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Transfusion reactions: recognise them and speak up

Transfusion is a safe procedure, but reactions are possible, from mild itching to rare serious events. Staff watch closely, especially in the first minutes, and your words are the fastest signal.

Last updated: ~1 min read
A doctor talking with a patient sitting in a hospital bed
Figure 1.If something feels wrong, say so at once

01Short answer

If you feel unwell during a transfusion, press the call bell or speak up at once: chills, shivering, a temperature, itching, a rash, swelling of the face or lips, breathlessness, wheezing, chest or back pain, dizziness or a sense that something is wrong. Staff will stop the transfusion, check you and give the care you need. Afterwards, ask your team what kind of reaction it was and remember it; there may be precautions for future transfusions. For delayed signs at home, see “After a transfusion: what to watch for”.

02Simple explanation

Feel unwell: speak up at once.

Staff stop it.

Remember the reaction.

Next time: tell them.

03Scientific explanation

MedlinePlus: signs of a transfusion reaction include fever, chills, back pain, breathlessness and dark urine; if one is suspected, the transfusion is stopped at once.

NCI: chemotherapy can lower neutrophils, platelets and red cells, which raises the risk of infection, bleeding and fatigue.

04What happens in the body?

Types

Allergic, febrile, haemolytic and fluid overload.

Checks

The bag and a blood sample are checked again.

Neutrophils

The first defence against infection; when they are low, hygiene matters most.

Platelets

Help blood clot; when they are low, protect yourself from injury.

05Daily protection: four steps

Wash, protect, check, report.

Wash — Hands and personal hygiene.1WashHands and personal hygiene.
Protect — Against injury and infection.2ProtectAgainst injury and infection.
Check — Temperature and skin.3CheckTemperature and skin.
Report — Tell your team about changes.4ReportTell your team about changes.
HygieneClean hands.
TemperatureThe 38 °C threshold.
ProtectionYour team's rules.

06Key points at a glance

TopicIn brief
TypesAllergic, febrile, haemolytic and fluid overload.
ChecksThe bag and a blood sample are checked again.
NeutrophilsThe first defence against infection; when they are low, hygiene matters most.
PlateletsHelp blood clot; when they are low, protect yourself from injury.

07Key terms

Febrile reaction
A temperature during a transfusion.
Anaphylaxis
A severe allergic reaction.
ANC
Absolute neutrophil count.
Thrombocytopenia
A low platelet count.

08Key points

  • Notice.
  • Speak up.
  • Remember.
  • Wash your hands.
  • 38 °C: call.

09Frequently asked questions

I had one reaction; will it happen again?

Not necessarily; your team can plan precautions.

I do not want to bother anyone.

That is exactly why staff are there; tell them.

What should I watch every day?

Temperature, bleeding, tiredness and the catheter site; tell your team about any change.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. I had one reaction; will it happen again?

  2. I do not want to bother anyone.

  3. What should I watch every day?

My questions

12Sources

  1. MedlinePlus. Blood transfusions
  2. MedlinePlus. Hemolytic transfusion reaction
  3. National Cancer Institute. Infection and Neutropenia during Cancer Treatment
  4. National Cancer Institute. Bleeding and Bruising (Thrombocytopenia) and Cancer Treatment
  5. National Cancer Institute. Anemia and Cancer Treatment
  6. World Health Organization. World Hand Hygiene Day
  7. Centers for Disease Control and Prevention (CDC). People at Increased Risk for Illness from Animals
  8. Centers for Disease Control and Prevention (CDC). Aspergillosis Basics
  9. Journal of Clinical Oncology (ASCO and IDSA), 2018. Antimicrobial Prophylaxis for Adult Patients With Cancer-Related Immunosuppression: ASCO and IDSA Clinical Practice Guideline Update
  10. Biology of Blood and Marrow Transplantation, 2009. Guidelines for preventing infectious complications among hematopoietic cell transplantation recipients: a global perspective
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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