Transfusion medicine handbook

3. Guide to Good Transfusion Practice

3.10 Provision of Red Cells in an Emergency

The nature and availability of red cells in an emergency situation depends on the urgency with which blood is required and the extent of pretransfusion testing that can be completed within the appropriate response time.

Table 3.2: Availability of Red Cell Units

If red cells are required immediately and before pretransfusion testing can be completed, the use of emergency group O RhD negative units should be considered.

As stocks of group O RhD negative red cells are limited, a timely switch to red cells of the patient’s group is recommended. It should be noted that whilst emergency red cells are group O RhD negative, complete serological compatibility cannot be guaranteed as the patient may have a red cell antibody.

Where time allows a confirmed ABO/RhD type to be obtained, uncrossmatched blood of the same group as the patient (‘group specific’) will be provided. On completion of a full group and screen, and as long as the patient does not have a red cell antibody, group-specific and crossmatch-compatible blood is available.

If the patient has a red cell antibody, finding compatible blood may be delayed while the antibody is identified, and antigen-negative red cells selected and crossmatched. Under these circumstances, if blood is still urgently required, incompatible red cells may have to be used. However, the decision to transfuse should be made in discussion with a NZBS Transfusion Medicine Specialist/Medical Officer.