Major Haemorrhage Management Useful Contacts Clinical Emergency 3333

Major Haemorrhage Management Useful Contacts: Clinical Emergency 3333 Surgical Sp. R page 8600 Anaesthetic Sp. R page 8602 Blood Bank Ext 80393 or via switchboard Consultant Haematologist CALL FOR HELP Check: Airway Breathing Circulation Minimise bleeding Consider arterial or direct pressure Insert two size appropriate Large bore IV cannula. If unsuccessful <6 yrs >6 yrs 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 m. Ls/kg of warmed Saline, Hartmans or PPS Contact ITU. Ask for blood warmer as an emergency – Ext 80083 Cap refill > 2 secs Cap refill < 2 secs Following 1 st fluid bolus Reassess ABC Give 2 nd bolus of clear fluid Following 2 nd fluid bolus Give 20 m. Ls/kg blood If total blood loss 40 m. Ls/kg Give 10 m. Ls/kg FFP If platelets < 50 Give 10 m. Ls/kg of platelets If Fibrinogen < 0. 8 g/l Give 5 m. Ls/kg of Cryo Reassess ABC

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 -5 m. Ls 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 10 mins after receipt of sample Fully Crossmatched Available 40 mins after receipt of sample Authors: P Bolton/E Harrison Version: 1. 0 Final Issue Date: March 2007