25th July 2024

You are called to the ward to review a patient who is currently having a blood transfusion

You are called to the ward to review a patient who is currently having a blood transfusion. On your A-to-E assessment you note an expiratory wheeze and swelling of the lips, but the airway appears patent.

Saturations are 85% on RA, RR 28 and there is reduced air entry bilaterally with expiratory wheeze on auscultation. Heart sounds are normal, HR is 100 bpm and BP 82/41 mmHg and the patient is apyrexial.

You immediately stop the transfusion, start the patient on 15 L oxygen via a non-rebreathe mask, and give IV NaCl 0.9%.

What would the next most important step in management be?

Select the SINGLE most appropriate option from the list below. Select ONE option only.