1. Major Haemorrhage Management
Useful Contacts:
Clinical Emergency 3333
Surgical SpR page 8600
Anaesthetic SpR page 8602
Blood Bank Ext 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
>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 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