# Three questions about blood transfusions **URL:** \ **Category:** Factual Questions\ **Created:** [April 27, 2015, 8:22pm UTC](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670 "2015-04-27T20:22:42Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\ **Post date:** [April 27, 2015, 8:22pm UTC](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670/1 "2015-04-27T20:22:42Z")
If the patient was anemic or suffered blood loss, does it feel like the transfusion makes their strength return within an hour or two? Why do some patients in emergency care require dozens or even hundreds of units of blood? Is it because of injuries that keep leaking blood? Finally, an IMHO type question, but the idea of having someone else’s blood go into my bloodstream seems creepy to me. (Just FYI, I’m healthy and don’t need any transfusion right now.) I’m sure, of course, that if I ever \*need \*a transfusion, I’ll be very grateful and too sick or injured to care. But for any Dopers here who have had a transfusion, did it feel weird? ---
**Author:** ![running\_coach](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/running_coach/32/15836_2.png) [@running\_coach](https://boards.straightdope.com/u/running_coach)\ **Post date:** [April 27, 2015, 8:29pm UTC](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670/2 "2015-04-27T20:29:57Z")
> [@Velocity](#): > > Why do some patients in emergency care require dozens or even hundreds of units of blood? Is it because of injuries that keep leaking blood? That was it in my case. Broken femur and a degloving of the back of the thigh along with an avulsed hamstring. Took 75 units in the first two days. ---
**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\ **Post date:** [April 27, 2015, 8:33pm UTC](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670/3 "2015-04-27T20:33:56Z")
> [@running\_coach](#): > > That was it in my case. Broken femur and a degloving of the back of the thigh along with an avulsed hamstring. > Took 75 units in the first two days. Thanks…but where did the other 74 units go, so to speak? Was it bled internally into the body, which is of limited internal space? Or all bled out onto the bed and sheets, etc? Sorry for the really direct question, but this is what’s confusing me. ---
**Author:** ![running\_coach](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/running_coach/32/15836_2.png) [@running\_coach](https://boards.straightdope.com/u/running_coach)\ **Post date:** [April 27, 2015, 8:41pm UTC](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670/4 "2015-04-27T20:41:57Z")
Since the broken ends of the bone were exposed to the air, any bleeding was out and gone (and the femur is very vascular) plus the torn/mangled muscle and skin. I really don’t know how they dealt with the bleeding in the hospital, I was in an induced coma by then. ---
**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\ **Post date:** [April 27, 2015, 8:45pm UTC](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670/5 "2015-04-27T20:45:20Z")
> [@running\_coach](#): > > Since the broken ends of the bone were exposed to the air, any bleeding was out and gone (and the femur is very vascular) plus the torn/mangled muscle and skin. > I really don’t know how they dealt with the bleeding in the hospital, I was in an induced coma by then. Thanks, I see. So they infuse blood to keep the blood level adequate in the short term while trying to stop the hemorrhage. ---
**Author:** ![Yllaria](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/yllaria/32/3452_2.png) [@Yllaria](https://boards.straightdope.com/u/Yllaria)\ **Post date:** [April 27, 2015, 10:47pm UTC](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670/6 "2015-04-27T22:47:59Z")
> [@Velocity](#): > > If the patient was anemic or suffered blood loss, does it feel like the transfusion makes their strength return within an hour or two? . . . I’d guess that it’s complicated, but that you don’t generally get a two hour trip to just feeling better. In the case of anemia, it’s not just your blood that’s been low iron, the rest of your tissues have been shorted for long enough to cause symptoms and get the diagnosis. It’s going to take awhile to fix that, although maybe you could feel the difference after one sleep cycle. In the case of blood loss, there was a reason that you lost blood and your body is going to have to deal with that. If it was a single, sharp cut that just happened to hit a major vein, then blood loss might be your main problem. But odds are that you’re going to need surgery and they’re probably going to have to go deep enough that you’ll need general anesthesia. Just recovering from the anesthesia is going to keep you from feeling 100% for at least one day. Damn, **running coach**. That was a nasty one. I’m glad those 75 units were there. ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [April 27, 2015, 11:08pm UTC](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670/7 "2015-04-27T23:08:14Z")
If it’s any comfort, red blood cells and blood plasma (what you’re mostly getting if they’re transfusing you in the trauma center) don’t contain any DNA, so in a sense, it’s not “someone else’s blood”. It’s just blood, the same as what you already have. ---
**Author:** ![Springtime\_for\_Spacers](https://avatars.discourse-cdn.com/v4/letter/s/a3d4f5/32.png) [@Springtime\_for\_Spacers](https://boards.straightdope.com/u/Springtime_for_Spacers)\ **Post date:** [April 28, 2015, 3:30am UTC](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670/8 "2015-04-28T03:30:28Z")
I don’t know how many units I was given whilst my broken ankle was being repaired but, as I had an epidural I do know that a fair amount ended up splattered over my surgeon’s chest! (I had an epidural so I was conscious throughout. They had screens up so I couldn’t actually see what he was doing but he did step to the side a couple of times. I was also high as a kite from painkillers so the whole thing was surreal and far more interesting than upsetting.) ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [April 28, 2015, 6:53am UTC](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670/9 "2015-04-28T06:53:44Z")
> [@running\_coach](#): > > Since the broken ends of the bone were exposed to the air, any bleeding was out and gone (and the femur is very vascular) plus the torn/mangled muscle and skin. > I really don’t know how they dealt with the bleeding in the hospital, I was in an induced coma by then. On top of that, transfused blood has citrate in it to prevent it from clotting prior to transfusion, so it’s not going to clot like “your” blood. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [April 28, 2015, 6:55am UTC](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670/10 "2015-04-28T06:55:59Z")
> [@Velocity](#): > > If the patient was anemic or suffered blood loss, does it feel like the transfusion makes their strength return within an hour or two? I’ve never had a transfusion, but people I’ve spoken to who have said that they felt better almost immediately. Whether it was from the blood itself or the volume expansion probably depends on the person and overall situation. I’m thinking in particular of a former co-worker who had slow blood loss from excessive menstrual bleeding, and she said she didn’t realize just how terrible she felt until after she had her transfusion. She had a hysterectomy not long afterwards. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [April 28, 2015, 6:59am UTC](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670/11 "2015-04-28T06:59:51Z")
> [@Chronos](#): > > If it’s any comfort, red blood cells and blood plasma (what you’re mostly getting if they’re transfusing you in the trauma center) don’t contain any DNA, so in a sense, it’s not “someone else’s blood”. It’s just blood, the same as what you already have. Remember last fall when several American Ebola patients got plasma transfusions from the first one, Dr. Brantly? Some of us wondered just how much of the plasma they got was “his” to begin with, because it’s quite likely that at some point, he was having O-negative dumped into him by the gallon, and all those cases came along within a matter of weeks afterwards. IDK how rapidly plasma recirculates, but I do know that RBCs last about 4 months after formation. ---
**Author:** ![usedtobe](https://avatars.discourse-cdn.com/v4/letter/u/ec9cab/32.png) [@usedtobe](https://boards.straightdope.com/u/usedtobe)\ **Post date:** [April 28, 2015, 7:49am UTC](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670/12 "2015-04-28T07:49:22Z")
I was “ashen” and the folks in the ICU expected me to die. 14 hours later, I walked out on my own power to my home 1/4 mile away. 3 units following massive hemorrhage. Th effect in my case was immediate - had I still been leaking, it would not have had the same effect. It’s a matter of oxygen getting back to brain which causes the alertness. ---
**Author:** ![bob\_2](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bob_2/32/3341_2.png) [@bob\_2](https://boards.straightdope.com/u/bob_2)\ **Post date:** [April 28, 2015, 8:27am UTC](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670/13 "2015-04-28T08:27:21Z")
And of course there is that thing athletes did - Blood doping - now banned. > **[What is Blood Doping?](https://www.livescience.com/32388-what-is-blood-doping.html)** > > Blood doping increases an athlete's red blood cell count and boosts performance. > [@](#): > > Blood doping refers to a handful of techniques used to increase an individual’s oxygen-carrying red blood cells, and in turn, improve athletic performance. The most commonly used types of blood doping include injections of erythropoietin (EPO), injections with synthetic chemicals that can carry oxygen, and blood transfusions, all of which are prohibited under the World Anti-Doping Agency’s (WADA) List of Prohibited Substances and Methods. ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [April 28, 2015, 1:29pm UTC](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670/14 "2015-04-28T13:29:03Z")
> [@](#): > > Quoth **Springtime for Spacers** : > > I don’t know how many units I was given whilst my broken ankle was being repaired but, as I had an epidural I do know that a fair amount ended up splattered over my surgeon’s chest! > > (I had an epidural so I was conscious throughout. They had screens up so I couldn’t actually see what he was doing but he did step to the side a couple of times. I was also high as a kite from painkillers so the whole thing was surreal and far more interesting than upsetting.) Not necessarily a good indication. You can make a huge mess with a very small amount of blood. Properly applied, a thimbleful of blood can turn an entire room into a gory mess. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [April 28, 2015, 10:54pm UTC](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670/15 "2015-04-28T22:54:39Z")
FTR, “slow leaks” (i.e. chronic blood loss) is more dangerous than an acute hemorrhage. Example: I used to work with a woman who lost about half her blood volume immediately after giving birth, and she didn’t have a transfusion. 😕 They did give her albumin, and had her take extra iron for a while afterwards. ---
**Author:** ![running\_coach](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/running_coach/32/15836_2.png) [@running\_coach](https://boards.straightdope.com/u/running_coach)\ **Post date:** [April 28, 2015, 10:59pm UTC](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670/16 "2015-04-28T22:59:07Z")
> [@nearwildheaven](#): > > FTR, “slow leaks” (i.e. chronic blood loss) is more dangerous than an acute hemorrhage. > > Example: I used to work with a woman who lost about half her blood volume immediately after giving birth, and she didn’t have a transfusion. 😕 They did give her albumin, and had her take extra iron for a while afterwards. I doubt that. I lost half my volume at the scene and the paramedics didn’t think I would live long enough for the helicopter to arrive. ---
**Author:** ![KarlGauss](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/karlgauss/32/3713_2.png) [@KarlGauss](https://boards.straightdope.com/u/KarlGauss)\ **Post date:** [April 29, 2015, 12:55am UTC](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670/17 "2015-04-29T00:55:11Z")
> [@nearwildheaven](#): > > FTR, “slow leaks” (i.e. chronic blood loss) is more dangerous than an acute hemorrhage. I can’t give you that one. In fact, it’s pretty much the opposite. It’s not all that rare to see people come in to the hospital with hemoglobin levels around 4.0 (with normal somewhere in the 12 to 15 range) yet be virtually asymptomatic from it - maybe some are fatigued or ‘get winded easily’ but nothing dramatic. On the other hand, if someone lost 3/4 of their blood over 20 minutes or so, and went from 12 to 3, you’d bet they’d be symptomatic (if they were even alive). We are well designed to withstand chronic anemia. Indeed, on an evolutionary level it makes sense given all the different (and common) reasons there are to become anemic. If anyone is interested in the compensation mechanisms, look [here](http://www.openanesthesia.org/anemia_compensation/) or [here](http://www.cmaj.ca/content/suppl/2002/04/05/156.11.DC1/bk_rev_physiologic.pdf) (the latter cite being far more detailed). ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [April 29, 2015, 3:25am UTC](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670/18 "2015-04-29T03:25:26Z")
> [@running\_coach](#): > > I doubt that. I lost half my volume at the scene and the paramedics didn’t think I would live long enough for the helicopter to arrive. She was already in a hospital, on an IV, and her doctor was there, aggressively trying to stop the hemorrhage. Not being a physician, let alone there, I don’t know any further details. However, she too was very surprised that a transfusion wasn’t ordered. ---
**Author:** ![running\_coach](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/running_coach/32/15836_2.png) [@running\_coach](https://boards.straightdope.com/u/running_coach)\ **Post date:** [April 29, 2015, 3:31am UTC](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670/19 "2015-04-29T03:31:31Z")
> [@nearwildheaven](#): > > She was already in a hospital, on an IV, and her doctor was there, aggressively trying to stop the hemorrhage. Not being a physician, let alone there, I don’t know any further details. However, she too was very surprised that a transfusion wasn’t ordered. I have a feeling she didn’t lose nearly as much as she claimed. Half her volume would be 6-7 pints, nearly a gallon. ---
**Author:** ![usedtobe](https://avatars.discourse-cdn.com/v4/letter/u/ec9cab/32.png) [@usedtobe](https://boards.straightdope.com/u/usedtobe)\ **Post date:** [April 29, 2015, 3:38am UTC](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670/20 "2015-04-29T03:38:51Z")
“Blood Doping”, as done most famously by Lance, is made possible by kidney failure (I’m at stage IV) - the kidneys produce “EPO” (see previous post for spelling), which cause the bone marrow (femur esp.) to produce hemoglobin. In kidney failure, the EPO does not get produced. There were 2 treatments possible - transplant and dialysis. Then Genetech came up with artificial EPO (actually they have patents on 3 different synthetic EPOs.). The name used for any of them is “Epogen”. Last I heard it was $2500/week. Yes, Medicare covers it, even if you do not otherwise qualify for Medicare (my understanding). Osama bin Laden had kidney failure and still managed to live in a cave (home dialysis is now common). [Next page](https://boards.straightdope.com/t/three-questions-about-blood-transfusions/718670.md?page=2)