A child with Thalassemia major has a history of treatment for cardiac arrhythmia due to iron overload. Now the child came for regular transfusion and while transfusion the child became anxious and developed complaints of backpain. What is the next management?
b. Stop transfusion and look for clerical errors style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif">(Ref: )Transfusion reactions:Category 1: Mild reactionsSignsSymptomsPossible causeImmediate managementUrticaria/rashPruritis (itching)Allergic* Stop transfusion* Assess patient* An antihistamine may be required* Transfusion may be restarted if no other signs/symptoms are present* If signs/symptoms worsen treat as Category 2. Category 2: Moderately severe reactionsSignsSymptomsPossible causeImmediate managementFlushingUrticariaRigorsFeverRestlessnessTachycardiaAnxietyPruritisPalpitationsMild dyspneaHeadacheAllergic (moderately-severe)Febrile non-hemolytic transfusion reaction:-antibodies to white cells or platelets* Antibodies to proteins including IgA* Possible contamination with pyrogens and /or bacteria* Stop transfusion and maintain IV line with NSaline* Contact Medical Officer* Patient may require antihistamine and/or paracetamol* Further investigation and management according to clinical features* If investigation required: complete Transfusion Reaction Form and send blood pack, form and samples to blood bank Category 3: Life-threatening reactionsSignsSymptoms Possible cause Immediate managementRigorsFeverRestlessnessHypotensionTachycardiaDark UrineUnexplained bleeding (DIC)AnxietyChest painPain at infusion siteRespiratory distressLoin/back painHeadacheDyspneaAcute intravascular hemolysis (wrong blood)Bacterial contamination and septic shockFluid overloadAnaphylaxisTransfusion related acute lung injury (TRALI)* Stop transfusion and maintain IV line with N.Saline* Contact Medical Officer* Manage immediate needs:- Fluid for hypotension- Oxygen- Adrenaline for anaphylaxis- Diuretic for fluid overload* Complete Transfusion Reaction Form and send blood pack, form and samples to blood bank* Further management according to likely cause
ECG
Stop transfusion and look for clerical errors
Continue transfusion while monitoring for vitals
Check for reddish discolouration of urine
C.V.S.