If the urgency of the blood requirement precludes completion of standard compatibility testing before release of Red Blood Cells for transfusion during an emergency, this will be noted on the Transfusion Record Form. An Emergency Request section of the Blood Bank Requisition Form must be signed by the responsible physician to authorize the issuance of blood without compatibility testing during an emergency. It is not absolutely necessary that the physician's signature be obtained prior to transfusion, but it will be required eventually. In most emergency situations involving hypovolemic patients, the treating physician will transfuse volume expanders immediately, thereby allowing Blood Bank personnel sufficient time to complete standard compatibility testing. If emergency use of blood is anticipated, direct consultation with Blood Bank personnel will expedite the provision of the required blood components.
Several options are available for obtaining blood under emergency circumstances.
As the amount of compatibility testing decreases, the possible risk of transfusing incompatible blood increases. It also must be noted that many hemolytic transfusion reactions have occurred under emergency conditions when routine patient identification procedures are ignored or circumvented. However, a blood sample should be drawn for typing and crossmatching before transfusion is initiated. Blood Bank personnel will proceed with crossmatching of additional units of blood with the patient's blood specimen and provide group and type specific blood as soon as possible. The use of type specific blood in these situations, rather than group O Red Blood Cells, conserves group O Red Blood Cells for those patients who must receive it.