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Acute Transfusion Reaction Management — FRCA Final MCQ

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ModerateGeneral AnaesthesiaAcute Transfusion Reaction ManagementFRCA Final

A 58-year-old woman develops rigors and temperature 39.2°C 45 minutes into a packed red cell transfusion. HR 105, BP 128/78, SpO2 97%. What is the most important initial step?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Stop the transfusion immediately and disconnect the giving set

Rigors with fever during transfusion mandate immediate cessation and disconnection of the blood bag. The bag must be returned to blood bank with fresh samples for repeat crossmatch, DAT, and culture. This could represent febrile non-haemolytic reaction, bacterial contamination, or acute haemolytic reaction. Continuing at any rate risks catastrophic haemolysis if ABO incompatibility.

Reference: SHOT/BSH – 2023 – Guidelines for investigation and management of acute transfusion reactions