Albumin Reaction

Nurses General Nursing

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Hi!

I had my second day of clinical where the pt. with CHF was being given Albumin followed by Lasix. Shortly after starting the drip she began itching, welts appeared on her back, sides, and breasts. She also turned red all over her body except for her legs.

Is this a common reaction?

My question is: Is Albumin considered a blood product at your hospital? It is not at my facility. This is why I was able to administer it since SN's are not allowed to administer blood products per policy.

:confused:

Specializes in LTC/Rehab,Med/Surg, OB/GYN, Ortho, Neuro.

I'm a little confused. She developed the reaction shortly after the drip was started. So that means she hadn't received the lasix yet, right???

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I'm a little confused. She developed the reaction shortly after the drip was started. So that means she hadn't received the lasix yet, right???

When the albumin drip was almost finished we began a bed bath and noticed what looked like mosquito bites on her back, sides and breasts. We called in the CN, the pts. primary nurse, and our clinical instructor to look at it. They were not too alarmed, but paged the DO. We continued the bed bath and put on her new gown. After the drip was completed we pushed the lasix. She was still sitting on the edge of the bed with her back exposed. I gave her a back rub with her own lotion (the lotion was ruled out) and then she became severely itchy, and red everywhere except her legs and complained of her "throat feeling tight". Her SOB worsened.

The DO then came in and thought it was from the albumin. She never mentioned the lasix being an issue. Pt. does have a known sulfa allergy.

Could she have possibly had a reaction to both the albumin and lasix?

Pt. was given benadryl for the reaction. The albumin was d/c.

Pt. is scheduled for IV push lasix at 0730 tomorrow.

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You seem to have great learning experiences in your clinicals. Good luck!

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I've never seen an allergic reaction to albumin before.

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Specializes in Medical.

Goonette, do think about joining the fabulousness of Medscape - it's free, packed with fabulous information (including dozens of free weekly subscriptions of masses of specialties), and has free CME units; you can only check your education record, as far as I can tell, by doing another CEU.

In Australia blood products are federally regulated, so albumin counts everywhere here, but artificial chrystalloids like Gelofusine don't. I haven't seen a reaction to either, but we monitor patients getting albumin (or immunoglobulin, or factor VIII) as closely as packed red cells.

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Specializes in Pediatric/Adolescent, Med-Surg.
I've never seen an allergic reaction to albumin before.

Me neither. I was thinking an Albumin reaction would have to be rare.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

i personally have only seen/used human albumin, but i am aware that bovine plasma exists. untoward allergic reactions to albumin are extremely rare, although nausea, fever, chills or urticaria may occasionally occur. such symptoms usually disappear when the infusion is slowed or stopped for a short period of time.

http://www.talecris-pi.info/inserts/plasbumin5la.pdf

the major beef allergens are bovine serum albumin (bsa) and bovine igg. sometimes, milk might have these allergens too, making the individual not only allergic to beef but also with cow's milk too. in rare cases, other meats such as pork, goat meat, and lamb meat can contain bovine serum albumin and bovine igg.

the symptoms of beef allergy are quite similar to the other food allergy symptoms. for milder symptoms, medications such as antihistamine and other anti-allergic medicines will do but for severe symptoms, it is imperative to seek medical aid. the symptoms can vary for each individual but may include one or more of the following:

digestive symptoms:

  • abdominal pain
  • indigestion
  • nausea and vomiting
  • diarrhea

respiratory symptoms:

  • runny nose
  • stuffiness of the nose
  • sneezing
  • watery eyes
  • coughing
  • asthma (wheezing)

cutaneous symptoms:

  • swelling and itchiness of the skin
  • lip, tongue and throat swelling
  • hives

http://www.phadia.com/alergenos/immunocap-allergens/epidermals-and-animal-proteins/allergen-components/nbos-d-6-bsa-cow/

:up:;)

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This was human albumin. I guess I should have stated that.

Thanks for all the replies! I learned a lot yesterday during this clinical. Thanks again!

:)

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Specializes in maternal child, public/community health.

Thanks. Great information.

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Just finished reading this article. Thanks for the suggestion!

I am also a member of medscape now which looks like it's going to be a good resource. Thanks again!

:D

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