Premedication for blood transfusion

Nurses General Nursing

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I am a 2nd semester RN student. I've never had blood transfusion experience before. As I was working with my RN on blood transfution order from a doctor for a patient whose hemoglobin was 4.6, doctor ordered to premedicate the patient with Benedrryl 25mg and Tylenol 650 mg. Is it a standard procedure? What is it for?

Specializes in Education, FP, LNC, Forensics, ED, OB.
Are there other medications that might be used prior to blood transfusion?

I use the acetaminophen/benadryl in my practice as do the physicians with whom I am associated.

Some institutions utilize lekoreduced blood products and do not use the above premedication. Still a call by the attending physician/NP.

Some providers will use steroids prior to platelet transfusions as well.

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Specializes in Education, FP, LNC, Forensics, ED, OB.
how bout corticosteroids, as oppose to benadryl, have u used it before just as prophylaxis, if pt's presents with fever, without having previous transfusion reactions before or do u just stick with benadryl.

I generally utilize the acetaminophen/benadryl premedication, hrtprncss. :balloons:

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Specializes in Education, FP, LNC, Forensics, ED, OB.
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Thank you, hrtprncss. I appreciate those kind words. I love to teach! :balloons:

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Specializes in Oncology/Haemetology/HIV.
We often do that for patient's who have recieved blood in the past. Having had past transfusions can sometimes make you more susceptible to having an allergic reaction.

Premedication is quite common on oncology units where the patients receive or will receive many transfusions. Sometimes hydrocortisone or solumedrol is also used. And ocasionally a patient may have a "cold" antigen that requires a blood warmer be used.

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Specializes in Med-Surg, Geriatric, Behavioral Health.

Thread moved here from Intro and Greeting forum.

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Hey Y'all

Just wanted to chime in. I've imagined that there are two kinds of antibody-antigen reactions possible when we give blood. The first is of course if the Pt's own immune response is stimulated by the 'foreign' blood cells. This is the BIG reaction that we are all taught to worry about and detect early.

The second is a reaction by the 'foreign blood' against the 'native' blood in which it suddenly finds itself. Since the transfusion is a small--relatively small--portion of the total blood volume, and because the transfused blood cannot command the entire immune response that the 'native' blood could, this is smaller. But still we'd avoid this reaction if we could. Therefore RBCs are irradiated and given thru a leukocyct-removing filter--and the pt is premedicated.

All these precautions don't mean that the possibility of a hemolytic reaction is reduced. Blood is much more accurately matched now-a-days but still, **** happens.

I donate blood every couple of months and have learned a couple of interesting things. One of my daily meds is a baby aspirin. Even that lil' ol' 81mg tablet taken within 24hrs keeps my platelets from being used. And also, the pathogens I've been exposed to over the years gives my blood a rich soup of immune globulins--I'm a highly sought-after blood donor. (At least SOMEBODY loves me .)

Anyhow, with Blood transfusions, we have to remember we're giving a sort of "living" thing--very very different from a bag of LactRingers.

Papaw John

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Specializes in Education, FP, LNC, Forensics, ED, OB.
Hey Y'all

Just wanted to chime in. I've imagined that there are two kinds of antibody-antigen reactions possible when we give blood. The first is of course if the Pt's own immune response is stimulated by the 'foreign' blood cells. This is the BIG reaction that we are all taught to worry about and detect early.

The second is a reaction by the 'foreign blood' against the 'native' blood in which it suddenly finds itself. Since the transfusion is a small--relatively small--portion of the total blood volume, and because the transfused blood cannot command the entire immune response that the 'native' blood could, this is smaller. But still we'd avoid this reaction if we could. Therefore RBCs are irradiated and given thru a leukocyct-removing filter--and the pt is premedicated.

All these precautions don't mean that the possibility of a hemolytic reaction is reduced. Blood is much more accurately matched now-a-days but still, **** happens.

I donate blood every couple of months and have learned a couple of interesting things. One of my daily meds is a baby aspirin. Even that lil' ol' 81mg tablet taken within 24hrs keeps my platelets from being used. And also, the pathogens I've been exposed to over the years gives my blood a rich soup of immune globulins--I'm a highly sought-after blood donor. (At least SOMEBODY loves me .)

Anyhow, with Blood transfusions, we have to remember we're giving a sort of "living" thing--very very different from a bag of LactRingers.

Papaw John

Some good points here.

Remember that the acetaminophen and benadryl are given to try and thwart a febrile reaction...... Not a hemolytic one. :balloons:

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