Resuscitation: Red Blood Cells (RBCs)
Indications: Generally Hgb < 70, OR < 80 if the patient has known coronary artery disease.
Considerations for earlier transfusion include:
- High rate of on-going blood loss
- Hemodynamic instability
- Delayed blood work
- Evidence of tissue ischemia e.g. ↑HR, evidence of new or past acute coronary disease.
Important Considerations:
- The 3rd leading cause of death due to transfusion is ABO hemolytic transfusion reaction, primarily due to clerical error. Hence confirming the correct blood product for the patient is crucial.
- ABO antibodies are primarily IgM capable of causing life-threatening hemolysis.
- RhD antibody is the next most important.
- Given PRBC contains citrate to avoid clotting, massive transfusion causes hypocalcemia.
- Shelf life of 42 days but must be transfused within 3 hours of being issued.
- O blood is the universal PRBC donor while AB is the universal plasma donor.
Next page: Frozen Plasma (FP)