A 30-Year-Old Man Is Admitted for Observation Following a Motorcycle

A 30-year-old man is admitted for observation following a motorcycle collision.  He was hemodynamically stable at presentation, and the initial workup revealed an isolated liver laceration.  The patient has no chronic medical conditions and takes no medications.  He consumes 3-4 alcoholic drinks daily and has been smoking 1 pack of cigarettes daily for the past 10 years.  Overnight, his hemoglobin levels acutely decreased, and a packed red blood cell transfusion was ordered.  An hour after the transfusion starts, the patient develops difficulty breathing.  The transfusion is stopped.  Temperature is 36.9 C (98.4 F) , blood pressure is 86/42 mm Hg, pulse is 110/min, and respirations are 26/min.  Pulse oximetry shows 88% on room air.  Lung examination reveals bilateral crackles.  Skin examination is normal.  Chest x-ray reveals bilateral pulmonary infiltrates.  Which of the following is the best next step in management of this patient's respiratory distress?

A) Anticoagulation therapy
B) Broad-spectrum antibiotics
C) Diuretic therapy
D) Intravenous antihistamines
E) Respiratory supportive care only

Correct Answer:

Verified

Show Answer