Final answer:
The first action when a patient experiences a reaction during a blood transfusion is to stop the transfusion immediately and seek medical help while maintaining venous access with saline and monitoring vital signs.
Step-by-step explanation:
The first action to take when a patient begins to show signs of a reaction during a blood transfusion is to stop the transfusion immediately. The described symptoms of lower back pain, shortness of breath, and chills can indicate a possible hemolytic transfusion reaction (HTR), which is a serious and potentially life-threatening event. A direct answer to this would be: Stop the transfusion and seek immediate medical assistance. HTRs occur when the patient's immune system aggressively attacks the transfused blood cells, leading to their destruction. Symptoms develop within the first 24 hours and can include fever, chills, back pain, dyspnea, and in severe cases, shock.
If a patient exhibits such symptoms during a transfusion, it’s crucial to interrupt the transfusion, maintain venous access with saline to keep the line open, monitor vital signs, and notify a physician immediately. Prompt action is essential to manage the reaction appropriately, identify the cause, and prevent further complications. The medical team will likely perform tests to confirm if an HTR is occurring and will treat the patient to manage any complications that may arise. Future transfusions will require careful matching to prevent recurrence of such reactions.