Transfusion Reaction Identification and Management at the Bedside

Common RBC antigens in O type Tunisian blood donors and their importance in alloimmunization

BACKGROUND

The presence of some red blood cell (RBC) antigens may affect the preference for using type O blood in emergency situations because they may induce complex or multiple alloimmunization in special circumstances.

METHODS

A subgroup of 77 type O blood Tunisian donors were genotyped for 19 common blood alleles using the single specific primer-polymerase chain reaction method. The statistical analysis was done using HaploView software.

RESULTS

The study showed the dominance of the alleles RH*5, KEL*2, FY*2, and CO*1 and the absence of the homozygous state of the KEL*1 and CO*2 alleles. Furthermore, a complete linkage disequilibrium between the RH*2/RH*4 and RH*3/RH*5 loci and the FY*Null/FY*Exp and FY*A/FY*B loci was detected. Additionally, it seems that sensitization to MNS:3, FY:1, and RH:3 may constitute a potential factor for alloimmunization after transfusion with O blood type units: the probabilities of simple alloimmunizations are 24.5 per 100, 18.5 per 100, and 18 per 100, respectively. Multiple alloimmunization against RH:1;KEL:1 or RH:1;KEL:1;RH:3 phenotypes may occur, with probabilities of 7 per 1000 and 2 per 1000, respectively.

CONCLUSION

Some O-type RBC units may contain blood with very immunogenic phenotypes, the use of which in an emergency requires great caution because it can be a step towards subsequent alloimmunization.

Transfusion-Associated Adverse Events: A Case Report of Nurse Hemovigilance and Recognition of Respiratory Distress

Although blood transfusions are considered a potentially life-saving therapy, noninfectious and infectious adverse events can lead to significant morbidities and even mortality. Vital signs and visual observation of patients during blood transfusions are thoroughly taught in nursing school. Updated terms of hemovigilance and transfusion-associated adverse events ( TAAEs ) are presented through this case study. A patient with factor V deficiency, which requires chronic plasma transfusions, experienced 2 types of TAAEs, anaphylaxis and transfusion-associated circulatory overload. The patient's history and TAAEs are presented and discussed to provide evidence for the importance of vigilant bedside surveillance. Early identification of TAAEs may prevent unnecessary morbidity and/or mortality. The primary nursing functions and responsibilities are presented with algorithmic supplementation to facilitate better understanding of best practice. Ongoing assessment of hemovigilance practices is indicated to ascertain which monitoring tools can lead to optimal patient care.

A structured approach to analyse logistics risks in the blood transfusion process

Blood transfusion is a critical health care process due to the nature of the products handled and the complexity driven by the strong interdependence among the sub-processes involved. Most of the errors causing adverse events originate during the blood logistics activities. Several literature contributions apply risk management to the transfusion process but often in a fragmented and reactive way. Moreover, few of them focus on logistics risks and assess the effectiveness of risk responses through operational key performance indicators (KPIs). The present paper applies a comprehensive and structured approach to proactively identify and analyse logistics risks as well as define responses to improve blood bag traceability, focusing on hospital wards. The implementation of such actions is monitored by specific KPIs whose measurement enables an improved communication flow among actors allowing to uncover residual risks. Future research will extend the application to further blood transfusion settings and supply chain echelons. The outcomes of this work might assist practitioners in improving policy making about blood supply chains. As a matter of fact, they allow a better understanding of the associated material and informational flows and the related risks, which supports setting effective strategies to either prevent adverse events or mitigate their effects.

Convalescent Plasma Therapy for Management of COVID-19: Perspectives and Deployment in the Current Global Pandemic

The world is striving against the severe crisis of the COVID-19 pandemic. Healthcare professionals are struggling to treat their patients based on nonspecific therapies. Amidst this uncertainty, convalescent plasma therapy (CPT) has appeared to be an interim adjuvant therapy for severely ill patients of COVID-19 until long-term clinical trial treatment options are available. Considering the transfusion-related hazards, especially lung injuries and microbial transmission, where sensitivity is not ensured, rigorous trials should be conducted to determine this therapy's efficacy. Moreover, the ratio of recovered cases to plasma donors is not satisfying, which questioning this therapy's availability and accessibility. Although some countries are making the treatment free, the attributable cost mandates a justification for its suitability and sustainability. Our article aimed to review the published facts and findings of CPT's effectiveness in lowering the mortality rate of COVID-19. This pandemic showed that healthcare systems worldwide need core reform. A unified global collaboration must align and coordinate to face the current pandemic and enhance world readiness for future outbreaks based on health equity and equality.

Associated Factors With Acute Transfusion Reaction From Hospital Online Reporting Events: A Retrospective Cohort Study

In our hospital’s hemovigilance system, a Wi-Fi–based vital signs monitor that automatically transmits data to ensure patient safety has been implemented. We derived the potential clinical characteristics for subsequent association of acute transfusion reactions (ATRs) using the hospital information system database.

Rhabdomyosarcoma: an overview and nursing considerations

This article aims to provide nurses with a clinical overview of rhabdomyosarcoma, a rare type of soft tissue sarcoma. The causes, clinical features, pathophysiology, diagnostic process, prognosis and treatment will be explored. Some of the main nursing considerations for rhabdomyosarcoma patients will be discussed in light of current treatment recommendations.