Page 106 - ATP-P 11th Ed

Indications
If the patient is in shock, especially in the presence of known or suspected non- compressible
SECTION 1 hemorrhage, then resuscitate IAW the most current CoTCCC guidelines.
Overview
1. Whole blood (WB) is blood that has not been modified except for the addition of an
anticoagulant. WB provides the equivalent of fresh frozen plasma (FFP), RBCs, and
platelets (PLTs) in a 1:1:1 ratio. FWB will have a shelf-life of 24 hours and should be
transfused immediately or stored at 33–43° F (1–6° C) within 8 hours after collection,
unless otherwise directed by medical staff due to insufficient or no red blood cell (RBC)
or plasma product inventory. It should be tested with rapid test kits to decrease the risk
of infectious disease transmission. Identify a blood donor who is ABO identical with
the intended recipient.
2. WB is sometimes referred to fresh whole blood (FWB) if it has been recently collected.
However, there is no time standard as to when it is no longer considered to be fresh. It
is also referred to as warm fresh whole blood (WFWB) when it is still warm following
collection. WB is separated into different components.
Any separated component, including RBCs or packed RBCs (PRBCs), is consid-
ered a blood component and therefore CANNOT be correctly referred to as blood.
Blood refers to WFWB, FWB, and WB.
3. The following are in use by SOF medics.
a. Fresh frozen plasma (FFP)
b. Packed red blood cells (PRBCs)
c. Warm fresh whole blood (WFWB)
d. Fresh whole blood (FWB)
e. Whole blood (WB)
f. Freeze dried plasma (FDP)*
*FDP is being used under an investigational new drug (IND) protocol within USSOCOM.
This is the ONLY authorized manner by which FDP can be administered in a role I setting.
4. Prior to initiation of transfusion, the following will be checked:
a. Vital signs (T, P, R, BP). Measure, evaluate and record baseline vital signs. Every
effort should be made to monitor temperature as an increase in temperature may be
the first indicator of a transfusion reaction.
b. Casualty blood type should be confirmed.
i. In an emergency, establish ABO/Rh of recipients and donors via local testing or
previous testing.
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ii. EldonCard tests should ONLY be used to confirm previous results obtained
using the ABO/Rh test tube method.

96 SECTION 1 TACTICAL TRAUMA PROTOCOLS (TTPs) ATP-P Handbook 11th Edition 97