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Remote Dispensing of Emergency Release Red Blood Cells.
Stephanie A Whiteneck1, Stephanie Lueckel2, Jonathan H Valente3
1Department of Coagulation and Transfusion Medicine, Lifespan Academic Medical Center and the Alpert Medical School of Brown University, Providence, RI, USA.
American Journal of Clinical Pathology
|August 9, 2022
Summary
Emergency release (ER) group O red blood cells (RBCs) are transfused to patients with acute bleeding. While generally safe, a study found a 0.4% rate of acute hemolytic transfusion reactions (AHRs), highlighting the need for improved safety measures.
Area of Science:
- Transfusion Medicine
- Hematology
- Patient Safety
Background:
- Emergency release (ER) group O red blood cells (RBCs) are commonly used for patients with acute bleeding.
- This transfusion practice has been associated with a low incidence of acute hemolytic transfusion reactions (AHRs).
Purpose of the Study:
- To evaluate the safety and incidence of AHRs associated with ER RBC transfusions.
- To identify potential risk factors and mitigation strategies for ER RBC-associated AHRs.
Main Methods:
- Retrospective review of patients receiving ER RBCs over 30 months.
- Utilized electronically connected satellite refrigerators (ECSR) in the emergency department (ED) for improved compatibility checks.
- Technologists cross-referenced patient identification with serologic records before transfusion.
Main Results:
- 935 patients received 1,847 units of ER RBCs.
- 30 patients had existing RBC antibodies; 15 incompatible units were interdicted.
- Four cases of AHR (0.4%) occurred in six urgent transfusions, including one fatality due to anti-KEL1.
Conclusions:
- Electronically connected satellite refrigerators (ECSR) and KEL1-negative RBCs show promise in reducing ER RBC-associated AHRs.
- Further consideration of these strategies is warranted to enhance transfusion safety.
