Breathlessness during a red cell transfusion
RN OSCE practice station

The task

Rose Campbell becomes breathless during a red cell transfusion. She has known heart failure. Assess and demonstrate the immediate response, communicate with the doctor and complete the transfusion reaction record. The patient is a manikin; address the patient and the examiner voices their answers and supplies findings. Dr Taylor Singh is reachable by phone. RN Alex Morgan is available.

What this station tests

• Stop the transfusion for new respiratory distress and get urgent help.
• Overload is one possible reaction; describe the evidence without prematurely closing the diagnosis.
• Do not flush remaining blood or give an unprescribed fluid bolus to a breathless overloaded patient.

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

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

Practise next

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