Mabel Adams Posted November 7, 2007 Share Posted November 7, 2007 Have any of you changed reaction reporting forms or protocol to try to better capture cases of TRALI and appropriately manage them when you find them?We have used a protocol that divides reactions into classes based on initial signs/symptoms or on our testing results. Class I is allergic, class II is FNH, class III is hemolytic. The signs of TACO and TRALI are kind of vaguely lumped into class III but it doesn't make sense to do a huge serological workup for TACO or TRALI. Do I add a Class IV or just go to a flow chart? I need to make this easy for nursing as well as techs and our generalist pathologists.Has anyone already invented this wheel? Thanks for any procedures or info you can share. Link to comment Share on other sites More sharing options...
pdavenport Posted November 9, 2007 Share Posted November 9, 2007 We're in the process of modifying our report form and SOP. The form will ask for documentation of hypoxia (pulse ox, FiO2). We can check the computer to see if an ABG was done. Hopefully that will help us detect TRALI. The biggest part for us has been physician education. We did a presentation of TRALI at grand rounds, and got a lot of positive feedback from the physicians. Link to comment Share on other sites More sharing options...
Eagle Eye Posted November 10, 2007 Share Posted November 10, 2007 Is there any study out there indicating the use of blood gas value to diagnose TRALI? In other words, what are the values do you look for? Link to comment Share on other sites More sharing options...
kirkaw Posted February 9, 2015 Share Posted February 9, 2015 We are noticing that physicians are finally starting to look for signs/symptoms of TACO and TRALI. I wonder if we need to change our adverse event form to be more definitive on these. Has anyone done this? This thread was originally started in 2007, so I'm interested to know if more people are doing something.Also, if the patient reports shortness of breath, do you look for a chest X-Ray or administration of diuretics or any other indication that the physician suspects TRALI or TACO?Thanks! Link to comment Share on other sites More sharing options...
tbostock Posted February 10, 2015 Share Posted February 10, 2015 Any respiratory reaction, during or up to 4 hours after transfusion is reported to us per protocol. We ask them to order a chest Xray (TRALI: bilateral infiltrates usually with normal heart size, TACO: looks like CHF, cardiopulmonary edema, usually enlarged heart), we ask them to order a BNP (elevated in CHF or TACO, usually normal in TRALI). We suggest diuretics, especially if it appears to be a TACO. Then we report it to our blood supplier. kate murphy and Yanxia 2 Link to comment Share on other sites More sharing options...
Eagle Eye Posted February 12, 2015 Share Posted February 12, 2015 we do almost similar to tbstock... Link to comment Share on other sites More sharing options...
Mabel Adams Posted March 10, 2015 Author Share Posted March 10, 2015 We mostly have doctors writing in patient's charts that they think they have TRALI but they never tell the Blood Bank about it! One of our hospitals did have a severe case of TRALI a few months back. It was so striking and so soon after the transfusion that it did get reported as a transfusion reaction so we were able to have it worked up by our supplier. The donor was found to have several HLA antibodies. Yanxia 1 Link to comment Share on other sites More sharing options...
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