Page 108 - ATP-P 11th Ed

x. Hypotension
xi. Pain, inflammation, and/or warmth at the infusion site
SECTION 1 after a blood transfusion may represent hematuria (indicating bleeding in the
xii. Red or brown urine (hemoglobinuria) – The onset of red urine during or shortly
lower urinary tract (tube #1 below) or hemoglobinuria (indicating an acute
hemolytic reaction, tube #2 below). If freshly collected urine from a patient
with hematuria is centrifuged, red blood cells settle at the bottom of the tube,
leaving clear yellow urine supernatant (see tube #3 below). If the red color is
due to hemoglobinuria, the urine sample remains red after centrifugation (see
tube #4 below).

Tube: 1 2 3 4
Uncentrifuged and Centrifuged Urine Samples
(Retrieved from http://img.medscape.com/pi/emed/ckb/hematology/197800-206885-156.jpg)

xiii. Alternatively, urine tests strips can reveal the presence of blood in the urine.
This may represent hemoglobinuria (indicating an acute hemolytic reaction)
or hematuria (indicating bleeding in the lower urinary tract).
xiv. Plasma in a sample of centrifuged anticoagulated venous blood is normally
clear (tube #1 on page 42), but will be pink-red if significant intravascular
hemolysis (e.g., hemoglobinemia) has occurred within the previous few hours
(tubes 2–4 on page 42).
c. Febrile Nonhemolytic Reactions
i. Fever not as severe as with an acute hemolytic reaction
ii. Chills
iii. Dyspnea
d. Urticarial Reactions – Urticaria
i. Flushing (especially in the face), urticaria, or edema

98 SECTION 1 TACTICAL TRAUMA PROTOCOLS (TTPs) ATP-P Handbook 11th Edition 99