4.11: Monitoring the transfusion episode
Transfusion observations should be recorded on a dedicated transfusion record or electronic device that can generate a report for filing in the clinical record. Minimum monitoring of each unit transfused should include:
- Regular visual observation of the patient during the transfusion and encouragement to report new symptoms.
- Baseline pulse rate, blood pressure (BP), temperature and respiratory rate (RR) must be recorded no more than 60 minutes pre-transfusion.
- Pulse, BP and temperature should be checked around 15 minutes after the start of transfusion (many serious reactions, such as ABO incompatibility or bacterial transmission present early in the transfusion episode). If any of these observations have changed, check RR as well.
- If the patient reports new symptoms, repeat the baseline observations and take appropriate action (see Chapter 5).
- Check pulse, BP and temperature not more than 60 minutes after the end of the transfusion (and as a baseline before any further units are transfused).
- Inpatients should be observed for late reactions over the next 24 hours and day-care patients advised to report symptoms developing after discharge (preferably with issue of a ‘Contact Card’ giving access to immediate clinical advice).