Whole Blood

Question 1

Whole Blood Trade Name

Answer 1

No Trade Name (Not carried by Danbury).
“Low titer O-negative Whole Blood”

Question 2

Whole Blood Classification

Answer 2

Blood Components

Question 3

Whole Blood Mechanism

Answer 3

Per Mr. Fortin:
Directly replaces blood volume, including RBCs, clotting factors, platelets and volume, etc.
Medscape:

“ increases oxygen, carrying capacity by adding available, RBCs and hemoglobin, enhances blood clotting by the addition of clotting factors and replaces blood volume lost to hemorrhage”

Each unit (~450-500mL) provides the equivalent of one unit of RBCs and one unit of plasma. However, the plasma may be deficient in “labile clotting factors” (V & VIII) since these factors degrade rapidly during storage. The platelets undergo conformational changes even with short-term refrigerated storage that causes rapid removal of transfused platelets by the reticuloendothelial system and thus are unlikely to provide much improvement in hemostasis.

Question 4

Whole Blood Onset of Action

Answer 4

Per Mr. Fortin: Immediate

Question 5

Whole Blood Duration of Action

Answer 5

Per Mr. Fortin: Varies

Question 6

Whole Blood Indications

Answer 6

Per Mr. Fortin:
> Blunt or penetration trauma causing hypovolemia.
> GI Bleed causing hypotension/hypovolemia.
> Suspected AAA.
> Post partum hemorrhage.
> Witnessed traumatic arrest with significant hemorrhaging.

Question 7

Whole Blood Contraindications

Answer 7

Per Mr. Fortin:
> Mentally competent and alert person who refuses
> Known transfusion reaction
> Injuries incompatible with life

Question 8

Whole Blood Side Effects/ Precautions/ Comments

Answer 8

Per Mr. Fortin
Transfusion Reaction (looks like anaphylaxis)

Comments:
Superior to crystalloid and colloid products
Easier than blood components
Shelf life – must be refrigerated
Research supports use is a best practice for hemorrhagic shock
Long transports
Minimal equipment needed
Reduce waste by giving slightly stale blood back to ER for them to use more quickly.

Question 9

Whole Blood Adult Dose

Answer 9

Per Mr. Fortin
500ml-1000ml (Max 1000ml)

Question 10

Whole Blood Pediatric Dose

Answer 10

Per Mr. Fortin
10-20 ml/kg (Max 500ml)

Question 11

Whole Blood Max Dose Adult (Pediatric)

Answer 11

1000ml (500ml)

Question 12

Whole Blood Routes of Administration

Answer 12

IV/IO (PO for vampires)

Question 13

Whole Blood How Supplied

Answer 13

450-500ml