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jojo808

Transfusion Reaction Criteria

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Hi all,

I am trying to overhaul our policy for transfusion reactions as recommended by our last CAP inspector. We were basically culturing all reactions except urticaria and the inspector said we were wasting time and energy and I agree but I need more assurance for the definite criteria so I want to know what are your criteria for culture and gram stain for blood products that are in question. I've looked online and found some use only temperature increase while others use temp increase with or without other symptoms What my research has found is the following: Most call febrile reactions bet 38-40C, or an increase in temp bet 1-2C from the baseline (pre-transfusion). The ones that use other symptoms use tachycardia and/or hypotension.

Just want a poll for several things:

1. At what temp do you call it a Febrile reaction?

2. Do you also use temp increase from the baseline? If so what is?

3. Do you use other criteria with Temp increase for culture? If so what are they?

4. If you do have one, what is your definition for tachycardia (eg =>100 bpm?)

5. Same with Hypotension, any numerical definition?

I know there are threads on this but I don't want to sort through it all. Please, I would love as much input as possible. Add any advice or other pertinent information is greatly appreciated. Thank you all in advance. 

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7 hours ago, jojo808 said:

Hi all,

I am trying to overhaul our policy for transfusion reactions as recommended by our last CAP inspector. We were basically culturing all reactions except urticaria and the inspector said we were wasting time and energy and I agree but I need more assurance for the definite criteria so I want to know what are your criteria for culture and gram stain for blood products that are in question. I've looked online and found some use only temperature increase while others use temp increase with or without other symptoms What my research has found is the following: Most call febrile reactions bet 38-40C, or an increase in temp bet 1-2C from the baseline (pre-transfusion). The ones that use other symptoms use tachycardia and/or hypotension.

Just want a poll for several things:

1. At what temp do you call it a Febrile reaction?

2. Do you also use temp increase from the baseline? If so what is?

3. Do you use other criteria with Temp increase for culture? If so what are they?

4. If you do have one, what is your definition for tachycardia (eg =>100 bpm?)

5. Same with Hypotension, any numerical definition?

I know there are threads on this but I don't want to sort through it all. Please, I would love as much input as possible. Add any advice or other pertinent information is greatly appreciated. Thank you all in advance. 

1.  Febrile 1-2 C.

2.  Measured from the baseline, which is just before the transfusion starts.

3.  Cultures are done only when directed by a pathologist or other physician.

4. and 5.  These are nursing calls.

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Here, a temp >1 degree Celsius over baseline AND any other symptom gets an automatic culture.  Plus I suppose we would honour any direct request for a culture (not that I've seen that happen). 

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1. At what temp do you call it a Febrile reaction? >/= 38C

2. Do you also use temp increase from the baseline? If so what is? No

3. Do you use other criteria with Temp increase for culture? If so what are they? Have symptoms related to sepsis (CDC defin); however it is our MD call to culture.

4. If you do have one, what is your definition for tachycardia (eg =>100 bpm?) do not define

5. Same with Hypotension, any numerical definition? do not define

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