Emergency blood transfusion
Yomna Mohamed El-mwafy;
Abstract
Blood transfusion is an essential therapeutic intervention, we all may need blood in any emergency and some of us need regular transfusions.
Throughout the 20th century, milestones in the advancement of blood transfusion are synchronised with the onset of military conflict around the world. The practice of blood transfusion advanced with the outbreak of the First World War, mainly due to the new knowledge of matching different blood groups and the use of an anticoagulant that facilitated indirect transfusion. Prior to this, transfusion was only possible using defibrinated blood, as described by Mossand by direct donor-to-patient techniques.
Safe transfusion of red blood cells (RBC) is possible because donor RBC units can be selected for their compatibility with the recipient's blood type. Transfused RBC units do not need to be antigenically identical to the recipient's RBCs, but they do need to lack antigens that could provoke clinically significant hemolysis in the recipient (e.g, a blood group a donor unit transfused to a blood group O recipient).
A properly labeled sample is critical to the safety of blood transfusion; a clinical error may lead to a fatal transfusion reaction
Tests that must be performed prior to release of an RBC component include ABO/Rh(D) typing, antibody screen, and compatibility testing. A patient sample can be tested for blood type and the presence of antibodies (ie, type and screen) without identification of a specific RBC unit for transfusion, or the type and screen can be combined with compatibility testing ABO and Rh(D) typing are required every time a red cell transfusion is ordered
Emergency release blood is available for immediate transfusion when there is insufficient time to perform pretransfusion testing (blood type, RBC antibody screen, and compatibility testing). This differs from "massive transfusion," in which a large number of units of RBCs (often with platelets and plasma) are required to treat major bleeding. In some cases of massive transfusion, emergency release blood is used (eg, treatment of massive trauma when pretransfusion testing is incomplete); in others, it is not needed (e.g, scheduled liver transplantation).
In urgent/emergent situations, time may be insufficient to complete all components of pretransfusion testing (eg, life-threatening anemia, brisk hemolysis, rapid bleeding). Decisions regarding transfusion in such settings depend on assessment of the risks and benefits of immediate transfusion versus completion of pretransfusion testing, including compatibility testing. These decisions are made by the clinician caring for the patient with involvement of transfusion medicine personnel.
Blood designated for emergency release is typically group O, Rh(D)-negative. At many institutions, group O, Rh(D)positive RBC units may be used for males and females who are beyond childbearing age or when the usage is expected to be very high. The designated RBC units are generally stored separately from other RBC units to allow rapid access and to avoid potential mis-transfusion of non-group O blood.
Throughout the 20th century, milestones in the advancement of blood transfusion are synchronised with the onset of military conflict around the world. The practice of blood transfusion advanced with the outbreak of the First World War, mainly due to the new knowledge of matching different blood groups and the use of an anticoagulant that facilitated indirect transfusion. Prior to this, transfusion was only possible using defibrinated blood, as described by Mossand by direct donor-to-patient techniques.
Safe transfusion of red blood cells (RBC) is possible because donor RBC units can be selected for their compatibility with the recipient's blood type. Transfused RBC units do not need to be antigenically identical to the recipient's RBCs, but they do need to lack antigens that could provoke clinically significant hemolysis in the recipient (e.g, a blood group a donor unit transfused to a blood group O recipient).
A properly labeled sample is critical to the safety of blood transfusion; a clinical error may lead to a fatal transfusion reaction
Tests that must be performed prior to release of an RBC component include ABO/Rh(D) typing, antibody screen, and compatibility testing. A patient sample can be tested for blood type and the presence of antibodies (ie, type and screen) without identification of a specific RBC unit for transfusion, or the type and screen can be combined with compatibility testing ABO and Rh(D) typing are required every time a red cell transfusion is ordered
Emergency release blood is available for immediate transfusion when there is insufficient time to perform pretransfusion testing (blood type, RBC antibody screen, and compatibility testing). This differs from "massive transfusion," in which a large number of units of RBCs (often with platelets and plasma) are required to treat major bleeding. In some cases of massive transfusion, emergency release blood is used (eg, treatment of massive trauma when pretransfusion testing is incomplete); in others, it is not needed (e.g, scheduled liver transplantation).
In urgent/emergent situations, time may be insufficient to complete all components of pretransfusion testing (eg, life-threatening anemia, brisk hemolysis, rapid bleeding). Decisions regarding transfusion in such settings depend on assessment of the risks and benefits of immediate transfusion versus completion of pretransfusion testing, including compatibility testing. These decisions are made by the clinician caring for the patient with involvement of transfusion medicine personnel.
Blood designated for emergency release is typically group O, Rh(D)-negative. At many institutions, group O, Rh(D)positive RBC units may be used for males and females who are beyond childbearing age or when the usage is expected to be very high. The designated RBC units are generally stored separately from other RBC units to allow rapid access and to avoid potential mis-transfusion of non-group O blood.
Other data
| Title | Emergency blood transfusion | Other Titles | نقـــل محتويــات الـدم فى الحــالات الحرجـة | Authors | Yomna Mohamed El-mwafy | Issue Date | 2016 |
Recommend this item
Similar Items from Core Recommender Database
Items in Ain Shams Scholar are protected by copyright, with all rights reserved, unless otherwise indicated.