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MunoRN, RN · Mar 19, 2017

Because I cannot wrap my head around how someone could even ask if we ever give blood because a family member tells us the patient's blood type. As if we would ever bypass type and screen except for emergencies.

I think it's a reasonable question if it's something the OP didn't know the answer to, which isn't unheard of. People are generally aware that we check type and rh factor, but often aren't aware that those aren't the only things we are checking.

russianbear · Mar 19, 2017

I think it's a reasonable question if it's something the OP didn't know the answer to, which isn't unheard of. People are generally aware that we check type and rh factor, but often aren't aware that those aren't the only things we are checking.

Seems odd to me because I remember in school going over all that stuff in great detail.

booradley · Mar 23, 2017

You can give O positive to everyone except young women/women of childbearing age without a type and screen in an emergency. One of the other posters linked an article to it above.

Editorial Team / Moderator · Mar 23, 2017

You can give O positive to everyone except young women/women of childbearing age without a type and screen in an emergency. One of the other posters linked an article to it above.

It's okay, no one listened to me. Twice. lol.

ThePsychWhisperer, BSN, MSN, APRN, NP · Mar 27, 2017

It's okay, no one listened to me. Twice. lol.

If you know the rationale, can you shed a little light on this new standard for me, Pixie? I'm in an ED that still transfuses only O- blood in emergent situations for those that have not been typed and crossmatched. I read the article through that you posted (very informative, by the way), but did not see an exact rationale on why it is acceptable to transfuse O+ blood to adult males and females of non-reproducing potential. Perhaps its my own cynicism, but I'm just seeing a young women and children before the dispensable old maids and adult males thing here. I would legitimately appreciate knowing the rationale behind this, though.

Editorial Team / Moderator · Mar 27, 2017

It's at the bottom of page two of the article that I attached previously. Here is another excerpt that explains it from Pretransfusion Testing and Transfusion of Uncrossmatched Erythrocytes | Anesthesiology | ASA Publications

Group O RhD-negative blood is typically used in emergencies when the recipient's RhD status is unknown. Because RhD-negative blood is a scarce resource, priority for its use is given to RhD-negative females with childbearing potential to prevent alloimmunization against D antigen and subsequent risk of hemolytic disease of the fetus and newborn. RhD-positive erythrocytes can be transfused to RhD-negative patients who have not made anti-D antibodies as a result of prior exposure to RhD antigen because D-negative individuals do not constitutively produce anti-D antibodies. In experimental studies, anti-D antibodies are detected in approximately 80% of healthy RhD-negative volunteers immunized with RhD-positive blood, but the alloimmunization rate observed in clinical studies of hospitalized patients who were transfused at least one unit of RhD-positive blood ranges from only 10 to 33%.

ThePsychWhisperer, BSN, MSN, APRN, NP · Mar 30, 2017

It's at the bottom of page two of the article that I attached previously. Here is another excerpt that explains it from Pretransfusion Testing and Transfusion of Uncrossmatched Erythrocytes | Anesthesiology | ASA Publications
Group O RhD-negative blood is typically used in emergencies when the recipient's RhD status is unknown. Because RhD-negative blood is a scarce resource, priority for its use is given to RhD-negative females with childbearing potential to prevent alloimmunization against D antigen and subsequent risk of hemolytic disease of the fetus and newborn. RhD-positive erythrocytes can be transfused to RhD-negative patients who have not made anti-D antibodies as a result of prior exposure to RhD antigen because D-negative individuals do not constitutively produce anti-D antibodies. In experimental studies, anti-D antibodies are detected in approximately 80% of healthy RhD-negative volunteers immunized with RhD-positive blood, but the alloimmunization rate observed in clinical studies of hospitalized patients who were transfused at least one unit of RhD-positive blood ranges from only 10 to 33%.

Thanks for posting this! I was unaware that the protocol for blood administration had changed for the administration of Rh positive and negative blood. After reading over the information you provided though, it made a lot of sense. Good information to have working in an ED, especially sense O- blood reserves have become kinda scarce.