Febrile Nonhemolytic Reactions
PRESENTATION: Febrile Nonhemolytic Transfusion Reactions typically present in a rather boring way.
A patient is getting a transfusion (generally red cells or platelets, though the FNH may occur with other products) and notices that he or she is developing chills.
The caregiver in charge of the patient does the appropriate first step (STOP the transfusion!) and takes the patient's temperature and other vital signs, discovering an elevated temperature. In general, the other vital signs are perfectly stable and unremarkable.
Occasionally, an FNH may present in a more dramatic way, such as with nausea or vomiting or a severe headache, but most of them are just big yawners. (One Blood Bank reference, "TRANSFUSION MEDICINE" by Jeff McCullough, states that these reactions are potentially fatal, which I suppose is theoretically possible, but not very likely) As I mentioned before, though, keep your index of suspicion high and be sure to evaluate any temperature increase thoroughly.
Next, on to diagnosis of an FNH.
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