One drug that we occasionally need to give in trauma patients is Rho-Gam (immune globulin to Rh).
The inication for this drug is to prevent Rh isoimmunization in Rh negative individuals who are exposed to Rh positive blood.
Most commonly, we consider giving this to pregnant trauma patients who are found to be Rh negative. Even minor trauma may cause fetomaternal blood transfusion which may sensitive an Rh negative mother to make antibodies against her Rh positive fetus.
Any time a pregnant patient sustains trauma, we should determine her Rh status.
Another situation that we think about less commonly is the trauma patient (male or female) who has received a massive transfusion. A patient may require non-cross-matched blood at the beginnning of their resuscitation and often this may consist of one or more units of Rh positive blood for male patients. If a patient is later found to be Rh negative, they should also receive RhoGam. The dose of RhoGam varies with the amount of blood that is actually transfused.
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