Acute Transfusion Reaction Recognition & Management — free guideline decision tool

This tool gives targeted management for acute transfusion reactions by type, anchored on the universal first steps of stopping, verifying, sampling, and reporting.

All → stop transfusion, keep IV access, verify identity/bag, monitor, report, retain samples. AHTR → fluids/protect kidneys/DIC support. Anaphylaxis → epinephrine. TRALI → respiratory support. TACO → diuresis/slow. Sepsis → cultures + broad-spectrum antibiotics.

Use to identify the reaction type and apply both the universal first steps and the type-specific treatment, while distinguishing overlapping severe presentations.

TACO responds to diuretics while TRALI does not, and that response is a key bedside discriminator between the two. (original synthesis · not guideline verbatim) Stopping the transfusion and keeping IV access open precede all type-specific treatment. Severe reactions overlap in fever, hypotension, and dyspnea, so a differential workup is sent.

For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.

Inputs: Reaction type Acute hemolysis (ABO incompatibility) → Result: Reaction type Acute hemolytic reaction（Universal first steps: Stop the transfusion immediately, keep IV access open (normal saline); verify patient identity and blood-bag details; monitor vital signs (ABCDE); notify the transfusion service/blood bank and the attending physician; retain the blood sample and remaining blood bag for testing, Targeted management: Stop the transfusion immediately, normal saline to maintain perfusion and urine output; anticipate hypotension, AKI, DIC and support (vasopressors, monitor renal function and electrolytes, transfuse plasma/cryoprecipitate/platelets for DIC bleeding); send blood sample + blood bag to the blood bank for re-verification (direct antiglobulin test DAT, recross-match), Differential/tests: Severe reactions often overlap (fever, hypotension, dyspnea); as needed check CBC, chemistry, coagulation, hemolysis panel, DAT, urinalysis, chest X-ray, cultures to distinguish hemolysis/TRALI/TACO/sepsis） Inputs: Reaction type Suspected bacterial contamination / sepsis → Result: Reaction type Suspected bacterial contamination / sepsis（Universal first steps: Stop the transfusion immediately, keep IV access open (normal saline); verify patient identity and blood-bag details; monitor vital signs (ABCDE); notify the transfusion service/blood bank and the attending physician; retain the blood sample and remaining blood bag for testing, Targeted management: High fever/chills/shock: stop immediately, blood cultures and blood-bag culture, empiric broad-spectrum antibiotics (anti-pseudomonal coverage for RBC products), aggressive fluid resuscitation and vasopressor support; report to the blood bank to recall co-sourced products, Differential/tests: Severe reactions often overlap (fever, hypotension, dyspnea); as needed check CBC, chemistry, coagulation, hemolysis panel, DAT, urinalysis, chest X-ray, cultures to distinguish hemolysis/TRALI/TACO/sepsis）