| Assessment | ||
| Pediatric Pearls: | Signs & Symptoms: | Differential: |
| □ Hypotension: (SBP < 70+ 2x Age in years) | □ Hives □ Respiratory distress □ Airway swelling □ Increased temperature | □ Respiratory failure □ Hypovolemia □ Trauma □ Tension pneumothorax |
Clinical Management Options
| EMT-B |
| • BLS airway management • Keep patient supine and warm • Administer Oxygen via NRB |
| Paramedic |
| • Stop the transfusion, flush the line. • Keep the blood with the patient for testing • Consider Tylenol if the patient is alert and protecting their airway • Give Benadryl IV for skin changes/hives • Consider IM epinephrine for anaphylaxis in patients who have airway changes, changes in mental status with skin changes (hives) • ETCO2 assessment • Advance airway management as needed |
Contact Medical Control as needed
Pearls
- Transfusion reaction is much lower when transfusing in hemorrhagic shock, although not impossible. Early recognition and treatment is critical.
- Classic symptoms of hemolytic transfusion reaction are fever, flank pain, and red/brown urine. Other symptoms include chills, hypotension, back pain, renal failure.
- TRALI-Transfusion related acute lung injury is an acute reaction to a blood transfusion where patients rapidly develop non-cardiogenic pulmonary edema. Often associated with fevers/chills.
- If a transfusion reaction is suspected, the primary treatment is to stop the blood transfusion. Continue transport and make sure the receiving team is aware.
CHEMS Field Treatment Guidelines 