How do you manage TRALI?
Treatment / Management Immediate management of TRALI is to stop the transfusion and notify the blood bank to screen the donor unit for antileukocyte antibodies, anti-HLA or anti-neutrophil-specific antibodies.  Supportive measures must be taken to improve oxygenation.
What are the nursing interventions for a blood transfusion reaction?
If you suspect a transfusion reaction, take these immediate actions:
- Stop the transfusion.
- Keep the I.V. line open with normal saline solution.
- Notify the physician and blood bank.
- Intervene for signs and symptoms as appropriate.
- Monitor the patients vital signs.
How do you reduce risk for TRALI?
There have been several other suggestions for preventing TRALI, which include:
- Screening of all donors for anti-neutrophil or anti-HLA antibodies.
- Use of pre-storage leukoreduced blood.
- Appropriate utilization of blood products.
Do you use diuretics in TRALI?
Diuretics play no role in TRALI as the underlying pathology involves microvascular injury, rather than fluid overload. Be alert that any respiratory distress occurring during or following blood or blood component(s) transfusion could potentially be TRALI. Discontinue the transfusion immediately.
Which of the following strategies may assist in preventing a transfusion reaction for your patient?
The most common approach to preventing FNHTR and allergic reactions is to give the patient premedication with an antipyretic such as paracetamol and an anti-histamine such as diphenydramine. There is very widespread use of these drugs prior to a transfusion.
How is hemolytic transfusion reaction treated?
Acute hemolytic reactions (antibody mediated) are managed as follows:
- Immediately discontinue the transfusion while maintaining venous access for emergency management.
- Anticipate hypotension, renal failure, and DIC.
What nursing actions are needed prior to administering the blood?
Before the Transfusion
- Find current type and crossmatch. Take a blood sample, which will last up to 72 hours.
- Obtain informed consent and health history. Discuss the procedure with your patient.
- Obtain large bore IV access.
- Assemble supplies.
- Obtain baseline vital signs.
- Obtain blood from blood bank.
What is TRALI transfusion reaction?
TRALI is an acute complication following blood transfusion that is characterized by severe shortness of breath, often associated with fever and low blood pressure. Although rare, it is one of the most common causes of transfusion- related death.
How do you confirm TRALI?
To diagnose TRALI, physical exam, chest x-ray, and arterial blood gas studies are recommended. In distinguishing TRALI from TACO, an echocardiogram may be useful in determining whether the observed pulmonary edema is of cardiogenic origin.