How far out from a transfusion would you perform a reaction workup for a fever? We had a transfusion where vials were fine throughout the transfusion, including  a normal temp on  the post 15 minute vitals. Almost wo hours later when they did baseline vials for the second unit, the temp had increased  from 98.7 (1st unit post temp @1845) to 101.2. (Second unit baseline @2015 .) 

Would you have performed the workup, told them fever wasn't  related, etc. There were no othere symptoms  present and the bag had already been discarded so nothing left to culture. 

We would have done it, but they would have dug that bag out of the trash!

We had a similar situation recently but it was only an hour between units. Of course in that situation they complicated things by spiking the second unit, taking vitals and deciding to report a transfusion reaction and using the DIN of the second unit for everything...  

If they report it, investigate it.  It the time frame is extreme, pathologist should put a note on the patient's chart.

Ive had MDs order TRALI workups 2 days after rbc transfusions . . .

We work them ALL up! If the patient has a reaction either immediate or delayed we work them up. We took the thought process out of the picture for the nurses, if they suspect a reaction (and we do provide them with a chart of reactions and how they may present) they order it. They can call the patient's physician, but we wrote it into our policy and had it approved by our MEC to order it if they feel a reaction is happening.

If a reaction gets reported, we work it up.  We let the pathologist decide if it was a significant reaction.

 

anne

Two hours later does not seem extreme to me - depending on the state of the patient.  But was 98.7 not high already?  Sorry - can't remember normal values in °F

98.6 F=37 C, so it's basically a normal temp to start.

On ‎11‎/‎9‎/‎2016 at 9:55 AM, TreeMoss said:

If a reaction gets reported, we work it up.  We let the pathologist decide if it was a significant reaction.

 

anne

we do also