Case 120 – Update 2!

Thanks for everyone’s contributions so far!

Our 57 year old female patient is haemorrhaging following a road traffic accident. The multidisciplinary team are trying to establish source control of the bleeding. The major haemorrhage protocol has been activated. She has received packed red cells and FFP in a 1:1 ratio. She has received the following products:

  1. 4 units packed red cells: 1 unit Group O D negative, 3 units Group O D positive
  2. 4 units FFP: 2 units Group AB and 2 units Group A (negative for high-titre anti-B)

The baseline blood results are now available:

Hb 81, Plts 60, WCC 5. PT 19, APTT 42, Clauss Fib 1.4

The ABO group and D status result is available for interpretation (antibody screen in progress):

Forward Group Reverse Group
Anti-A Anti-B Anti-D1 Control A1 cells B cells
5 0 5 0 0 5

Questions:

  1. What ABO group is this patient? What is the Rh D status?
  2. What is the potential impact of the potential blood products that have already been given? How would you manage this?

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