A patient develops fever and chills during a transfusion. What should the nurse do first?

• A. Increase the transfusion rate to flush the reaction.
• B. Continue the transfusion with a reduced rate and observe.
• C. Notify the provider and blood bank but do not stop the infusion.
• D. Stop the transfusion immediately; maintain IV line with saline; notify the provider and blood bank.

Answer: (D)

When a fever and chills appear during a transfusion, the immediate action is to stop the transfusion right away. This reaction could be an acute transfusion reaction, which can become life-threatening if the transfusion continues. After stopping, keep the IV line open with normal saline to maintain circulation and to prepare for any needed medications or further treatments. Notify the provider and the blood bank immediately so they can assess the patient, order appropriate tests, and identify the cause. Send the blood product and tubing to the blood bank for investigation and collect any ordered specimens. Only after the team directs you should you determine how to proceed with a future transfusion, but the critical first step is stopping the infusion and securing the patient.