QuestionSBA
QuestionChoice
The transfusion must be stopped or slowed to prevent the progression of fluid overload into pulmonary oedema. A chest x-ray might help show pulmonary oedema but is not an appropriate first-line management as the fluid overload needs to be reversed with furosemide.
10001436
e
Stop the transfusion and order a chest x-ray
QuestionChoice
Continuing the transfusion might worsen the fluid overload, increasing the risk of pulmonary oedema and worsening symptoms. The transfusion should be stopped and fluid overload treated with IV furosemide.
10001433
b
Continue the transfusion and review in 30 minutes
QuestionChoice
This patient is suffering from transfusion-associated circulatory overload(TACO) as a complication of the blood transfusion. This is more likely to occur in patients with a history of cardiovascular disease. The aim of TACO treatment is to reverse the fluid overload through the use of diuretics.
10001432
a
Stop the transfusion and administer 30mg IV furosemide
QuestionChoice
This is the treatment for anaphylaxis which can also be a complication of blood transfusions. A patient with anaphylaxis would present with dyspnoea, wheeze, angioedema and hypotension.
10001434
c
Stop the transfusion and administer IM adrenaline
QuestionChoice
Furosemide is indicated to treat the fluid overload, but the IV route is favoured over oral as it has a higher bioavailability and faster onset.
10001435
d
Stop the transfusion and administer 30g oral furosemide
Concept
Chapter
2693
3929
Blood Transfusion
Topic
157
Haematology
12833
A 52-year-old female is in hospital following surgery for renal cell carcinoma. Bloods showed Hb levels of 69g/L (normal range 115 - 155 g/L), so 1 unit of blood is transfused. Following the blood transfusion, she develops progressively worsening shortness of breath. On auscultation, bilateral crackles are heard at the lung bases. She has a past medical history of stable angina. Vital signs are normal apart from a blood pressure of 147/81.


What is the most appropriate management for this patient?
a