« transfusion »

81 passage(s) dans 11 référentiel(s).

• JTS — Prehospital Blood TransfusionJTS
  • p. 7Prehospital Blood Transfusion CPG ID: 82 Guideline Only/Not a Substitute for Clinical Judgment 7 TRANSFUSION REACTION The rate of non-infectious transfusion reaction ... low.31 In a recent evaluation of 4,857 transfusion episodes approximately 1% were associated with a serious reaction.32 Transfusion-associated circulatory overload was most common (~1%); while transfusion-related acute lung injury, anaphylactic reaction and hypotensive reactions
  • p. 22Prehospital Blood Transfusion CPG ID: 82 Guideline Only/Not a Substitute for Clinical Judgment 22 APPENDIX F: PEARLS FOR TRANSFUSIONS PEARLS FOR TRANSFUSIONS PRE-TRANSFUSION PEARLS 1. Use of 2% Lidocaine (2-3ml) with 0.9% NS is permitted ... flush any IO site prior to blood product transfusion. 2. Consider pain control measures to reduce tachycardia resulting from uncontrolled pain. 3. Once removed from storage container blood products will be transfused in under 4 hours 4. ONLY
  • p. 3Prehospital Blood Transfusion CPG ID: 82 Guideline Only/Not a Substitute for Clinical Judgment 3 INTRODUCTION Early administration of blood products to the trauma patient in extremis is the standard in combat casualty care and becoming more common ... critical care.1-7 Although there is some dissent regarding the level of evidence for and benefits of prehospital blood transfusion in the civilian literature, much of the data informing that discussion precedes the use of whole blood and involves
  • p. 4Prehospital Blood Transfusion CPG ID: 82 Guideline Only/Not a Substitute for Clinical Judgment 4 (HR) >120 bpm or Oxygen Saturation (SaO2) <90%. Following the fifth transfused unit, oxygen saturation was excluded as a transfusion trigger and multiple amputations ... with at least one proximal amputation) were included as transfusion triggers. There were no adverse reactions and no instances of blood product temperature outside of the accepted range. Advanced clinical care during patient transport has demonstrated improved outcomes.15-17

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• JTS — Damage Control ResuscitationJTS
  • p. 6concentration). Every Ranger is trained in how to set up and administer a Fresh Whole Blood buddy transfusion. This program represents a success story of leadership and since 2015 every Ranger task force has deployed with a functional ... Patients receiving MT with CWB stored for more than 2 weeks may require additional support with platelet transfusions or FWB (consider a ratio of 3:1 of CWB: FWB as available). Similarly, CWB that has been leukoreduced with
  • p. 9conjunction with damage control resuscitation following combat injury. This association is most prominent in those requiring massive transfusion.14,74 In casualties at high risk of hemorrhagic shock, TXA reduces mortality IF GIVEN WITHIN THREE (3) HOURS of injury ... mmol/l). One gram of calcium IV/IO should be given to patients in hemorrhagic shock during or immediately after transfusion of the first unit of blood product and with ongoing resuscitation after every 4 units of blood products
  • p. 16Spinella PC, Perkins JG, et al. The ratio of blood products transfused affects mortality in patients receiving massive transfusions at a combat support hospital. J Trauma, 2007. 63(4): p. 805-13. 16. Holcomb JB, Wade CE, Michalek ... Perkins JG, et al. The ratio of fibrinogen to red cells transfused affects survival in casualties receiving massive transfusions at an army combat support hospital. J Trauma, 2008. 64(2 Suppl):p. S79-85; discussion S85. 18. Shaz
  • p. 17definition of "fresh" whole blood: an in vitro characterization of coagulation properties in refrigerated whole blood for transfusion. Transfusion, 2011. 51(1): p. 43-51. 32. Cotton BA, Podbielski J, Camp E, et al. A randomized controlled pilot ... trial of modified whole blood versus component therapy in severely injured patients requiring large volume transfusions. Ann Surg, 2013. 258(4): p. 527-32; discussion 532-3. 33. Bahr MP, Yazer MH, Triulzi DJ, et al. Whole blood

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• Agressions collectives par armes de guerre — conduites à tenirMinistères de l'Intérieur, des Armées et de la Santé
  • p. 138137Spécificités pédiatriques du damage control il est recommandé de transfuser des plaquettes lors de la deuxième prescription transfusionnelle, pour maintenir une numération plaquettaires > 50 000 / mm3 et probablement > 100 000 / mm3 en cas de traumatisme crânien associé ... saignement. » Une hypocalcémie ionisée peut survenir lors d’une transfusion massive et doit être corrigée pour une calcémie > 0,9 mmol /l. Un monitorage de la calcémie ionisée ou une administration systématique toutes les 2 ou 3 prescriptions
  • p. 100remplissage restrictive améliore la survie globale et peropératoire précoce des traumatisés thoraciques. 2.5 Réanimation hémostatique et stratégie transfusionnelle D’installation très rapide au décours du traumatisme, la coagulopathie nécessite une correction prompte par l’administration précoce de produits ... rando- misée, contrôlée, l’effet bénéfique de l’administration d’acide tranexamique sur la mortalité et les besoins transfusionnels a été observé. Une analyse a posteriori retrouvait un bénéfice d’autant plus important que l’administration était précoce
  • p. 118117Prise en c h a r g e p é r i-opératoire et stratégie transfusionnelle L’établissement français du sang (EFS) et le service de santé des armées (SSA) sont en train d’élaborer une stratégie ... offre l’utilisation, en traumatologie, de plaquettes stockées 15 jours à 4 °C. Conclusion La gestion des capacités transfusionnelles passe par la mise en œuvre d’une stratégie adaptée au volume et à la gravité des blessés pris
  • p. 113Introduction L’hémorragie est la première cause de mortalité évitable après blessure par armes de guerre. La thérapeutique transfusionnelle est donc au cœur de la prise en charge de tels blessés. Du reste, les données des conflits récents ... thérapeutique trans- fusionnelle et les chances de survie de ces patients. Pour pouvoir appliquer une stratégie transfusionnelle adaptée à de tels blessés, il est nécessaire de connaître les grands principes thérapeutiques ayant démontré un bénéfice en termes

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• OMS — Managing Complications in Pregnancy and Childbirth (2e éd.)OMS
  • p. 61CLINICAL USE OF BLOOD, BLOOD PRODUCTS, AND REPLACEMENT FLUIDS C-37 Obstetric care sometimes requires blood transfusions. It is important to use blood, blood products and replacement fluids appropriately and to be aware of the principles designed ... deciding when (and when not) to transfuse. The appropriate use of blood products is defined as the transfusion of safe blood products to treat a condition leading to significant morbidity or mortality that cannot be prevented or managed
  • p. 64Clinical use of blood, blood products, and replacement fluids Transfusion of red cells might also be vital to restoring the oxygen- carrying capacity of the blood. Minimize “wastage” of a woman’s blood (to reduce the need ... clinical signs and symptoms and prevent significant morbidity and mortality. • The clinician should be aware of the risks of transfusion-transmissible infection in blood products that are available. • Transfusion should be prescribed only when the benefits
  • p. 62shortage of blood products for women in real need. Blood is an expensive, scarce resource. RISKS OF TRANSFUSION Before prescribing blood or blood products for a woman, it is essential to consider the risks of transfusing against ... SAFETY • The risks associated with transfusion can be reduced by: - effective blood donor selection, deferral and exclusion; - screening for transfusion-transmissible infections in the blood donor population (e.g. HIV/AIDS and hepatitis); - quality-assurance programmes; - high-quality blood grouping
  • p. 63replacement fluids C-39 SCREENING FOR INFECTIOUS AGENTS • Every unit of donated blood should be screened for transfusion- transmissible infections using the most appropriate and effective tests, in accordance with both national policies and the prevalence of infectious ... from circulation. Blood that has not been obtained from appropriately selected donors and that has not been screened for transfusion-transmissible infectious agents (e.g. HIV, hepatitis) in accordance with national requirements should not be issued for transfusion, other

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• JTS — U.S. Army Aeromedical Evacuation Standard Medical Operating GuidelinesJTS
  • p. 19TABLE OF CONTENTS 19 BLOOD TRANSFUSION REACTIONS Treatment • STOP THE TRANSFUSION! • If a blood transfusion reaction is suspected o Apply O2 (if hypoxic), IV / IO, and cardiac monitor o Establish advanced airway per individual competencies, contraindications ... reaction. These are mostly benign with no lasting sequelae. Treatment consists of antipyretics • TRALI is the leading cause of transfusion-related mortality; a concern in patients who have undergone recent surgery, massive transfusion, or have an active infection
  • p. 18flushed with NS prior to use • Transfuse blood through an approved fluid warming device if available o Rapid transfusion can be achieved via pressure bag up to 300 mmHg; a 60 mL syringe or manual pressure can also ... Calcium Chloride IV / IO should be given to patients in hemorrhagic shock during or immediately after transfusion of the first unit of blood product and with ongoing resuscitation after every 4 units of blood products. Ionized calcium should
• JTS — Damage Control Resuscitation in Prolonged Field CareJTS
  • p. 18When an emergency situation does not allow complete donor assessment according to the Joint Trauma System Whole Blood Transfusion Clinical Practice Guidelines ... following rapid donor screen may be used. Relaxing the donor acceptance criteria will increase the risk of transfusion-transmitted disease. The decision is a risk- benefit analysis. Primary Triage (question as a group) Serial Question Yes No Action
  • p. 14should be built into individual and unit training for PFC scenarios. REFERENCES 1. Gurney JM, Spinella PC. Blood transfusion management in the severely bleeding military patient. Curr Opin Anesthesiol. 2018;31: 207–214. 2. Spinella PC, Perkins ... Grathwohl KW, et al. Risks associated with fresh whole blood and red blood cell transfusions in a combat support hospital. Crit Care Med. 2007;35:2576–2581. 3. Spinella PC, Perkins JG, Grathwohl KW, et al. Warm fresh
  • p. 4hemorrhagic shock is clinically suspected: Begin treating immediately once hemorrhagic shock is suspected. Predictors associated with massive transfusion (i.e. more than 10 units of blood in the first 24 hours) may help identify patients who will require massive ... transfusion. The more predictors present, the higher the risk of massive transfusion.13–22  Penetrating mechanism  Positive focused assessment with sonography for trauma (FAST) examination (especially if two or more regions are positive)  Lactate concentration greater than 4mmol/L
  • p. 3survival. The immediate priorities are to control life-threatening hemorrhage and maintain vital organ perfusion with rapid blood transfusion.1 Experience with fresh whole blood (FWB) resuscitation by military surgical teams deployed in US Central Command ... point of injury.7,8 Efforts to prevent death from hemorrhage begin with external hemorrhage control, followed by transfusion of whole blood (WB) or reconstituted WB with components in a 1:1:1 unit ratio when possible.9 DCR also

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• JTS — CBRN Part 4: Biological CasualtiesJTS
  • p. 26Activated charcoal is reasonable after ingestion, if not vomiting. Intravenous fluids, electrolyte repletion. Vasopressors for hypotension. Blood product transfusions for hematologic disturbances. Benzodiazepines for seizures. Early plasma exchange proposed for treatment (Abbes et al., 2021) Saxitoxin Activated charcoal ... Toxin Antiemetics, analgesics, intravenous fluids. Wound care. Intravenous fluids and vasopressors for shock. Blood product transfusion for gastrointestinal hemorrhage. Antibiotics for neutropenic fever. Gangrenous laryngitis has been described and airway management and mechanical ventilation may be required. (Tucker
• JTS — High Bilateral Amputations and Dismounted Complex Blast InjuryJTS
  • p. 4physical and psychological morbidity, as well as mortality. Survival is initially contingent upon rapid hemorrhage control and massive transfusion being delivered in <40 minutes, through well-resourced and rehearsed resuscitation protocols.3 A coordinated team approach is essential ... nasopharyngeal airway and ventilation assist; simultaneous airway management, volume resuscitation (ideally with Whole Blood (WB) or balanced ratio transfusions), and immediate control of life-threatening hemorrhage.4 Later risks for morbidity and mortality include sepsis, including invasive fungal infection
  • p. 6blood product. This underscores the imperative that massive (>10 units of PRBCs/WB in 24 hours) and ultra-massive transfusion (>20 units of PRBCs/WB in 24 hours) are necessary for these casualties to survive. These casualties are resource intensive ... appropriately for the demand signal, then these injuries, while devastating are survivable with early hemorrhage control (tourniquets), massive transfusion, and transport to a surgical capability. The role for early (and effective) tourniquets and blood products cannot be overemphasized
  • p. 5rapid infusion catheter) the better the chance of survival. This injury pattern mandates immediate activation of massive transfusion protocol with the preferential use of whole blood and no crystalloid as part of the resuscitation. If there is prior ... rapid transfuser (Belmont or Level 1) prior to the casualty arriving. A good starting formula for transfusion requirement is 8 units of whole blood for each above knee amputation (AKA). Thus, a casualty with bilateral AKAs should have
  • p. 14June 2011 . 3. Shackelford SA, Del Junco DJ, Powell-Dunford N, et al. Association of prehospital blood product transfusion during medical evacuation of combat casualties in Afghanistan with acute and 30-day survival. JAMA ... Holcomb JB et al, PROPPR Study Group. Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial

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• JTS — Prolonged Casualty Care GuidelinesJoint Trauma System (DoD)
  • p. 11survival. The immediate priorities are to control life-threatening hemorrhage and maintain vital organ perfusion with rapid blood transfusion.4 Pre-deployment, Mission Planning, and Training Considerations 1. Conduct unit level blood donor testing (for blood typing, transfusion transmitted
• JTS — Joint En Route Care GuidelinesJTS
  • p. 9slow IV/IO push after the first unit (and for every four units thereafter). See CPG: Prehospital Blood Transfusion; CPG: Whole Blood Transfusion, and Damage Control Resuscitation in Prolonged Field Care (Category: “Blood”). • Replace saturated absorbent pads, as needed ... including tube thoracostomy output) HAND-OFF • Verify TQ and/or hemostatic interventions, amount transfused, and times of interventions and transfusion. • If aortic occlusion was performed, note zone placement, inflation time, balloon volume, catheter depth, and ensure catheter is well
• OMS / CICR — Basic Emergency Care (cahier du participant)OMS · CICR · IFEM
  • p. 118that can provide spinal care. [See SKILLS] Stomach or intestinal bleeding • Start IV fluids and refer for blood transfusion. [See SKILLS] Ectopic pregnancy • Give IV fluids and refer for blood transfusion and obstetric care. [See SKILLS] Postpartum haemorrhage ... Give oxytocin and IV fluids and plan for rapid transfer to facility with blood transfusion and obstetric care capabilities. • Give IV fluids and massage uterus until it is hard. [See SKILLS] • Give oxytocin. [See SKILLS] • If the placenta