Exchange Transfusion
Procedure in the Event of an Adverse Outcome or Reaction

 

 Reviewed by K. Brokenshire & Pita Birch
December 2009
Clinical Guidelines Back Newborn Services Home Page

Procedure in Case of Adverse Reaction and/or Negative Outcome

Steps Action
1
  • At first sign of any adverse reaction - STOP the blood being infused.
2
  • Initiate resuscitative measures as indicated:
    • CPR
    • Intubation & ventilation
    • IV medication
3
  • The IV cannulae/catheter may be re-used once flushed with 0.9% NaCl.
4
  • All blood and infusion lines used in the Exchange Transfusion must be returned to the Blood Bank for investigation.
5
  • Document adverse reaction using the on-line reporting system. Document the file number in the medical notes.
6
  • In the case of infant’s death resulting from an Exchange Transfusion:
    • Inform the Duty Manager and Clinical Director of Newborn unit.
    • Photograph the transfusion set up and bedspace, in as much detail as possible
    • The Consultant/Registrar contacts the Police and Coroner.  The Consultant/Registrar must ask the Coroner’s permission before any lines can be removed.
    • If lines and blood pack are removed they must be sent to Blood Bank for proper analysis.
    • Blood Bank must hold all blood samples, the units of blood and lines until the Police or Coroner state otherwise.  (Notify Blood Bank to ensure this happens)
    • All clinical records for the baby are photocopied prior to being sent to the Coroner.
NB
  • Do not dispose of anything used in the Exchange Transfusion.  It will be required by the Police and the Coroner.