base line pretransfusion vitals

[Eileen]

I have been seeing nurses come to pick up blood components for patients with high fevers i.e. 101.2 and another with high pressures i.e. systolic of 176...I have not seen any transfusion literature that mentions recommended vital limits for transfusion.  What is the role of blood bankers with such findings? besides alerting the nurse to the high or abnormal vital? 

[John C. Staley]

My only concern with pretransfusion vitals was to give a baseline in case there was a change during or shortly after the transfusion.  I'm curious as to why you are aware of the pretransfusion vitals?  I would certainly hope the nurse is aware and not in need of being alerted.

 

[R1R2]

Agree with John.  

[David Saikin]

Agree also.

[AMcCord]

Agree - the baseline is the important thing, not the starting point.

[Moira Johnson]

We require the baseline pre-transfusion temperature when dispensing blood products.  The baseline is necessary to determine problems with the next/subsequent transfusion vitals for the product, as stated in the replies above.  I must say that I believe Eileen may have been asking about the actual temperature itself, meaning is it too high to start a transfusion, and that being said, has the attending/ordering physician been informed and given consent for the transfusion?  We always ask that question if the pre-transfusion temp is 101 degrees F or higher.  This is stated in our policy as well, which nursing follows in practice.

I hope this helps, Eileen!

[Eagle Eye]

Our only concern: patient must be monitored against base line vitals once they start transfusion. Eg. They can start trnasfusion with temp. of 102 and if the temp. does not spike above 104, they can complete transfusion.

Clinically the vitals may be abnormal but if the patient need transfusion, we can not hold transfusion due to abnormal vitals...that is clinical judgement.

[Eileen]

Thank you for your feedback. As we all know and it is well understood the link between vitals and transfusion reactions, but I needed to see how others are handling abnormal vitals while issuing. Moira Johnson's feedback is very helpful and my questions to Moira is who decided on the 101 temperature benchmark?  Was it literature or medical decision. I would like to adapt that into our practice. 

 

eileen