Transfusing Blood Products

I can always count on Dale for great medical questions. Dale asks:

I was curious about blood transfusions. Sometimes in stories when a character gets a transfusion the writer messes it up, and of course those who do this sort of thing for a living know better. So how does a blood transfusion work, and what type of blood is universal?

Jordyn says:

The first thing is to determine the patient’s blood type. This is typically referred to as a “type and cross” if we know we are going to transfuse the patient.

When you donate blood, you’re giving whole blood and this is rarely used for transfusion. The blood bank splits the whole blood up into several components (after testing for infectious diseases) into packed red blood cells, platelets, cryoprecipitate, and fresh frozen plasma. Each of these four components would be in a different bag and are used for different reasons.

Transfusing blood products is relatively simple. We’ll take packed red blood cells. You get the bag of blood up from the blood bank. For adults, it resembles the bag they collect when you donate. For pediatric pateints, it comes up in a syringe at times because we give a lot less volume.

You can prime the tubing with just the blood product or with normal saline. We only use normal saline for transfusion as it won’t cause the cells to break and rupture like other IV fluids will.

All hospitals require a couple of double checks to ensure the correct blood is given to the right patient. This generally includes a check when picking up the blood product from the blood bank, and a double check against the patient’s blood ID band (which the patient should be wearing) at the bedside (nurse/nurse, nurse/doctor). Who double checks the blood at the bedside is co-signed on the transfusion record.

In the case of packed red blood cells, the infusion is typically given IV over four hours and the patient is closely monitored for several types of reactions. Different blood products are given over different lengths of time. Of course, if needed, the blood can be given very rapidly if the patient requires it due to hemorrhage.

There is no universal blood type. What you might be thinking of is this. O negative blood is the universal blood donor. Anyone can receive O negative blood and it is often used in emergency situations if a patient needs blood before a type and cross can be done. Type AB positive is the universal recipient. A person with this blood type can be transfused with any blood type.

Here’s a previous post about how blood type is determined: http://www.jordynredwood.com/2011/02/how-to-determine-blood-type.html.

Have you written a scene that has a blood transfusion?

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Here’s more about Dale in his own words:

My name is Dale Eldon, I am originally from Colorado Springs, and have spent most of my life in the Midwest. I am currently working on a four part sci-fi thriller series that takes espionage to the next level.
 In book one, two CIA agents fight to uncover the truth behind a terrorist related syndicate that seems to have their hands in a wide range of power across the country. Time is running out as the shadowy syndicate continues to practice dangerous experiments that could rip the space-time-continuum itself in half. The journey will go beyond personal sacrifice for a country; the world slowly through scientific manipulation is on the downward spiral to malicious hands.
 In book two, I will be focusing a lot on a FBI supervisory agent (profiler), who suffers from an unknown mental condition that is caused by one of these experiments. I had asked Jordyn to help me with some information on the medical side of what this character goes through.
 I am not yet published, but plan to be when I am finished writing my manuscripts. 

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