Which blood group can be used in an emergency or when the desired blood group is not available?

Appeared in: AIIMS Delhi NO - 2017

Explanation

Blood group O is considered the universal donor because its red blood cells (RBCs) lack both A and B antigens.
In an emergency, transfusing O-type blood minimizes the risk of an immune reaction, as there are no antigens for the recipient's antibodies to attack.
Specifically, O-negative blood is the universal donor type used in emergencies when the patient's blood type is unknown to prevent acute hemolytic transfusion reactions.
The recipient's plasma contains anti-A and anti-B antibodies, but since O-type donor cells have no A or B antigens, no agglutination (clumping) occurs.

Option A: Blood group B has B antigens on its red blood cells and anti-A antibodies in the plasma. It cannot be given to patients with blood types A or O, as their antibodies would attack the B antigens.
Option B: Blood group AB has both A and B antigens on its red blood cells. It can only be given to another person with AB blood. Giving it to any other blood type (A, B, or O) would cause a severe immune reaction.
Option C: Blood group A has A antigens on its red blood cells and anti-B antibodies in the plasma. It cannot be given to patients with blood types B or O, as their anti-A antibodies would destroy the transfused cells.

Clinical Relevance

Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Blood group compatibility and the universal donor principle in emergency transfusions in acute care settings.
In an emergency, a nurse's priority is patient safety. Using O-negative blood when a patient's type is unknown is a critical life-saving measure that prevents fatal transfusion reactions.
Nurses are responsible for the 'two-person verification' process at the bedside, checking the blood product against the patient's identification to ensure the correct blood is given to the correct patient.
What if the patient is a woman of childbearing age? It is crucial to use O-negative blood (not O-positive) to prevent Rh sensitization, which could cause hemolytic disease of the newborn in future pregnancies.

How to Approach the Question

First, identify the core question: which blood group is safe in an emergency without matching?
Recognize that this question is asking for the 'universal donor'.
Recall the principles of the ABO blood group system. The universal donor is the blood type that lacks antigens on its red blood cells, which prevents an immune reaction in the recipient.
Identify that blood group O has no A or B antigens.
Therefore, select 'O' as the correct answer for emergency transfusions.

Concept Tested & Keywords

Concept Tested: Blood group compatibility and the universal donor principle in emergency transfusions.
Stem keywords: blood group, emergency, transfusion
Lead-in keywords: Which
Clinical cues: The care setting changes urgency, monitoring level, and the expected nursing action.
Negative lead-in flag: false

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E6 Physiology Essentials Sembulingam 10e Part 1 p. 146-148

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