輸血反應之護理

The Nursing Management of Transfusion Reactions

血液製品像藥物般，輸注過程中可能出現輕微的頭痛、發熱等不適，甚而因嚴重的輸血反應導致呼吸困難或休克而危及到病患的性命。美國醫療機構評鑑聯合會(The Joint Commissionon Accreditation of Healthcare Organizations, JCAHO)的統計報告指出，每年約有12到13位病患因輸血錯誤所導致的ABO血型不合致命；英國嚴重輸血意外(Serious Hazards of Transfusion, SHOT)機構統計分析輸血意外報告中指出，約有25%接受輸血的病患引發急性或延遲性輸血反應。本文介紹臨床常見的血品應用、輸血反應及處理，和輸血護理，希望護理人員在執行輸血技術過程中，能即早發現輸血反應並提供適切的措施，以維護病患的生命安全。Blood products may cause adverse reaction just like drugs. The severity of reactions ranges from mild headache, and fever to lethal response, such as respiratory distress or shock. There is no statistics regarding the mortality of blood transfusion in Taiwan. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) indicated that ABO incompatibility was due to transfusion errors that resulted in an estimated 12 to13 deaths per year. Serious Hazards of Transfusion (SHOT) showed that 25 % of reported hazards were caused by either acute or delayed transfusion reactions. The aim of this article is to introduce the common utilization of blood products, the sequential transfusion reactions and their respective medical managements, and the nursing managements. It is speculated that this article will help nurses find out transfusion reactions earlier, in order to provide adequate management and maintain the life safety of patients.