Page 83 - PJ MED OPS Handbook 8th Ed

5. 1 site for blood infusion
a. 1 site for TXA, more blood or emergency access
b. Blood may be administered through IO needles if IV access in unobtainable
c. Connect blood administration line to IV site on recipient
6. Open regulator clamp until administration line is dark red all the way up to recipients arm
7. Record a complete set of vitals every 5 minutes while blood flows into casualty
8. Monitor for transfusion reactions
9. Treat transfusion reactions in accordance with unit protocol
10. If after 15 minutes (three sets of complete vitals) recipient has no signs of transfusion reaction,
continue to infuse remaining blood if administering slowly for reason other than shock
11. When blood collection bag is empty flush saline through line to deliver the residual blood
12. Discontinue transfusion when recipient vital signs have stabilized or transfusion is complete
13. Prepare for evacuation or continue PFC
Patient documentation
1. Document recipient and donor info
2. Send empty blood bags with the patient
3. Send Eldon blood cards with the patient

PJ PEARLS:
• If bags of donor blood remain after casualty has been evacuated, re-infuse blood back
into donors.
• Blood can be safely stored in an FDA approved collection bag at room temperature for 24
hours (this is not recommended because the blood should be given immediately to the
casualty or re-infused into the donor).
• Donor blood type for this procedure should be exactly the same as recipient blood type.
However, in extreme circumstances (a patient is obviously dying and there is no exact
match available), Operators may utilize Group O fresh whole blood from a live donor.
• Eldon card should be performed on donor and recipient just prior to transfusion.
○ Easy to follow instructions on package
○ Added confirmation just prior to transfusion builds Operator confidence
NOTE: there is an approximately 11% error rate on the blood types on dog tags.
• Donors could return to fight after one unit donation. In exceptional circumstances, two
units may be collected from a single donor, but that will place the donor out of the fight.
• May attempt to restore donor volume with IV crystalloids.
• If the blood infusion filter fills with clots it may become necessary to use a new infusion
line.
• STOP the transfusion for anything that seems wrong: fever, chills, flank pain, sudden/
severe deterioration with dropping BP and respiratory distress, tea/cola colored urine
(best if Foley in all patients in shock when possible). Flush with crystalloids, treat for ana-
phylaxis, infection, etc., if there is clinical suspicion.

Chapter 7. Blood Administration and Protocol n 81