Major Haemorrhage Management

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Major Haemorrhage Management
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 Airway Breathing Circulation
Minimise bleeding Consider arterial or direct
pressure
Insert two size appropriate Large bore IV
cannula.If unsuccessful
gt6yrs
lt6yrs
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 lt 2secs
Reassess ABC
Cap refill gt 2secs
Following 2nd fluid bolus
Following 1st 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 lt 50 Give 10mLs/kg of platelets If
Fibrinogen lt 0.8g/l Give 5mLs/kg of Cryo
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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
• UEs 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

Authors P Bolton/E Harrison Version 1.0
Final Issue Date March 2007