Low-Titer Group O Whole Blood in Pediatric Severe Bleeding

Evidence Supporting Use in Pediatric Trauma

• Group O RhD negative blood should be immediately available and transfused when hemorrhage is life-threatening, with Group O RhD negative prioritized for children and women of childbearing potential, as recommended by the Anaesthesia guideline society 1

Current Guideline Framework for Emergency Transfusion

• Major hemorrhage protocols should result in immediate release and protocolized administration of blood components without prior approval from a hematologist, according to the Anaesthesia guideline society 1
• In massive bleeding situations, patients have minimal circulating antibodies and will usually accept group-specific blood without reaction, as stated by the Anaesthesia guideline society 2, 3, 4

Clinical Application in This Case

• The child meets criteria for massive transfusion protocol activation given hemodynamic instability and positive FAST examination, as per the World Journal of Emergency Surgery guideline society 5
• Group O RhD negative LTOWB is preferred for this pediatric patient, as recommended by the Anaesthesia guideline society 1