put this added vital sign check after instituting the Hemovigilance Surveillance through the CDC (NHSN) after we started seeing a lot of hypotensive reactions and because being a children's hospital we see a lot of allergic reactions that aren't necessary happening during the transfusion but some times right after.  It hasn't significatntly increased the number of reactions reported.