Principle:

The physician on-call for the blood bank requires a certain minimum amount of data to determine the significance of a suspected transfusion reaction and to decide if further testing is required.

Policy:

1. DO NOT call the transfusion physician about a transfusion reaction until the following data is ready:
   1. Patient name and hospital number
   2. Patient age and diagnosis and location
   3. Previous transfusion history including antibodies and previous transfusion reactions
   4. Vital signs (BP, temperature, pulse, and respiratory rate) before AND after the transfusion
   5. Clinical symptoms (e.g. fever, chills, rash, urticaria, dyspnea, hematuria, etc.)
   6. Repeat ABO and D type on the post-transfusion specimen
   7. Direct antiglobulin/Coombs test (DAT) on the post-transfusion specimen
   8. DAT on the pretransfusion specimen if the post-transfusion specimen is DAT-positive
   9. Results of hemolysis check on pre- and post-transfusion plasma/serum
2. The transfusion physician may order additional testing based on the above results.