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Group O Rh-Negative Red Cells
Updated July 7, 2016
Mandatory Indications: Intrauterine transfusions
- (Deb Lane) Should read ‘Intravasular transfusions (IVT)’ that depend on mother’s antibodies
Have added in IVT as one of the kinds of IUT.
Highly Recommended Indications: Group O-negative neonates and children < 18 years of age
- (Deb Lane) Should read ‘Group O-negative female neonates and children’
Changed in document
Highly recommended indications: Emergency issue for neonates and children < 18 years of age when blood group is unknown
- (Susan Nahirniak) Why are we concerned about male pediatric patients having to receive O negative unmatched blood? This issue was changed in the local (AB) policy. Should read ‘females < 18 years of age’
- (Debra Lane) Agree with ‘females < 18 years of age’. This was changed in MB as well. The basis may have been a CSTM standard at one time.
- (Debra Lane) Should read ‘ Emergency issue for females less than 45 years of age’
- (Brian Muirhead) Agrees with Debra and Susan above.
- (Donna Ledingham) As for young males, it could go either way. Given the likelihood of a trauma in males aged 16-30, prefer not to start them off with anti-D which might make the situation more difficult later.
Changed bullet to read: Group O-negative females <18 years of age…but then realized that this was covered within the mandatory indications section, so deleted bullet.
Possibly Acceptable Indications
- (Jen Fesser) Instead of ‘possibly’ should read ‘generally’
Changed in document
Likely Unacceptable Indications: O-positive patient for whom a historical blood group is unavailable
- (Bob Coupland) Drop the very last bullet since it is unnecessary and non-patient centered in its intent and outcome. We will immediately be giving Rh pos blood to all Rh neg patients if they do not fit one of the approved categories.
- (Deb Lane) Should read ‘The indication should be based on sex and age’.
- (Jen Fesser) Should this be ‘O Rh positive patient for whom a historical blood group is unavailable, so long as the patient is not female of child-bearing potential?’
- (Irene Sadek) Need to clarify if the patient is already known O pos but there is no historical group for confirmation OR where the patient’s blood group is unknown.
- Agree with Bob Coupland if the blood group is unknown, would not consider transfusing O neg to be unacceptable practice as it is patient centred and safer for the patient. Should be in the same category as ‘Possible Acceptable Indications’, remove it or qualify it.
- Add under ‘Unacceptable Indications’ transfusing O neg blood to O pos patient because units are approaching expiry.
- (Donna Ledingham)- Agrees with Coupland and Sadek above.
Last bullet has been deleted.
Have added in “Non-O-negative patient because unit is approaching expiry”
Likely Unacceptable Indications: O-negative males without anti-D requiring a large volume transfusion (> 8 units)
Likely Unacceptable Indications: O-negative females (older than child bearing age) without anti-D requiring a large volume transfusion (>8 units)
- (Bob Coupland) Alter these statements to say that ‘any male without anti-D’ and ‘any female without anti-D’. Consider having a 4 or 6 U limit for those same age/gender category patients with unknown blood group as a time for considering switching to O pos if there is on-going bleeding and a blood group was still not available as the time point to change groups. This change would encourage conservation of the blood supply at an early active decision in every case.
- (Brian Muirhead) Agrees with 4-6 units.
- Instead of ‘Likely Unacceptable’ for O neg, we should be saying ‘indications for O pos’.
Have changed first two bullets to address comments (addition of “any” and changed “8“ to “4-6”.
Have added in “indications for O-positive red cells” to heading.
Other changes
Graph has been updated with recent figures