Hematology Question 22 Instructor

A 31 year old healthy woman (G2P2) is seen in the ER post motor vehicle accident. She has numerous contusions, is conscious and can move her limbs. She complains of severe abdominal pain. A FAST ultrasound illustrated a liver laceration and splenic rupture. Her BP is 74/40 and her HR is 148 bpm. She is on a face mask and is becoming increasingly delirious.

What type of blood should she be transfused immediately and why?

Ideally, female patients of childbearing age should be given Rh negative blood to minimize allo-immunization to the Rh factor in case of future pregnancy and risk of hemolytic disease of the newborn.

Patients who cannot wait for a group and screen or cross match should be given group O blood. This blood has no A or B antigen on its RBC surface. Thus blood group “O” patients are universal donors and there should be no risk of ABO mismatch.

She required an urgent splenectomy. What immunizations are required?

Immunizations are required to protect against encapsulated organisms against Strep pneumonia, N. Meningitides, and H. flu.

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