major haemorrhage management
DESCRIPTION
Useful Contacts: Clinical Emergency 3333 Surgical SpR page 8600 Anaesthetic SpR page 8602 Blood Bank Ext 80393 or via switchboard Consultant Haematologist. CALL FOR HELP Check: A irway B reathing C irculation. Minimise bleeding Consider arterial or direct pressure. - PowerPoint PPT PresentationTRANSCRIPT
Major Haemorrhage Management
Minimise bleedingConsider arterial or direct pressure
CALL FOR HELPCheck:AirwayBreathingCirculation
Give: 20 mLs/kg of warmed Saline, Hartmans or PPSContact ITU. Ask for blood warmer as an emergency – Ext 80083
Give 20 mLs/kg blood
Cap refill< 2secs
If total blood loss 40 mLs/kgGive 10 mLs/kg FFP
If platelets < 50 Give 10mLs/kg of plateletsIf Fibrinogen < 0.8g/l Give 5mLs/kg of Cryo
ReassessABC
Reassess ABC
Give 2nd bolus of clear fluid
Insert two intraosseus needles
Useful Contacts:Clinical Emergency 3333Surgical SpR page 8600Anaesthetic SpR page 8602Blood Bank Ext 80393 or via switchboardConsultant Haematologist
Take blood for: Crossmatch - pink bottleFBC - pink bottle
Phone Blood BankExt 80393 or via switchboard
>6yrs <6yrs
Consider venous cut down or intraosseus route
Insert two size appropriateLarge bore IV cannula.If unsuccessful
Following 2nd fluid bolus
Cap refill> 2secs
Following 1st fluid bolus
Major Haemorrhage Management
• Contact relevant staff – see over for details
• You must alert Blood Bank when a major haemorrhage is suspected
• Assess weight of patient
• Allocate one person to have ongoing contact with the Consultant Haematologist and Blood Bank
• Take blood for:Crossmatch, 1-5mLs EDTA bottleFBC, EDTA bottleCoag, purple topped bottleU&E’s orange topped bottle
• Blood available:O Negative2 units available in Blood Bank and Theatre.
Group SpecificAvailable 10mins after receipt of sample
Fully CrossmatchedAvailable 40mins after receipt of sample
Authors: P Bolton/E HarrisonVersion: 1.0 FinalIssue Date: March 2007