During a PRBC transfusion, which monitoring step is recommended in the first minutes of the infusion?

• A. The transfusion must be completed within 1 hour
• B. Monitor for transfusion reactions during the first 10 minutes
• C. Premedicate with acetaminophen
• D. Do not obtain consent

Answer: (B)

Monitoring for transfusion reactions during the initial minutes of a PRBC infusion is essential because most acute reactions show up early, often within the first 10 to 15 minutes. This early window is when symptoms such as fever/chills, itching or hives, dyspnea, wheezing, tachycardia, or hypotension are most likely to occur. Detecting signs right away allows you to stop the transfusion, flush with normal saline, notify the clinician, and manage the reaction promptly to prevent progression. Premedication with acetaminophen isn’t routinely done for all transfusions, consent should be obtained, and completion timing is a separate consideration from the immediate monitoring step. The practice focused here is vigilant early observation for any transfusion reaction.