Not infrequently we identify patients who need to have some sort of blood product transfused in the ER. Most of these patients are not crashing, and have time to have a formal conversation about risks, benefits, and alternatives to transfusion. Of course you know all of the risks associated with transfusion (you do know them, right?). But do you feel confident in your ability to tell patients exactly how (un)common they are if asked? What complications are most likely? Here are some hard numbers sourced from Roberts & Hedges:
- Major allergic reaction 1/100
- Anaphylaxis 1/20,000 – 1/50,000
- Anaphylactic Shock 1/500,000
- Minor hemolytic reaction 1/6,000
- Fatal hemolytic reaction 1/100,000 of allergic reactions from blood products
- Death from sepsis (RBCs) 1/5,000,000
- Death from sepsis (platelets) 1/500,000
- Platelets are stored at room temperature
- Hepatitis C < 1/1,000,000
- Hepatitis B 1/140,000
- HIV 1/2,000,000
- Acute Lung Injury 1/500,000
In my experience, the thing patients are worried most about is infection. Being able to quote hard numbers is a great way to both reassure your patients as well as inspire a lot of confidence that you really know what you’re talking about.
