ESTABLISHMENT OF URGENT TRANSFUSION ORGANIZATION IN A GENERAL HOSPITAL-EXPERIENCE WITH TYPE O BLOOD USAGE IN AN EMERGENCY ROOM-

To prevent delays in transfusion and the development of hemolytic transfusion reactions at the emergency room of a local hospital, we implemented a Type O blood usage program for life-threatening bleeding patients in August 2001 according to Japanese government guidelines for transfusion. To better understand actual conditions for urgent blood transfusion before and after implementation of this program, we surveyed the time between ordering to the start of transfusion, shock index at the start of transfusion, total volume of transfused blood, causes of death, irradiation of blood, side effects, and reasonable adaptation of transfusion. Results showed the time between ordering to the start of transfusion shortened to 9.3 minutes from 62.2 minutes after implementation. There was no case in which non-irradiated blood unit, was transfused, nor of incompatible blood transfusion following cross matching. Further, there was no increase in workload following implementation of the Type O blood usage program. In conclusion, Type O blood usage programs can dramatically save time between ordering to the start of transfusion. However, they carry risks such as Rh-positive blood transfusion to Rh-negative patients (about 0.5%) and antigen-positive blood transfusion to patients positive for irregular antibodies (about 1.3%). Adaptation of this transfusion must be carefully controlled. All patients receiving type O blood transfusion should be investigated for suitability after transfusion.