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The various types of Transfusion Reactions can be remembered by the transfusion-IV causing a wealth of reactions by mixing blood inappropriately. Acute hemolytic reactions, shown by the acute-angle with hemolysing RBCs, usually develop within the first 15 minutes. They result in chills, fever, lower back pain, flushing, tachycardia, tachypnea, hematuria, oliguria, decreased BP, and possibly acute renal failure. Febrile, non-hemolytic reactions, shown by the fever-beaver with the nun holding an RBC, is the most common type of reaction and classically appears with a sudden fever rising more than 1 degree and chills. Mild allergic, the mild allergy-alligator, is a minor reaction and only requires a temporary stop of the infusion, while an anaphylactic reaction, depicted as the anvil-axes, requires having epinephrine ready for injection and manifests quickly as anxiety, urticaria or hives, difficulty breathing often with wheezing, bronchospasm, hypotension, shock, and possible cardiac arrest. Circulatory overload, shown by the circulatory-system overloaded, occurs when a volume of blood is administered that is larger than the circulatory system can handle. Symptoms are similar to that of fluid volume excess. A sepsis reaction, shown by our sepsis-snake, occurs when bacteria contaminates the blood products. It results in a rapid onset of chills, high fever, warm skin, vomiting, diarrhea, and severe hypotension that may lead to shock. The trolley lungs represents transfusion-related acute lung injury (TRALI) which occurs when white blood cells release cytokines thereby causing increased capillary leakage. This results in an increase in the amount of fluid in the lungs causing noncardiogenic pulmonary edema. The last reaction listed is a massive blood transfusion, shown by the massive-amounts of transfusion-IVs. In patients receiving large volumes of blood via transfusion, electrolyte disturbances and citrate toxicity are of concern as it can lead to hypocalcemia and hyperkalemia.&nbsp; So to review, the 8 types of transfusion reactions include acute hemolytic, febrile, non-hemolytic, mild allergic, anaphylactic, circulatory overload, sepsis reaction, transfusion-related acute lung injury, and massive blood transfusion.

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Transfusion-IV Reaction

Transfusion Reactions

Blood groups and transfusions

Complications – Blood Transfusion

acute angle with hemolysing rbcs.png

Acute-angle with Hemolysing RBCs

Acute Hemolytic

Which transfusion reaction usually develops with in the first 15 minutes and may result in chills, fever, lower back pain, flushing, tachycardia, tachypnea, hematuria/oliguria, decreased BP, and possibly acute renal failure?

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Fever-beaver with Nun RBCs

Febrile, Non-Hemolytic

Which of the following is the most common type of transfusion reaction and a diagnosis of exclusion?

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Mild Allergy-alligator

Mild Allergic

Which type of transfusion reaction is also known as a urticarial transfusion reaction or UTR, and is minor and typically manifests as flushing, pruritus and urticaria?

anvil axes.png

Anvil-axes

Anaphylactic

Any reaction involving urticaria, hives, feeling of  anxiety and/or presence of hypotension and difficulty breathing is considered  _______________ when associated with blood product transfusions.

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Circulatory-system Overloaded

Circulatory Overload

This transfusion reaction occurs when a volume of blood is administered that is larger than the circulatory system can handle.

sepsis snake.png

Sepsis-snake

Sepsis Reaction

This transfusion reaction occurs when bacteria have contaminated the blood products.

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Trolley Lungs

Transfusion-Related Acute Lung Injury (TRALI)

This transfusion reaction may occur as white blood cells release cytokines which increases capillary leakage.

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Massive-amounts of Transfusion-IVs

Massive Blood Transfusion

Which of the following transfusion reactions deal with electrolyte disturbances and citrate toxicity and can lead to hypocalcemia and hyperkalemia?

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This diabolical transfusion-IV is mixing blood in all the wrong ways, causing the eight types of reactions. &nbsp;His first batch of blood was ABO incompatible with the recipient and turned him into a psycho with lower back pain. &nbsp;And he took out his pain on others by using an acute-angle to lyse poor little rbc's. &nbsp;Fever-beaver received his blood and started burning up, terrified that he would be the next victim. &nbsp;But then a gentle nun came to his rescue and reassured him that no one would lyse his little RBCs. &nbsp;He was just experiencing WBC sensitivity. &nbsp;The next batch of blood caused allergic reactions, as one itchy fellow jumped into the open arms of an alligator, fearing a more severe reaction. &nbsp;At least until it started pouring mild salsa on him. &nbsp;The reaction that had driven him into the gator arms was the falling anvil with axes. &nbsp;It had smashed one unlucky fellow, leaving only his hive covered limbs exposed. &nbsp;The transfusion IV then experimented with different flow rates and sent blood rushing into a man so fast that his circulatory system ballooned up, overloaded, and his neck veins bulged. &nbsp;Blood was then pumped into the ground, becoming dirty and infected, and a sepsis-snake exploded from its burrow. &nbsp;The last batch of blood went after the lungs driving a trolley, causing inflammation, edema, and capillary bleeding. &nbsp;The lungs lost control and crashed into the final victim. &nbsp;The impact sent him flying into a massive pile of transfusion IVs, and through this level of trauma, he needed his total blood volume to be replaced within 24 hours. &nbsp;And so the evil spree of reactions came to an end. &nbsp;For the time being.....

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