Question

A 35 year old O-negative male trauma patient receives a transfusion of two units of O-positive red blood cells before his blood type is known. After his typing is completed, he is switched to O-negative and he receives 6 additional type-specific RBC units. He survives and is transferred to the surgical ICU. Which of the following is TRUE regarding his situation?

a-He has an 80% chance of forming anti-D
b-He is at high risk for an acute hemolytic transfusion reaction
c-Blood bank case review is needed to find the reason for this error
d-He should immediately be given 20 vials of Rh Immune Globulin (RhIG)
e-He is unlikely to develop delayed hemolysis

Answer 1

The patient is at high risk for an acute hemolytic transfusion reaction after being administered O-positive red blood cells, despite being O-negative. A blood bank case review is necessary to investigate and prevent similar errors.

Step-by-step explanation:

The correct statement regarding the 35-year-old O-negative male trauma patient who received transfusion of O-positive red blood cells (RBCs) followed by O-negative RBCs is b-He is at high risk for an acute hemolytic transfusion reaction. This situation arises because the patient, being Rh-negative, was exposed to Rh-positive blood, which could lead to the formation of anti-D (Rh) antibodies against the Rh antigen. Since he already received Rh-positive blood, Rh Immune Globulin (RhIG) would not prevent the sensitization process that could have already occurred. Additionally, there's a potential risk of an acute hemolytic transfusion reaction due to the immediate immune response against the Rh-positive cells.

Furthermore, given the gravity of the situation, where a blood bank case review is warranted, the personnel involved have to analyze the processes and decisions leading to the administration of Rh-positive blood, ensuring such an incident does not reoccur.