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Approximately 41,000 blood transfusions are needed daily in the United States. While transfusions are largely safe and save countless lives, here are five pearls you should know.

1. The most common adverse reaction to transfusion is a fever and is treated with supportive care such as acetaminophen.

2. A minor allergic reaction limited to uticaria/hives can be treated with antihistamines and if symptoms resolve, the transfusion CAN be safely resumed (Tintinalli 6th ed).

3. Even though it is rare, Transfusion-Associated Acute Lung Injury (TRALI) is actually the most common cause of death from blood transfusions.

4. In massive transfusion or patients receiving chronic transfusions, hypocalcemia is often seem because of citrate in the blood products. While hypocalcemia often causes an abnormally long QT interval, using ECG findings to assess the significance of a patient’s hypocalcemia is not reliable.

5. Transfusion-Associated Circulatory Overload is most likely to effect geriatric patients (lower volume status).



Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. Emrey M: Blood and Blood Components, in Marx JA, Hockberger RS, Walls RM, et al (eds): . St. Louis, Mosby, Inc., 2010, (Ch) 5:p 45-

Tintinnalli, 7th edition, Chapter 233, “Transfusion Therapy.”

Episode 4 – Transfusions and Ingested Foreign Bodies