We were recently inspected by JCAHO.  In the policy manual we have stated must workup a transfusion reaction if patients temp increases 2 degrees from 98.6F or 1 degree from 37C.  What if patients pre transfusion temp is elevated before transfusion begins?  Is a transfusion reaction workup recommended (2 degree increase) from the "starting" temp or is it always 98.6F? I emailed AABB to clarify, never received a response.  I would like to know what others are doing.

 

Thanks for any help!!!

We use a 2 part temperature guideline based on ARC's reaction forms. 

 

If the temp is greater than or equal to 102.9 F a reaction is called.

 

If there is a 2 degree C rise in temp a reaction is called.

Our guidelines are the temperature must rise >2 degrees AND be over 100.6°F (or >1 and 38°C).

We go 2F/1C from whatever the starting temp is.

 

Scott

By the way, I don't think that any of the accrediting agencies state firm guidelines of what constitutes a "fever" (or "significant temperature increase.")

2 degrees F from the pre-transfusion temp AND at least over 100 degrees F

By the way, I don't think that any of the accrediting agencies state firm guidelines of what constitutes a "fever" (or "significant temperature increase.")

 

Yep. Accrediting/Regulatory agencies will instead see how your policy was developed (under guidance/direction by Medical Director?) and see if your institution is followig your policy.

Our original policy simply stated rise of 2°F and we would run into issues where the patient in the PACU whose temp is 95.2 goes up to 98.1 after the bair hugger or whatever and the literal interpretation of the policy says they needed to initiate a transfusion reaction workup, which is kind of silly.