Ordering Blood Components 

Administration Guidelines 

Transfusion Reactions 

Descriptions, Indications, and Therapeutic Effects 

Handling, Storage and Return 

Transfusion Safety 

Other Services
Revised: November 1999


Transfusion Reactions
Immediate Reactions
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Mild Allergic


A mild allergic reaction (urticarial) is one of the most common transfusion reactions occurring in approximately 1% to 5% of all transfusion recipients. The symptoms are mild and generally easy to treat.


Allergic symptoms during a transfusion are caused by recipient reactions to plasma proteins in the blood or component unit.

Signs and Symptoms

A mild allergic reaction can occur anytime during the transfusion to 1 hour post transfusion. Signs and symptoms of a mild allergic transfusion reaction are limited to:

  • hives and pruritus

Nursing Responsibilities

  1. Stop the transfusion. Closely monitor the patient’s vital signs and symptoms.
  2. Hang new tubing with normal saline to maintain IV access to administer medications and fluids. (NOTE: Some institutions may allow continuation of a transfusion at a slower rate if the patient is experiencing ONLY hives and pruritus. Follow your institution’s policies and procedures.)
  3. Notify the physician and obtain further orders to address the patient symptoms.


A mild allergic reaction is easily identified by the classic signs and symptoms listed above. More severe signs or symptoms of any other nature should be carefully assessed to determine the cause and subsequent treatment.


Symptoms associated with mild allergic reactions may be decreased by slowing the rate of transfusion. (The rate of the transfusion may be increased later if symptoms subside.) An antihistamine may be ordered to relieve the patient’s symptoms. Antihistamines may be ordered prophylactically if the patient experiences recurrent urticarial reactions. If symptoms worsen or recur later in the transfusion, the transfusion may need to be to discontinued if antihistamines do not alleviate the patient’s symptoms. Epinephrine may be indicated for severe persistent urticaria associated with bronchospasm. (See Anaphylactic Reactions). When allergic reactions occur despite pre-transfusion antihistamine, washed cells may be indicated. If allergic reactions are severe or persist despite premedication, consult with Puget Sound Blood Center Physician on Call at 206-292-6525.


2003  Puget Sound Blood Center Back to Top