John C. Staley Posted June 18, 2009 Share Posted June 18, 2009 I'd like a little clarification from those technologists that indicate their facilities have a policy to give O+ blood to males, and de facto to females past child bearing age, in an emergent trauma and O= blood to females (of child bearing age). While I understand that when O= is not readily available it may be necessary, at times, to do this, but to basically say if you're a male of Rh negative status we will give you Rh positive blood and we guarantee to give you a circulating antibody to D antigen for all your future years and increase your medical costs for all of those future antibody IDs that technologists will have to deal with or send out for reference. If that is your 'policy' then I have a good lawyer I'd like you to talk to. Please explain.There are no guarantees in medical science. If I recall correctly only about 70% of D neg people will make the anti-D. That means 30% will not. Giving a D neg patient D pos blood is not the kiss of death as you seem to think. Most patients will be greatful to be alive if they survive the emergent situation. The fact that the patient could possibly develop an anti-D was the least of my worries.:disbelief Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted June 18, 2009 Share Posted June 18, 2009 You are, of course, absolutely correct John.Some D Negative people appear to tolerate transfusions of D Positive blood until the "cows come home", and never make anti-D.There are, of course, a minority of D Negative people to whom you show a photograph of a bag of D Positive blood who will immediately produce an alloanti-D of great potency, but, as you say, at least they are alive. Link to comment Share on other sites More sharing options...
clmergen Posted June 18, 2009 Share Posted June 18, 2009 We prefer to keep the men alive and keep enough Rh= blood on the shelf for the female trauma that may be coming in right behind the male. Or the Rh= woman bleeding out after a delivery. Working up an anti-D is easy. Intrauterine and exchange transfusions not so easy. Link to comment Share on other sites More sharing options...
Jaimie Nicholson Posted June 19, 2009 Share Posted June 19, 2009 Surely you should have enough O Neg blood for both of them? If you get a sample taken as soon as they arrive in hospital, and do a rapid group, you should only be giving a couple of O Negs anyway, and then switching to group specific. Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted June 19, 2009 Share Posted June 19, 2009 Surely you should have enough O Neg blood for both of them? If you get a sample taken as soon as they arrive in hospital, and do a rapid group, you should only be giving a couple of O Negs anyway, and then switching to group specific.Jaimie, having had the dubious pleasure of working the hospital blood banks that dealt with three terrorist bombs (Chelsea Barracks, Hyde Park Corner and Harrods) and two train crashes (Purley and Ealing) I can assure you that the short answer to your question is NO! Very often in these situations (two of which happened on a Saturday) you are not fully stocked for any particular blood group, you are under staffed and there is traffic chaos outside, making re-stocking, even using blues and two, time consumming.At the same time, you have no idea how many victims you are to expect, and many of these have no identity, except for Major Incident Victim numbers and a sex.In one case, although I was not involved (the Kegworth air crash) the hospital was on one side of the crash, whilst the supplying Blood Centre was on the other. In such circumstances, it is quite common to have to limit the number of group O D Negative units you can give out, and you have to make hard decisions.I' m sorry, but in ideal circumstances you are probably right, but in the real world you are not.:mad: Link to comment Share on other sites More sharing options...
clmergen Posted June 19, 2009 Share Posted June 19, 2009 Even if I did a blood type on the Trauma patient and he was Rh neg, I would still give Rh pos blood if we thought he was going to use a lot of blood. And if they take uncrossmatched usually they use a lot of blood. The massive bleed patient from last week took 20 units of blood. No way would we have used jRh neg blood on him if he had needed it. Link to comment Share on other sites More sharing options...
Marilyn Plett Posted June 20, 2009 Share Posted June 20, 2009 O negative RBCs are transfused in excess of their proportion in the population. That means that O negative donors are constantly being asked by recruitment personnel to donate the minute they become eligible; I suspect some would say "hounded". Hospital policies about using O negatives should keep in mind the needs of the entire patient community. Link to comment Share on other sites More sharing options...
bbbirder Posted June 24, 2009 Share Posted June 24, 2009 Our policies on giving Rh pos blood Rh negs or unknown type are for those circumstances when NO-ONE could have enough Rh neg in house. Multiple victims, _massive_ bleeders.Every hospital I have ever worked in has has similar or identical policies.Linda Frederick Link to comment Share on other sites More sharing options...
bxcall1 Posted June 26, 2009 Share Posted June 26, 2009 If anyone is interested, here is an article in Transfusion discussing anti D formation in Rh negative recipients of emergency Rh pos. It's about 20%.Volume 43 Issue 7, Pages 893 - 898Published Online: 20 Jun 2003 Link to comment Share on other sites More sharing options...
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