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The serious hazards of transfusion haemovigilance organisation (<jats:styled-content style=\"fixed-case\">SHOT<\/jats:styled-content>) receives 30\u201340 reports of anaphylactic reactions each year. Other serious complications of transfusion, such as acute haemolysis, bacterial contamination, transfusion\u2010related acute lung injury (<jats:styled-content style=\"fixed-case\">TRALI<\/jats:styled-content>) or transfusion\u2010associated circulatory overload (<jats:styled-content style=\"fixed-case\">TACO<\/jats:styled-content>) may present with similar clinical features to <jats:styled-content style=\"fixed-case\">ATR<\/jats:styled-content>.<\/jats:p><jats:p>This guideline describes the approach to a patient developing adverse symptoms and signs related to transfusion, including initial recognition, establishing a likely cause, treatment, investigations, planning future transfusion and reporting within the hospital and to haemovigilance organisations.<\/jats:p><jats:p>Key recommendations are that adrenaline should be used as first line treatment of anaphylaxis, and that transfusions should only be carried out where patients can be directly observed and where staff are trained in manging complications of transfusion, particularly anaphylaxis. Management of ATRs is not dependent on classification but should be guided by symptoms and signs. Patients who have experienced an anaphylactic reaction should be discussed with an allergist or immunologist, in keeping with UK resuscitation council guidelines.<\/jats:p>","DOI":"10.1111\/bjh.12017","type":"journal-article","created":{"date-parts":[[2012,8,29]],"date-time":"2012-08-29T08:38:27Z","timestamp":1346229507000},"page":"143-153","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":123,"title":["Guideline on the investigation and management of acute transfusion reactions Prepared by the <scp>BCSH<\/scp> Blood Transfusion Task Force"],"prefix":"10.1111","volume":"159","author":[{"given":"Hazel","family":"Tinegate","sequence":"first","affiliation":[{"name":"Consultant Haematologist, NHS Blood and Transplant Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Birchall","sequence":"additional","affiliation":[{"name":"Consultant Haematologist NHSBT Filton UK and North Bristol NHS Trust Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Gray","sequence":"additional","affiliation":[{"name":"Programme Director Better Blood Transfusion Scottish National Blood Transfusion Service Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Haggas","sequence":"additional","affiliation":[{"name":"Blood Transfusion Quality Manager Leeds Teaching Hospitals Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin","family":"Massey","sequence":"additional","affiliation":[{"name":"Associate Medical Director\u2010Patient Services NHS Blood and Transplant Filton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek","family":"Norfolk","sequence":"additional","affiliation":[{"name":"Consultant Haematologist NHS Blood &amp; Transplant and Leeds Teaching Hospitals Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Pinchon","sequence":"additional","affiliation":[{"name":"Transfusion Nurse Specialist Hull and East Yorkshire NHS Trust Hull UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrock","family":"Sewell","sequence":"additional","affiliation":[{"name":"Visiting Professor Department of Immunology University of Lincoln Lincoln UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angus","family":"Wells","sequence":"additional","affiliation":[{"name":"Clinical Director Supply Chain Scottish National Blood Transfusion Service Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shubha","family":"Allard","sequence":"additional","affiliation":[{"name":"Consultant Haematologist NHSBT and Chair BCSH Transfusion Task Force London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,8,29]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2008.01918.x"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2004.04972.x"},{"key":"e_1_2_15_4_1","unstructured":"British Committee for Standards in Haematology. 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