Thread by @nihardesai7

Hey #medicine residents !!

PLEASE TRANSFUSE BLOOD PRODUCTS JUDICIOUSLY 🙏🏻

Not every patient with anemia needs blood and not is blood transfusion free of complications.

I'll list out a few TRANSFUSION REACTIONS in case you'll have forgotten about them 👇🏻

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1/10

Let's start w/ TACO🌮

This isn't the good Mexican 🌮 we love🤣

This is pulmonary oedema resulting from overzealous transfusion🤷‍♂️

Risk factors: patients who can't handle fluids we'll, i.e. patients w/ kidney,heart disease etc

Totally avoidable complication🙏🏻

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2/10

A close differential of TACO is TRALI. The symptoms are the same but this is non-cardiogenic pulmonary oedema.

So BNP will be normal here, neck veins won't be dilated

TACO needs diuretics and some restraint on your part🤣

TRALI=supportive care

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3/10

These are bad, but the worst is acute hemolytic transfusion reactions 😭😭

Can be fatal if not recognised & managed immediately😳

Clinically: fever, dyspnoea, flank pain, red urine

All because of intravascular hemolysis & most often due to mismatched group transfusion😭

4/10

It's less evil twin is DELAYED HEMOLYTIC TRANSFUSION REACTION

This is d/t alloimmunization & is more often seen in heavily transfused pts.

Occurs a week or so after transfusion, is IgG mediated (rarely complement) so p/w features of EXTRAVASCULAR HEMOLYSIS !

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5/10

There's another common reaction we see very frequently😭

FEBRILE NON-HEMOLYTIC TRANSFUSION REACTION (FNHTR)

This is d/t anti-leucocyte antibodies and is minimised if leucodepleted blood products are used.

P/w fever but no signs of hemolysis🙏🏻

Needs some supportive care.

6/10

This is obviously over and above the numerous INFECTIOUS COMPLICATIONS one can encounter !!

Hep B
Hep C
HIV
HTLV
CMV
Parvo
And rarely bacterial sepsis 😭😭😭

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7/10

Also, every unindicated transfusion takes up valuable nursing time.

Blood banks work hard to give you the product, help them out by saying NO to inadvertent transfusions 🙏🏻

Your reaction to unindicated transfusion must be 👇🏻

8/10

I don't think I need to remind you how blood banks obtain blood 🤷‍♂️

It's not from Pharma but from donors like you and me. It's a precious resource, DON'T WASTE IT.

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9/10

Thanks for reading this far 🫡🫡

I hope you'll stop and question yourself before you recommend the next transfusion 🙏🏻

#MedTwitter

End.