Indications/Contraindications
What is an appropriate shock index to begin administration?
Shock Index (SI) Greater than 1.0 (SBP/HR or HR>SBP)
How do you set up the infusion?
Prime entire Y-Tubing with NS/LR, stop once primed, then open valve for blood product directly to patient.
Skin Signs of Shock
Cool, Diaphoresis, pallor
What is the Contraindication(s)?
Isolated head injury, with GCS of three
What other medications must also be utilized with whole blood?
Tranexemic acid and Calcium
What are the four pieces of the trauma tetrad?
Hypothermia, Acidosis, Coagulopathy, Hypocalcemia
Which traumatic arrests can we administer whole blood?
Witnessed by providers
What do you when you notice allergic reactions?
Stop administration immediately, then go down guidelines of treating allergic reactions/anaphylaxis.
What vital sign parameters indicate whole blood administration for pediatric patients?
SBP: <80mmHg AND HR: >110bpm
OR
ETCO2: <25 mmHg
What is another Contraindication based on demographic?
Religious preferences (ex. Jehovah’s witnesses)
Transfusion Record
What size catheters are required for whole blood administration?
Greater than or equal to 20g
At what age range can you give whole blood for a pediatric patient
5-9 y/o
** <5y/o require Medical Control orders **
What is required on the Transfusion Record?
1) Patient demos
2) Unit information (number, product, exp date)
3) provider who administered
4) provider who witnessed administration
5) Vital signs and info about transfusion
At what percentage does the fatality rate increase without whole blood administration?
11% per minute increased fatality without whole blood administration