There are certain things you should condsider when blood is needed in an emergency, before full compatibility testing can be completed on the current valid sample.
In an emergency you should establish the blood group as soon as possible.
Blood tests for full blood count, coagulation screen and biochemistry should be taken at baseline and periodically to guide the need for blood and blood components.
You should seek advice from the local haematology team about additional blood product support if bleeding is ongoing.
You should seek early haematology advice for patients on anticoagulants or with known bleeding disorders.
Emergency red cells
Group O RhD negative red cells can be given in an emergency when the blood group is unknown. The following also may be issued:
- Uncrossmatched group O Rh D negative
- Uncrossmatched group O Rh D positive
- Uncrossmatched group-specific red cells
Emergency fresh frozen plasma
Group AB plasma or group A plasma that is high-titre negative can be given in an emergency when the blood group is unknown. Group AB plasma is universal but in short supply.
If transfusing Octaplas or Methylene Blue Treated FFP to patients of unknown group, group AB is used.
Group A fresh frozen plasma (FFP) that is labelled high-titre negative can be given to any blood group until the group is known.
Platelets of any group can be given to bleeding patients of unknown group.
If RhD positive platelets are given to RhD negative women under the age of 50 years, anti-D Ig may be required within 72 hours of the transfusion.
- Group A negative (or O negative platelets) that are labelled HT negative can be given to any blood group.
- In men and women aged over 50 years the D group doesn’t matter.
Major haemorrhage protocol
Local activation policies apply for major haemorrhage protocol (MHP):
- you should activate the MHP to obtain blood and blood components in an emergency where significant blood loss needs a rapid response without authorisation by a blood transfusion service (BTS) medic
Major surgical bleeding, major obstetric haemorrhage and Code Red traumatic major haemorrhage
You should refer to local policies to find out what steps to take.