Transfusion reaction is the result of hemolysis from improperly typed and crossed blood or clerical error (80%). It occurs in 1 of 6000 transfusions. Manifestations of hemolysis occur after 50 mL or less of blood has been transfused. The patient develops fever and chills. The symptoms may progress to headache, back pain, substernal chest pain, dypsnea and hypotension.
Management consists of discontinuing the blood transfusion and sending the blood for repeat type and cross. Resuscitation is initiated with maintenance of a high urine output (see Table 3.1).
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