acute haemolytic transfusion reaction

Vignette from CICM 2017: "where a trauma patient is seen to produce red urine with lots of haemoglobin in it, as well as oozing from all vascular access sites, being hypotensive and having a fever."
Etiology Often due to ABO incompatibility
Clinical presentation Rapid onset fever, rigors, pain at infusion site, hypotension...
Pathogenesis RBCs lysed by Complement system → inflammatory response/SIRS
Diagnostic investigations - Direct Antiglobulin Test (DAT)
- Repeat ABO compatibility testing
- Urine dipstick for haemoglobin
Management STOP and resuscitate patient