Say it’s a highly improbable situation where 1) a patient is bleeding to death and 2) the hospital just happens to be out of the correct blood type (say, no O blood for an O patient.)
Would doctors just give the wrong blood and then hope for the best?
“First do no harm” and the wrong blood type can be very harmful, indeed.
If a patient receives a blood type that is incompatible, antibodies that the patient already has in his or her blood will attack the donor red blood cells and destroy them. This could cause fever, chills, chest or back pain, bleeding, increased heart rate, shortness of breath, rapid drop in blood pressure, and/or kidney damage.
O negative is the universal donor. It lacks A and B and Rh antigens so can be tolerated by any patient (at least for those antigens, which are by far the most common).
So if they lacked AB+ for someone bleeding out, they’d dump O negative into 'em. Which I’ve done.
O negative is a very common blood type, and usually is available. O positive is also the universal donor for men and for women past childbearing age, as the Rh factor incompatibility affects fetuses.
While it is possible that an O type of blood might not be available emergently, it is unlikely. Until it can be found, fluid resuscitation along with infusion of clotting agents and other blood factors would proceed until the patient’s particular blood imcompatibilities could be determined.
My understanding is that O+ is the most common and of course can be used for any Rh+ patient. Does using, say, O+ blood in an AB- patient cause a potentially fatal issue as well in such a case, or could it be tolerated even if not ideal?
7% of the general population has O negative. I’m not sure I would call it “very common.” O positive, OTOH at 37% of the general population is very common. Just saying…
Blood incompatibility is a complex subject and I’m not a blood banking specialist, but in general:
Transfusing blood with major group incompatibility, i.e. group B blood into a group O recipient strongly risks serious acute hemolysis (breakup of red blood cells (RBCs)) and potentially fatal disseminated intravascular coagulation, kidney failure etc. It’s hard to imagine a situation where that would be risked - the priorities would instead include volume replacement and surgical intervention to halt bleeding.
There are a lot of other RBC antigens that can cause trouble in cases of incompatibility, like the Kidd antigen. Hemolysis in such situations can be serious but is much more likely to be delayed and less life-threatening than ABO incompatibility. So in an emergency, transfusion of such blood might be acceptable even in the face of a crossmatch problem, to save a life.
Occurring in 7% of the population makes it fairly common, in medical terms. With that frequency, there’s generally not a shortage of it in the blood bank, as over 23 million US residents have that type, O -. Unlike the AB blood types, which are uncommon, but not rare. Medical/epidemiologic use of terms like common/uncommon/rare are on a different yardstick than in general use, and in many other disciplines.
But I’ll grant that ‘fairly common’ is probably a better description of its frequency than my earlier ‘very common’.
It’s my understanding (and please somebody correct me if I’m wrong) that using O+ blood in an AB- patient is probably fine as long as the patient isn’t pregnant and doesn’t plan to become pregnant. If she is, then the baby may be adversely affected, and/or subsequent pregnancies may be at risk because of Rh sensitization, although Rh immune globulin at/near the time of transfusion can prevent this. It wouldn’t be an ideal situation, but in an emergency it could be tolerated.
@slash2k as I noted in my first post
I thought giving Rh+ blood to anyone who is Rh- was dangerous, and potentially fatal, regardless of age, gender, or reproductive status, and that’s why O-negative is the universal donor (and AB-positive is the universal recipient).
People who are Jehovah’s Witnesses, whose interpretation of the Bible prohibits blood transfusions, and people in other situations where a transfusion is not feasible would, like Qadgop said, get fluid replacement, and that does include various crystalloids and volume expanders.
Nope.
emergency red blood cell use
“Type O, Rh-negative RBC’s can be transfused to people of any type with only a slight risk of hemolysis. This risk increases in patients who have previously been transfused or pregnant and may have formed antibodies.”
It’s not best practice, but it’s not that risky, and often in emergencies the benefit outweighs those risks.
I know there are many sub-types, some of which are relevant for transfusion and others that are not. I didn’t know that there was EVER a situation where Rh+ blood could be transfused into a person who is Rh-, but TIL that there is, and specifically regarding packed red cells and not whole blood.
There are other options. The ideal is to stop the bleeding using surgery, tourniquets, pressure, devices, scopes, balloons, etc. - which would usually have to be done even if transfusing the patient. There are alternatives to blood, including normal saline and other blood products under certain circumstances. There are medicines that sometimes help stop bleeding, like tranexamic acid, or other medicines for specific situations (as in bleeding after delivering a baby). A few places can transfuse patients using their own blood.
One seeks to minimize reactions. Blood is commonly given. This is done as described above. In an emergency, one might not worry about the thirty or more other known factors and give blood with minimal antigens as best as is available. I’m sure giving whatever blood is available has happened before, when there are no reasonable alternatives. I’ve never seen that.
How long does it take to get the blood type and Rh info? Hours? Minutes?
Who does it? Do ERs have these people on staff 24/7?
Most hospitals have technicians that take blood. Simple tests are available to quickly type samples for the common groups. Even small hospitals have blood banks with at least several units of the safest types of blood to administer if you do not initially know the type or time is essential. It is not uncommon to give fluid (traditionally in “boluses” of 10-20mL/kg) to help support pressure while the blood is becoming available. It might take a few minutes to get generic blood and perhaps five to fifteen minutes to collect and find the group. Of course, these times are approximate, and since there are many other things contributing to blood type, if this is important (in a few circumstances) then they do an additional test mixing the patients blood with the proposed transfusion to rule out a reaction.
Consider donating blood - it really does save lives.
Interesting. I’m O- and I get regular ‘we want your blood’ messages from the transfusion service - is it true that this blood type is more common in the blood bank than it is in the population, because it is more highly sought?
The Red Cross explains why O-negative blood donations are highly valued.
When my newborn daughter was anemic, the ambulance taking her to nalal intensive care had O-negative blood stocked in case she needed a transfusion (she did, but not until after they typed her blood at the hospital). I would think this is pretty standard procedure for EMTs – you can’t bring a blood bank in the ambulance, so you’d stock a couple of units of O-negative in case the patient needs the blood before they get to the hospital.
Yes! I donate every 8 weeks. If you use the Red Cross app they send you an alert to let you know when your blood is delivered and to where. I’m saving lives in Akron 
Donating blood is awesome and I agree everyone who can, should!
That’s weird. I got a call from the transfusion service only a couple of hours after my post above, to tell me stocks of O negative are desperately needed