You have been asked to review a 63-year-old female who is receiving a blood transfusion in your Emergency Department for symptomatic anaemia. She is now 30 minutes into her second unit of packed red blood cells and has become unwell in the past 5 minutes with breathlessness and confusion. Her vitals are as follows : T 38.4°C HR 128 irregular BP 101/62 RR 24 Sats 89% 8L/min via HM GCS 14

1. List (3) transfusion-related adverse reactions which could explain this situation. (3 marks) 3 marks

2. Outline (5) immediate actions you would perform for this patient. (5 marks) 5 marks

You decide to do a haemolysis screen for this patient.

3. List (4) investigations you would order in this screen and the expected results should haemolysis be present. (4 marks) 4 marks