Major Haemorrhage Management

1. Useful Contacts: Clinical Emergency3333 Surgical SpRpage 8600 Anaesthetic SpRpage 8602 Blood BankExt 80393or via switchboard Consultant Haematologist CALL FOR HELP Check: Airway Breathing Circulation Minimise bleeding Consider arterial or direct pressure Major Haemorrhage Management Insert two size appropriate Large bore IV cannula.If unsuccessful <6yrs >6yrs Consider venous cut down or intraosseus route Insert two intraosseus needles Take blood for: Crossmatch - pink bottle FBC - pink bottle Phone Blood Bank Ext 80393 or via switchboard Give: 20 mLs/kg of warmed Saline, Hartmans or PPS Contact ITU. Ask for blood warmer as an emergency – Ext 80083 Cap refill >2secs Cap refill <2secs Reassess ABC Following 1st fluid bolus Following 2nd fluid bolus Reassess ABC Give 2nd bolus of clear fluid Give 20 mLs/kg blood If total blood loss 40 mLs/kg Give 10 mLs/kg FFP If platelets < 50 Give 10mLs/kg of platelets If Fibrinogen < 0.8g/l Give 5mLs/kg of Cryo

2. 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 bottle FBC, EDTA bottle Coag, purple topped bottle U&E’s orange topped bottle • Blood available: O Negative 2 units available in Blood Bank and Theatre. Group Specific Available 10mins after receipt of sample Fully Crossmatched Available 40mins after receipt of sample Authors: P Bolton/E Harrison Version: 1.0 Final Issue Date: March 2007