بعد ١٥ دقيقة من بدء نقل كريات دم حمراء، ارتفعت حرارة المريض من ٣٧ إلى ٣٨٫٩، وصار عنده رجفة وألم في الخاصرة، والضغط ٨٨/٥٠، والبول داكن. أوقفت الممرضة النقل فوراً. ما الخطوة التالية مباشرة؟

Fifteen minutes into a red-cell transfusion, the client’s temperature rises from 37 to 38.9 °C with chills, flank pain, BP 88/50 and dark urine. The nurse has stopped the transfusion. What is the next action?

1. Disconnect the blood bag and its tubing and run 0.9% saline through new tubing
2. Send the blood bag back to the blood bank before doing anything else
3. Slow the transfusion to the lowest rate and give the prescribed antipyretic
4. Flush the existing line with saline to clear the remaining blood from the tubing

Answer: A) Disconnect the blood bag and its tubing and run 0.9% saline through new tubing. These are signs of an acute haemolytic reaction. After stopping, remove the bag and tubing entirely, keep the vein open with saline through new tubing, then notify the provider and blood bank. Flushing the old line pushes more blood in, slowing is unacceptable, and returning the bag comes after the client is stabilised.