A blood transfusion is a special kind of transplantation, with the transfer of living tissue from one person to another. Reactions can occur with as little as 10 to 15 ml of incompatible blood. The onset of a reaction may be misleading or delayed, and its detection requires astute assessment. Responsibility for recognition of a transfusion reaction lies with the transfusionist, who is often a nurse. The following types of response can occur: hemolytic reactions, transfusion-induced graft-versus-host disease, hemoglobinuria, purpura, fever, circulatory overload, thrombophlebitis, urticaria, hyperkalemia, asymptomatic hemoglobinuria, pulmonary edema, and allergic and anaphylactic reactions. Critical care nurses need to be aware of the dangers of blood and blood product transfusions and to be prepared to react quickly.
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