SOP 107: Whole Blood

Indications/Contraindications

100

What is an appropriate shock index to begin administration?

Shock Index (SI) Greater than 1.0 (SBP/HR or HR>SBP)

200

What is the Contraindication(s)?

Isolated head injury, with GCS of three

300

Which traumatic arrests can we administer whole blood?

Witnessed by providers

400

What is another Contraindication based on demographic?

Religious preferences (ex. Jehovah’s witnesses)

500

At what age range can you give whole blood for a pediatric patient

5-9 y/o

** <5y/o require Medical Control orders **

Administration/Documentation

100

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. 

200

What other medications must also be utilized with whole blood?

Tranexemic acid and Calcium

300

What do you when you notice allergic reactions?

Stop administration immediately, then go down guidelines of treating allergic reactions/anaphylaxis.

400

What documentation for whole blood is required for PCRs?

Transfusion Record

500

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

Trauma

100

Skin Signs of Shock

Cool, Diaphoresis, pallor

200

What are the four pieces of the trauma tetrad? 

Hypothermia, Acidosis, Coagulopathy, Hypocalcemia

300

What vital sign parameters indicate whole blood administration for pediatric patients?

SBP: <80mmHg AND HR: >110bpm

OR

ETCO2: <25 mmHg

400

What size catheters are required for whole blood administration?

Greater than or equal to 20g

500

At what percentage does the fatality rate increase without whole blood administration?

11% per minute increased fatality without whole blood administration