Page 81 - PJ MED OPS Handbook 8th Ed

WARNING Before infusion, check that the glass flask is intact. Do not use the content of a dam-
aged flask under any circumstances.

6. Obtain a set of pre-infusion vital signs if tactical conditions permit. Ideally, vital signs will be
checked and recorded 15 minutes after the first infusion, and this will be repeated in 15 minutes,
then every 30 minutes (x2) and then hourly OR until transfer of care occurs.
7. Immediately inject the entire preparation IV/IO.
8. Obtain a set of post-infusion vital signs if tactical conditions permit.
9. Closely monitor the recipient for signs of an adverse reaction and for adequacy of resuscitation
(return of radial pulse or improvement in systolic blood pressure to approximately 90mmHg,
improvement in mental status, improved hemorrhage control).

NOTE: A US Pharmacopeia Convention (USP)-grade calcium solution (approved for parenteral
administration) will be administered per SOF protocol after 4 units of French FDP have been
infused to avoid citrate toxicity.

Administer Fresh Whole Blood (FWB)

NOTE: FWB will be administered in the field by a PJ for a trauma patient (or rarely a GI bleeder
on civil SAR) who is dying. The benefits outweigh the risks. Unlike hospital based transfusions
for anemia, push the blood as rapidly as able for severe shock through 2 lines.
Use FWB when indicated if standard blood products aren’t available, there is a need to
supplement existing blood products during PFC, and are specifically trained to do so.

Contraindications:
Inability to find donor blood that is compatible with casualty’s blood type
Donor contraindications:
• Received a prior blood transfusion
• Pregnant female
• Infected donor
• Plan to do retrospective testing: take donor to medical treatment facility for testing
Equipment checklist:
1. FDA approved blood collection bag (no more than 500mL capacity)
2. Blood administration set (180 micron filter)
3. 2 Clamps for blood line
4. Normal saline (50mL bag minimum)
5. Catheters (preferably 16 gauge for speed of infusion)
6. Alcohol pads
7. Eldon Blood Typing kit × 2
8. PRN Adapter (needle saline lock)
9. 550 cord – 9.5" strand
10. Diphenhydramine 50mg
11. Epinephrine 1:1000 (or epinephrine auto-injector)

Chapter 7. Blood Administration and Protocol n 79