If a transfusion reaction is suspected postpartum, what is the first action?

• A. Increase IV rate to flush line.
• B. Continue transfusion and document later.
• C. Stop the transfusion, maintain IV line with normal saline, notify physician and blood bank, monitor vital signs, collect specimen.
• D. Administer epinephrine immediately.

Answer: (C)

When a transfusion reaction is suspected, the immediate priority is to stop the transfusion and protect the patient. Halting the infusion stops further exposure to donor blood, which is essential to prevent worsening of the reaction. After stopping, keep the IV line open with normal saline to preserve access for fluids and potential medications. Notify the physician and the blood bank right away so they can assess the patient, determine the reaction type, and guide next steps, including any required testing or changes to the transfusion plan. Monitor vital signs continuously to detect progression to shock or other instability, and collect necessary specimens (such as blood samples for testing and a urine sample) to help diagnose the reaction. Documentation of findings is crucial. Epinephrine is not given automatically; it’s used if signs of anaphylaxis occur, but not as the first action in every transfusion reaction.