KKidd Posted February 28, 2011 Share Posted February 28, 2011 Our policy regarding a suspected transfusion reaction includes a 2F increase in temperature form the baseline. Recently we had a patient whose baseline temp was 91.5F. By the end of the transfusion, his temp was 94.1F. Does your policy take into account patients with a subnormal temperature?:pcproblem:pcproblem Link to comment Share on other sites More sharing options...
Deny Morlino Posted February 28, 2011 Share Posted February 28, 2011 All the reaction guideline sign snd symptoms are just that... guidelines. If a patient has a large jump in blood pressure numbers that is explained by volume infusion, nursing has the ability (and intelligence) to make a judgement call as to whether this "makes sense" given the clinical picture. I would think the same would hold true in the situation you describe. Link to comment Share on other sites More sharing options...
Eoin Posted March 1, 2011 Share Posted March 1, 2011 (edited) I agree Deny. We use 1.5 degrees Centigrade) rise. Our policy is to turn off, seek clinician direction and recommence if directed (often with some paracetamol), or cease if they are unhappy to continue. They are weighing up advantages / disadvantages for that particular patient (or they should be!)A lot of oncology and haematology patients would never get blood into them if strictly applied. I often follow-up on what would appear to be needlessly ceased trasfusions, but at the end of the day if they are good nurses, I trust their instinct. They know the patients better than I do in the Quality Office. Always better half a bag of blood lost, than a missed transfusion reaction. Additionally we are probably the last group in clinical labs doing good old fashioned experiments when we perform compatibility testing (I heard of a doctor, who went on to become a Haematology Consultant mixing donor whole blood and recipient whole blood in a saucer (emergency in the Oz outback). If it goes lumpy, don't transfuse.It is not an exact science and probably will continue the same for some time, despite moleculomics.CheersEoin Edited March 1, 2011 by Eoin Link to comment Share on other sites More sharing options...
GilTphoto Posted March 2, 2011 Share Posted March 2, 2011 How are these temps being taken? A temp of 91 to 94 are very low. While the guideline is 1C or 2F increase, this usually means from normal (98.6). Fever starts at a temp of 100F. Anything less is not a fever and a reaction should not be called.a temp change from 91 to 94 is an improvement! Link to comment Share on other sites More sharing options...
GilTphoto Posted March 2, 2011 Share Posted March 2, 2011 By the way.......What's the difference between an oral and rectal thermometer?.................... the taste! <g> Link to comment Share on other sites More sharing options...
snilon Posted March 3, 2011 Share Posted March 3, 2011 LOL GilTphoto! Link to comment Share on other sites More sharing options...
Eagle Eye Posted March 4, 2011 Share Posted March 4, 2011 how about the difference between Foley cathater temperature and auxillary temp.? Link to comment Share on other sites More sharing options...
Eagle Eye Posted March 4, 2011 Share Posted March 4, 2011 we use 2 degree temp. rise from base line.....if we have a case of 91 to 95 and patient was on bear hugger or was using warming blanket ...we do not call it significant. Link to comment Share on other sites More sharing options...
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