Blood Transfusion Question

[justme1972]

I have a few questions and I am looking for a specific source I am having trouble finding.

1. During preparations for a blood transfusion, is giving Tylenol and Benedryl considered protocol and a standard of practice or is this a per facility or per patient call?

2. If you had an anemic patient that had frequent blood transfusions and had a history of anaphylactic reactions....would pre-medication with Benedryl help with another one or is your best bet to infuse slowly and have epi, etc ready?

I'm trying to argue a test question. None of our textbooks mention Tylenol and Benedryl for pre-meds, but I do know that some facilities do this, but wondering if the "NCLEX" hospital does.

Our question had to do with a pt that had a hx of anaphylactic reactions and our options of something to do were to give Tylenol, Benedryl or to infuse slowly...the only reason I said to infuse slowly is my rationale was that Benedryl wouldn't do jack for a anaphylactic reaction...that if you had a pt with this hx you would need to infuse slowly, watch very carefully and have life-support measures on hand in case there was a major reaction....which should be on hand for all transfusions anyway, correct?

[Daytonite, BSN, RN]

i would think these questions are addressed on the national guidelines clearinghouse (for guidelines on procedures, etc.).

do a search for blood transfusions on this web site:

• http://www.guideline.gov/browse/browsetreatment.aspx

i posted weblinks to blood transfusion information on this sticky:

• https://allnurses.com/forums/1458776-post6.html

from my experience in practice, giving tylenol and benadryl is not a facility protocol. it was sometimes ordered by physicians based on individual patient history or the doctor's experience. there is a difference between anaphylactic reaction and incompatibility reactions. when blood typing and matching is done for transfusion, the patient's blood is only matched for several major factor compatibilities (i.e., abo). they, however, are not matched for other minor antigens which are the cause for the minor rise in fever or other symptoms they might get. that is not necessarily considered an anaphylactic reaction, nor life threatening. understand the pathophysiology of the process at work and the answer will be clearer.

[justme1972]

there is a difference between anaphylactic reaction and incompatibility reactions. when blood typing and matching is done for transfusion, the patient's blood is only matched for several major factor compatibilities (i.e., abo). .

see, this was exactly my thinking as well when i answered the question and when i went back and checked my textbooks, they didn't say anything about benadryl being given beforehand....just to be sure to always have epi and other life saving equipment b/c you never know what will happen.

thanks for the sources...you always give the best ones!