If an allergic transfusion reaction is suspected, what is the first action the nurse should take?

• A. Stop the transfusion.
• B. Increase the rate of infusion.
• C. Continue the transfusion with pretreatment.
• D. Place the client in Trendelenburg position

Answer: (A)

Stopping the transfusion right away is essential because an allergic transfusion reaction means the body is reacting to something in the donor blood. Halting the infusion stops further exposure and helps prevent the reaction from worsening. After stopping, keep the IV line open with normal saline to maintain circulation and to prepare for further care. Then notify the provider and the transfusion service so appropriate orders can be given, while you monitor the patient’s vital signs and symptoms. Treat the reaction per protocol (antihistamines or other medications as ordered) and be ready to manage airway or hemodynamic changes if they occur. Do not increase the infusion rate or continue the transfusion with pretreatment, as that could worsen the reaction, and there’s no indication for placing the patient in a Trendelenburg position.