CAP Pro Course - Blood Bank - Transfusion Reactions (2026 & 2027)

Author: Suzanne H. Butch, MA, MLS(ASCP)CMSBB, DLM
Reviewer: Patrick Tracy, MA, MLS(ASCP) and Laurie Bjerklie, MA, MLS(ASCP)CM

Continuing Education Credits

Objectives

  • Define immediate and delayed transfusion reactions and use clinical symptoms to further classify reactions.
  • Determine the actions to be taken when a transfusion reaction is suspected.
  • Identify events that must be reported to regulatory and accrediting agencies and voluntary biovigilance reporting.
  • Describe actions that may prevent transfusion reactions.

Course Outline

  • Define immediate and delayed transfusion reactions and use clinical symptoms to further classify reactions.
      • Classification of Reactions
      • Immediate versus Delayed Transfusion Reactions
      • Typical Symptoms Associated with Immediate Transfusion Reactions
      • Reactions by Blood Component
      • Common Causes of Transfusion Reactions
      • Acute Hemolytic Reactions
      • Delayed Immune Hemolysis
      • Use of Low-titer Group O and ABO Incompatible Plasma-containing Products in Trauma
      • Non-hemolytic Febrile Transfusion Reactions
      • Transfusion-associated Circulatory Overload (TACO)
      • Transfusion-related Acute Lung Injury (TRALI)
      • Allergic Reactions
      • Sepsis Due to Contaminated Unit
      • Acute Pain and Hypotensive Reactions
      • Dyspnea
      • Delayed Reactions
      • Typical Symptoms Associated with Delayed Transfusion Reactions
      • A 68-year-old patient with heart disease is experiencing difficulty breathing and hypertension at the end of a transfusion of a unit of Red Blood Cell...
      • A nurse calls the transfusion service and reports that the patient's temperature has risen from 36.5°C to 38.0°C during the transfusion of P...
      • Four weeks post transfusion, a patient exhibits a fever, skin rash, increased liver enzymes, and gastrointestinal tract symptoms, including diarrhea a...
  • Determine the actions to be taken when a transfusion reaction is suspected.
      • Immediate Actions When a Transfusion Reaction is Suspected
      • Laboratory Testing Protocols
      • Routine Testing Required to Rule Out Hemolytic Reactions
      • Additional Testing
      • Non-Infectious Disease Delayed Transfusion Reaction Investigations
      • Transfusion-transmitted Infection Investigations
      • Frequency of Transfusion-transmitted Infections
      • Final Report to the Patient's Medical Record
      • A physician reported that a patient transfused two weeks ago has nausea, vomiting, diarrhea, fever, and low platelets. Transfusion-associated graft-vs...
      • The patient has a fever of 2°C above the baseline temperature. Which of the following would most likely be ordered by the transfusion service med...
  • Identify events that must be reported to regulatory and accrediting agencies and voluntary biovigilance reporting.
      • Reporting to Regulatory and Accrediting Agencies
      • National Healthcare Safety Network Biovigilance Component
      • A patient has a transfusion reaction classified as transfusion-associated circulatory overload (TACO). The patient was treated with diuretics and is d...
      • Which of the following events must be reported by the Transfusion Service as a biological product deviation?
  • Describe actions that may prevent transfusion reactions.
      • Specimen Collection and Labeling
      • Reducing the Risk of Specimen Misidentification
      • Blood Component Processing: Reducing the Risk of a Reaction
      • Laboratory Testing and Component Selection
      • Procedures for Issuing Blood
      • Emergency Issue of Blood Components
      • Transfusion Procedures
      • Observing the Patient for a Reaction
      • Making Transfusions Safer
      • A blood sample has been delivered to the transfusion service accompanied by a requisition signed by the physician ordering blood for possible transfus...
      • A nurse has called the blood bank to say that red cells are needed in a life-threatening situation. Compatibility testing has not been completed. The ...
  • References
      • References

Additional Information

Level of Instruction:  Intermediate
Intended Audience:  This program is designed as an educational and training tool for medical laboratory scientists and medical laboratory technician personnel, medical laboratory science students and interns, pathology residents, and practicing pathologists. 
Author Information: Suzanne H. Butch, MA, MLS(ASCP)CMSBB, DLM, is currently working on special projects for the Department of Pathology at Michigan Medicine in Ann Arbor, Michigan. She formerly worked in Quality Assurance in the Department of Pathology and as the Administrative Manager for Healthcare, Blood Bank & Transfusion Service at the University of Michigan Hospitals and Health Centers in Ann Arbor, Michigan. She holds a bachelor's degree in Medical Technology from the University of Michigan, a master's degree in Management and Supervision from Central Michigan University, and Certifications as a Specialist in Blood Bank, as a Quality Audit, and as a Diplomate in Laboratory Medicine. 
The author has no conflict of interest to disclose. 
Reviewer Information:
Patrick Tracy, MA, MLS(ASCP), has been an MLT program director since 2012. His teaching experience has been in student labs, both face-to-face and online. His contribution to medical-laboratory education is most pronounced by his microbiology, blood bank, and chemistry YouTube channel.
Laurie Bjerklie, MA, MLS(ASCP)CM, is a Lead Education Developer. She earned a B.S. in Medical Laboratory Science from the University of North Dakota and an M.A. in Curriculum and Instruction from Saint Xavier University. She has over 15 years of experience in higher education and has held program director and faculty positions in both MLT and MLS programs.

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