title: A case for stocking O D+ red blood cells in emergency room trauma bays.
abstract: BACKGROUND
  AABB Standard 5.27 requires transfusion services to have a process for urgent release of blood before completion of compatibility testing. Our institution endorses a policy for the emergency release of group O, D+ red blood cells (RBC; O+ RBC) to males and females at least 50 years of age. Our emergency department (ED) stocks 4 O- RBC units. To determine if O+ RBCs can replace ED O- RBCs, we performed a retrospective review.
  
  
  METHODS
  Patients admitted to the ED between January 2001 and August 2011 and transfused emergency-release O- RBCs were identified. Data were collected on sex, age, length of stay, clinical status, ABO/Rh, RBC transfusions, and RBC antibody screen results.
  
  
  RESULTS
  A total of 498 ED O- RBC units were transfused to 268 patients (168 male, 100 female). A total of 322 units were transfused to males and 114 to females at least 50 years of age. Thirty-nine (14%) were D- with 18 receiving O+ RBCs. A total of 109 had follow-up antibody screens; one D- patient developed alloanti-D.
  
  
  CONCLUSIONS
  The findings support the placement of O+ RBCs in the ED. The majority of ED O- RBCs (88%) went to patients who qualified for O+ RBCs; a minority (1.5%) of patients were D- females less than 50 years of age. The rate of alloimmunization was low.
authors.affiliation: Joint Fellowship Program in Transfusion Medicine & Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.|Harvard Medical School, Boston, Massachusetts.
authors.forename: Erin
authors.initials: E
authors.lastname: Meyer
authors.affiliation: Joint Fellowship Program in Transfusion Medicine & Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.|Harvard Medical School, Boston, Massachusetts.
authors.forename: Lynne
authors.initials: L
authors.lastname: Uhl
mesh_terms: D000017:ABO Blood-Group System / Q000032:analysis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001787:Blood Group Incompatibility / Q000097:blood / Q000276:immunology / Q000517:prevention & control*; D001788:Blood Grouping and Crossmatching; D004630:Emergencies; D004636:Emergency Service, Hospital; D017707:Erythrocyte Transfusion / Q000009:adverse effects; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D007518:Isoantibodies / Q000097:blood; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012204:Rh-Hr Blood-Group System / Q000032:analysis / Q000276:immunology*; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000150:complications / Q000401:mortality
chemical_list: D000017:ABO Blood-Group System; D007518:Isoantibodies; D012204:Rh-Hr Blood-Group System; C026410:Rho(D) antigen