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Cathy

O Pos vs O Neg red cells for emergencies

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Hello All,

I'm wondering how many of you use O Pos instead of O Neg for emergency release of red cells for male patients and women older than child-bearing age?  If you start with O Negs for males, how many will you give before switching to O Pos?   Both of my questions are referring to patients for whom you have not been able to get an ABORh done yet. 

Thanks in advance!

Cathy

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We start with O Negs but after 4 - 6 units, we would switch to O pos for those patients in question in order to have the remaining  O Negs on hand for women of childbearing age, should  one show up.  Note also that our nearby blood supplier can have more RBCs to us within about 45 minutes.  We are a level 2 trauma center.

Scott

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If we know the patient's history and they are Rh Neg we might start off with a couple of Rh Neg O's.  We switch them over pretty quickly if they are going to use more.   Otherwise - they get O Pos.  

Took people in and outside of the lab a little while to get comfortable with this policy, but now no one blinks.

sandra

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We start with O Pos, though I would have to say that if we had history and knew the patient was Rh Neg, we would probably give Rh neg unless/until it looked like mass transfusion.

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Thank you all for your responses.  We are working hard to reduce our utilization so this is all good information.  Thank you and Happy Holidays!

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We start with O neg (2u - no more than 4u) and hope we have a specimen before the 2u are in.  We then switch to type specific and hope it is not O neg.  We are under pressure to switch to O pos by one of the ER docs - may have to go that way in the next year or so as they gear up here to be a Level 4 trauma unit.  So far, most of the emergency releases stop transfusing with 2 units.

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We are Level 1 Trauma Center with approximately 15 Massive Transfusion activations per month.  We keep 6 O POS and 6 O NEG in our ER refrigerator with 4 Group A Liquid Plasma.

We started stocking O POS units last summer when our blood supplier was struggling to keep up with our O NEG need.  The majority of our traumas are male and about 80% Rh positive.  It has made a tremendous impact on our O NEG usage.  The biggest concern was the possibility of a mistake and grabbing O POS for female patient but (knock on wood) that has not happened yet.  We have segregated the units by placing O POS in a Blue plastic bin and O NEG in a Pink plastic bin - and on a separate shelf.  O POS units are wrapped in a paper stating "FOR MALES ONLY". 

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