Page 80 - PJ MED OPS Handbook 8th Ed

2) Pelvic fracture
3) Multiple injuries
4) Proximal amputations (above knee or elbow)

Administer Blood Products Provided from Blood Bank/MTF
1. Inspect blood product for gas, discoloration, clots, foreign objects or sediment and no cracks or
leaks from the bag. Visually inspect the temperature indicator.
a. RED = UNACCEPTABLE
b. Blood products must be transfused within 4 hours of removal from storage container
2. Close all 3 clamps on Y tubing (under NO circumstances should non-filtered tubing be used), or
use single in-line filter tubing if available. Attach blood warmer if available.
3. Insert spike into blood product. Open roller clamp on administration line, allowing blood to
prime the line and fill half of the drip (upper) chamber. If there is a lower chamber completely fill
the lower chamber.
4. Confirm there are no air bubbles in the primed line.
5. Attach administration line to IV catheter.
6. Open roller clamp all the way and allow blood to flow wide open for patients in shock. If they
have 1 or more amputations and a radial pulse and are alert, start slowly over 10–15 minutes
and confirm no transfusion reaction (watch patient, check VS q5min × 2 or 3).

WARNING Under no circumstance will other medications or IV fluids (other than .9% NS) be
introduced through the transfusion line.

NOTE: The IV/IO port accommodating blood products may be utilized to introduce medica-
tions or IV fluids only if the blood tubing is disconnected and the port is flushed before and
after medication infusion.

7. Monitor vital signs at least every 15 minutes during the transfusion. Compare with baseline
vitals.
8. Observe for adverse reactions. If reaction occurs stop transfusion and identify/treat reaction.
9. Document IAW local procedures

Administer Freeze Dried Plasma (FDP)
Upon reconstitution, a bottle of French FDP is equivalent to 210mL of human plasma
FDP is reconstituted in the following manner:
1. Remove the protective capsules from the 2 flasks and disinfect the surface of each lid.
2. Pierce the lid of the flask containing the water with one of the bevels of the transfer system and
then use the other bevel to pierce the lid of the flask containing the powder.
3. Pour the entire contents of the water flask into the flask containing the powder.
4. During reconstitution, gently agitate the flask to homogenize the mixture; (do not shake).
5. Wait 3–5 minutes for the product to dissolve entirely before injecting. In most cases, French
FDP forms a cloudy liquid, sometimes with rare visible particles that do not constitute signs of
degradation.

78 n Pararescue Medical Operations Handbook / 8th Edition