I didn't know it was a series -- I'd only read Clone Home. Thanks!

A) would they have the entire missing amount transfused or just however many whole pints are missing?

Losing enough fluid to warrant a transfusion almost always means that the person is in hypovolemic shock, which is a body-wide lack of oxygenated blood due to extremey low blood pressure. It has the most immediate effect on the kidneys, often causing acute renal failure due to lack of blood flow. It also disturbs the body's pH value as the cells switch from aerobic to anaerobic production of energy, resulting in lactic acidosis.

Resuscitation is usually begun with two or three liters of normal saline or lactated Ringer's solution, pushed in as fast as it will go. (Quite literally, the person in the trauma room responsible for giving fluids will squeeze the bag in their hands to get it in faster.) Many times this will stabilize the person enough so they can wait for their own blood type to arrive from the blood bank. Then they'll get that infused in slowly over the course of a few hours provided their vital signs remain stable.

If the person has lost 30-40% of their blood volume or more, they'll get one or two liters of normal saline and two pints of O negative blood pushed in as fast as it will go, and then their own blood type.

Replacing all the fluid lost with just blood can cause clotting; won't normalize levels of sodium, potassium, and carbon dioxide, all of which are vital to life; and vastly increases the risk of a transfusion reaction.

B) How long until they were feeling up to normal activity?

If they live through the initial resuscitation--as many as 50% don't survive a loss of greater than 40% of their fluid volume--a good long while, especially if they required intubation and ventilation during the resuscitation. Weaning someone off a ventilator can take weeks. If their kidneys fail during shock, they'll have weeks of dialysis before the kidneys begin to work again. They'll be exhausted, because the level of red blood cells and thus oxygen in their blood (called hematocrit) will take a while to get back to normal levels, and their electrolyte balances will be all out of whack, resulting in lots of different problems. Muscle cells which were deprived of oxygen and died during the shock, will need replacing, and physical therapy will be required.

Having all the blood sucked out of you is one of the most fatal things that can happen to a person, and the recovery is difficult and long if it's possible at all. A month in the ICU and a few more months on a medical floor are common.

Eeek. Remind me not to get exsanguinated, K?

Crap. He's not getting out of the hospital the next day, then. The folks on little_details were going "Well, one pint is what they take for donation, and that's not so bad, so two pints wouldn't be that much worse would it?"

Losing two pints is roughly equivalent losing a liter of blood, which is about 15% of the total blood volume of six liters. That's actually quite easily compensated provided you drink some water and don't run a marathon immediately afterwards.

The problems I talked about before don't start until you lose more than 15% of total fluid volume, and the problem gets worse as more fluid is lost.

I found the following here:

Class I hemorrhage corresponds to a less than 15% blood volume loss and generally is well tolerated. Blood donors fall into this category. Treatment is oral rehydration or judicious use of IV fluids. These patients do have a diminished intravascular volume, but generally compensate well enough to have no classic physical signs of shock.

Class II hemorrhage is a 15%-30% volume loss. These patients generally will have tachycardia, anxiety and a lowered urine output. These are the first signs of shock. In these cases, prompt control of bleeding and resuscitation with IV crystalloid solutions are essential.

Class III hemorrhage is a 30%-40% blood loss. These patients will have a decreased blood pressure, tachycardia, minimal urine output and confusion. Such patients are unable to compensate for their volume loss. Control of bleeding and rapid resuscitation are essential to prevent later multiple organ dysfunction and death. This group of patients requires blood transfusion and may require surgical intervention to stop the source of bleeding.

Class IV hemorrhage is a greater than 40% blood loss and is rapidly fatal in all patient age groups.

So I guess it depends on how much blood is "a lot of blood" when lost to a vampire. Is your vampire character able to control him- or herself well enough to take less than 15%? If so, the victim will be good as new later that day. If it's more than that, things get dicey.

So if two pints are taken, would they bother transfusing that? That may be the problem. I can work around him not getting a transfusion, reword it to, "YOu've lost about two pints of blood, no running marathons for you, OK?"

Yes, the vampire did catch himself before he got more than a few good mouthfuls (Spike in my Career Advancement story). The fact that my victim was stone drunk at the time won't help how he feels the next day, either, so he can be good and woozy.

Ah! Sorry, I misunderstood the original question. Nope, two pints wouldn't warrant a transfusion, but if the victim does get to the hospital less two pints and still stone drunk, they'll definitely be given a liter of regular old normal saline IV; drinking dehydrates a person, and losing blood on top of that will make the person feel like reheated ass. They'll definitely be woozy and tired the next day.

Perfection. Thank you so much!

I want to go home and write! Or stay here at work and write, because the workplace makes my mind more focused on, well, working. My muse has set up a projector in my head and the next scenes are playing on the backs of my eyeballs. I keep getting distracted by character voices pitching witty dialogue at each other. But I need to work--and work with more focus than I currently am.

Dehydrated and drunk is no way to go through life, FlounderXander.

I wonder what it says about me that I bookmarked Jen's post just in case I should ever need that information.