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If the leader of a spell being cast with ritual spellcasting (see p. 295, SR5) knows the Sacrifice metamagic, they may use it during the ritual to generate Blood Magic
Blood Spirit Invocation
A magician who knows the metamagic techniques of Sacrifice and Invocation may create a truly frightening entity—a great form blood spirit. This is done with a Summon Great Form Spirit ritual (see p. 136) as per normal, with one exception. During the ritual, a metahuman victim must be killed; this is required to fuel the ascension of the blood spirit. If the summoning granted a Greater Power, the blood spirit gains the unique power of Hemorrhage.
Action: Complex Type: P Range: [Magic] meters Duration: Instant
With this frightening power, the spirit is able to burst blood vessels and rupture veins inside any living beings in close proximity. Make a Magic + Willpower [Force] vs. Strength (unaugmented) + Willpower Opposed Test for every living thing within range of the effect. Each net hit the spirit achieves causes one box of unresisted Physical damage. Additionally, all targets that took at least one box of damage are wracked with extreme pain. Treat the damage as if it had the Nausea effect (p. 409, SR5). Targets are incapacitated by this effect only if the number of boxes inflicted exceeds their Willpower.