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Serious Transfusion Incident Reporting - International ...

Serious Transfusion Incident Reporting - International ...

Incident category definitions Acute transfusion reaction (ATR) A reaction occurring at any time during or up to 24 hours following a transfusion of blood or components, excluding cases of acute reactions known to be due to incorrect component being transfused. Possible acute reaction types: Haemolytic transfusion reaction (HTR) HTR is clinically suspected if one or more of the following is present: fever and/ or other symptoms (including dyspnoea, hypotension, tachycardia, back pain) failure to achieve expected rise of the Hb post-transfusion or a drop in Hb>20g/L within 24 hours (excluding all causes for ongoing bleeding) rise in LDH >50 per cent within 24 hours rise in bilirubin, free haemoglobin (plasma or urine). HTR is confirmed by a positive direct antiglobulin test (DAT) and a positive red cell cross match. In the absence of a positive DAT, retrospective phenotype incompatibility of transfused units or a positive crossmatch in addition to clinical scenario consistent with acute haemolytic transfusion reaction may provide diagnosis. Non-haemolytic febrile transfusion reaction (NHTR) Moderate/severe febrile transfusion reaction chills/rigor headache nausea and vomiting and fever (>38.5°C or a change of 1.5°C above baseline) Allergic reaction One or more of the following; rash allergic dyspnoea (stridor, cyanosis, wheezing) angioedema urticaria and without hypotension during or within 24 hours. Anaphylactoid/anaphylaxis reaction Allergic reaction with associated hypotension or shock associated with transfusion. Transfusion-associated circulatory overload (TACO) Respiratory distress, tachycardia and increased blood pressure within 12 hours of the completion of the transfusion. Typical signs of cardiogenic lung oedema in the chest x-ray and a positive fluid balance, or known compromised cardiac status support TACO. 7 Better Safer Transfusion Program – STIR Guide

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