After stopping the transfusion due to a suspected reaction, which fluid should be started to maintain vein patency?

• A. Normal saline infusion with new tubing
• B. Lactated Ringer's solution
• C. Dextrose 5% in water
• D. Half-normal saline

Answer: (A)

When a transfusion reaction is suspected, the priority is to stop the transfusion and keep IV access open for safety and future management. Flushing the line with normal saline helps clear any remaining donor blood from the line and maintains patency so you can continue IV access if medications or further intervention are needed. Normal saline is compatible with all blood products; it won’t cause cross-reactions or hematologic damage.

Other fluids aren’t suitable for standard line flushing during a transfusion. Lactated Ringer’s contains calcium, which can interact with the citrate anticoagulant in stored blood and complicate the situation. Dextrose-containing solutions can cause red blood cell hemolysis when transfusion is involved. Half-normal saline is hypotonic and can cause red blood cells to hemolyze. Therefore, starting a normal saline infusion with new tubing is the best choice to maintain line patency safely.