Page 105 - ATP-P 11th Ed

ADMINISTRATION OF BLOOD
AND BLOOD COMPONENTS PROTOCOL

SPECIAL CONSIDERATIONS SECTION 1
1. Blood and blood components should only be administered by personnel who are
trained in the proper procedure and the identification and management of trans-
fusion reactions. As little as 30mL of incompatible blood or red blood cells
(RBCs) can cause a fatal hemolytic reaction.
2. Whole blood must be ABO compatible.
3. You must have a plan if you intend to use whole blood. You may use a strategy
of type A for type A and type O low titer in order to maximize the donor pool or
type O low titer as a “universal donor.” You may use type specific if you are
47
absolutely certain of the blood types. In extremis, type O, non-titered whole
37
blood may be used. The consequences of infusing a unit of possibly high titer
fresh whole blood far outweigh the risk of patient death if a transfusion is not
performed. 35,36,46
4. Once you begin transfusion type O blood, if the patients’ blood type is not type
O you may not switch to any other type. Doing so can cause a fatal hemolytic
reaction.
5. Use only collection bags designed for the collection of whole blood (WB) and
administration sets designed for the administration of blood and blood compo-
nents. Failure to do so may lead to fatal thromboembolic events.
6. The only solutions approved by the FDA and AABB for use with blood and
blood components are normal saline (NS) and Plasma-Lyte A pH 7.4. Although
lactated Ringer’s (LR) and other solutions have been shown to be compati-
ble under certain circumstances, they are not approved for use by the FDA or
AABB. 1-4
7. Any time an incompatible solution has been administered use a new catheter and
administration set or flush the catheter and administration set with 50mL of NS
before administering blood.
8. Sterile technique must be followed when performing transfusions in the field to
prevent subsequent infection.

PB SECTION 1 TACTICAL TRAUMA PROTOCOLS (TTPs) ATP-P Handbook 11th Edition 95