Rigors and hypotension during red cells
RN OSCE practice station

The task

You are the RN in an emergency department. Omar Ahmed, aged 52, is eight minutes into a red cell transfusion and suddenly feels unwell. Before starting he was alert with temperature 36.8°C, HR 88, BP 124/76, RR 18 and SpO2 98% on room air. Assess the change, manage a suspected transfusion reaction and communicate the response. Complete the supplied practice record. Speak to the patient and describe each assessment as you perform it. A second RN is available. You have eight minutes; describe and select physical actions in this online exercise.

What this station tests

• Stop Omar’s blood before investigating the cause of rigors and hypotension.
• Do not flush the existing blood line; preserve access through fresh equipment as directed.
• A matching clerical check does not rule out a severe transfusion reaction.
• Retain the pack and set safely and read back the requested blood and urine samples.

Sources for the clinical content

• Australian Red Cross Lifeblood: Management of suspected reactions
• Australian Red Cross Lifeblood: Monitoring and observation
• ACSQHC: Recognising and Responding to Acute Deterioration Standard
• ACSQHC: Communicating for Safety Standard

An original practice scenario with invented patients. Not an exam question.

Practise next

• Preparing to start a red cell transfusion
• An identifier mismatch before outreach transfusion
• A patient withdraws consent before transfusion
• Breathlessness during a red cell transfusion
• Preparing red cells for Peter Lawson