Adult Transfusion Guidelines

ADULT TRANSFUSION GUIDELINES
ORDERED PREPARATION INDICATIONS FOR USE ABO-RH COMPATIBILITY ADMINISTRATION SPECIAL

COMPONENT AND CONSIDERATIONS
COMPOSITION
Packed red cells RBCs, WBCs, Increase red cell mass and Recipient Donor Filter - standard blood filter Expected outcome -
(RBCs) platelets & plasma oxygen carrying capacity; increase Hg by one
(minimal) generally indicated when Hgb is O O Preferred needle gauge - 16-20; gram/unit or Hct 3%
7 gm or Hct 21 unless active 22 gauge for limited venous
A A, O access
cardiac disease is present.
AB AB, A, B, O Rate – approximately 2
mL/minute (120mL/hour) for 1st
B B, O
15 minutes, then increase rate to
Rh+ Rh+, Rh- infuse over 1 to 2 hours (150-250
mL/hr), or as ordered. Do NOT
Rh- Rh- hang longer than 4 hours.
In some cases, Rh+ blood Volume - 300-350 mL
can be given to Rh-
recipients.
11/2017 Legacy Laboratory Services Page 1 of 18

COMPOSITION
Leukocyte- RBCs, WBCs Same as RBCs plus decreases Same as RBCs Filter Same as RBCs
Reduced packed (negligible), risk for alloimmunization to
red cells (RBCs) platelets & plasma leukocyte or HLA antigens and • If product is not leukocyte
(minimal) CMV transmission; reduces reduced, use leukocyte
incidence of febrile transfusion removal filter.
• Otherwise standard blood
reactions
filter.
Preferred needle gauge – Same
as RBC’s
Rate - Same as RBCs
Volume - Same as RBCs
Red blood cells- RBCs, minimal Same as RBCs plus decrease Same as RBCs Same as RBCs Expiration time of unit is
washed WBCs, no plasma, risk for alloimmunization to 24 hours after saline
no platelets leukocyte or HLA antigens; washing; Hct of product is
reduce incidence of urticarial and 70-80%; contains viable
anaphylactic reactions to plasma lymphocytes and can
proteins; only ordered when induce GVHD
reactions not controllable with
meds and leukodepleted
products
Autologous RBCs, WBCs, and Increase red cell mass and Complete ABO-Rh Filter - Same as RBCs Same as RBCs; 2-hour
plasma; patient oxygen carrying capacity compatibility since blood reinfusion is OK unless
blood has donated own was donated by patient Preferred needle gauge - Same patient is volume
blood prior to prior to procedure as RBC’s sensitive;
surgical procedure
Rate - Same as RBCs
Volume - 200-500 mL

COMPOSITION
Plasma: Plasma, with Hemorrhagic condition Recipient Donor Filter - standard blood filter Expiration time of product
clotting factors associated with a clotting factor is 24 hours after thawing:
Fresh frozen deficiency; with (PT 18, INR > O O, A, B, AB Preferred needle gauge - 18-20 usual starting dose is 2-4
plasma (FFP), 1.5, or PTT  60) reverse units.
frozen plasma (FP) excessive anticoagulant therapy; A A, AB Rate - TKO x 15 minutes, then
bleeding complications due to as fast as tolerated
B B, AB
liver disease
(5-10 mL/min). Do NOT hang
AB AB longer than 4 hours.
Volume - actual volume is printed

on product bag
Platelet apheresis Platelets, plasma, To control or prevent bleeding Recipient Donor Filter - standard blood filter or Prophylactic pre-
small numbers of associated with deficiencies in leukocyte reduction filter (per transfusion medications
RBCs and WBCs platelet number (count < 5,000 - O O, A, B, AB physician order). (e.g., antihistamine and/or
10,000 chronic, < 50,000 preop) acetaminophen) may be
A A, AB, O, B Preferred needle gauge - 20-22
or function; not usually effective ordered to decrease
in conditions of rapid platelet B B, AB, O, A incidence of chills, fever
Rate - TKO - first 15 minutes,
destruction (e.g., ITP and DIC). and allergic reactions; one
then remaining volume within 20-
AB AB, A, B, O unit of pheresis platelets
30 minutes (5-10 mL/min). May
should increase platelet
ABO incompatible be placed on infusion device if
count by 20,000 to
platelets can be used if ordered over a specific amount
30,000/ul
not grossly contaminated of time.
with red cells. RH factor
Volume -. Approximately 270 mL.
is significant only when
platelets from Rh+ donor
are used in a Rh- female
(< 50 years).
Platelets Same as Same as random-donor Same as platelet Same as platelet apheresis Advance scheduling to
apheresis platelets platelets; used for patients apheresis concentrates concentrates obtain HLA-matched
HLA-matched but product is unresponsive to random donor platelets is required; all
tissue matched platelet concentrates because of HLA matched platelets
HLA alloimmunization; used for must be irradiated
patients who have had transplant
within last year or are scheduled
for future transplant

COMPOSITION
Platelets Same as Same as random donor platelets Same as platelet Same as platelet apheresis 24-hour advanced
apheresis platelets but used for patients who are apheresis concentrates concentrates scheduling required; new
crossmatched but crossmatched unresponsive to random donor clot tube specimen
with patient’s pheresis or HLA matched required for each order
serum platelet products; platelet
antibody screen is positive
Cryoprecipitate Factor VIII, von Treatment of hypofibrinogenemia ABO grouping may be Filter - standard blood filter Maximum patient benefit if
Willebrand’s (fibrinogen < 100 mg/dl) and Von disregarded; product has used within 2 hours; usual
(AHF) factor, factor XIII, Willebrand’s disease; may be negligible amounts of Preferred needle gauge - 18-22 starting dose for
fibrinogen; product used in hemophilia A but Factor plasma hypofibrinogenemia is 10
Rate - TKO x 15 minutes, then
is frozen VIII concentrate preferred. One units
as fast as tolerated (5-10
unit yields 100-350 mg of
mL/min)
fibrinogen.
Volume - 10 mL/bag; volume is
recorded on each bag. The
usual adult dose is ten (10) units
or approximately 100 mL.
Factor VIII Freeze dried factor Factor VIII deficiency Not required Filter –none required, filtered Product is obtained from
Antihemophilic VIII (hemophilia A); some products during preparation by pharmacy; Pharmacy; each bottle of
can be used in von Willebrand’s follow package instructions to AHF is labeled with
factor(AHF) disease reconstitute at room temperature. activity expressed in
international units.
Von Willibrand Use plastic disposable syringes
factor (Humate P) as proteins adhere to glass. There is a risk of
Visually inspect for particulate transmission of infectious
matter or discoloration prior to disease
administration. Do not
refrigerate after reconstitution.
Administer within 3 hours of
reconstitution. Slowly infuse the
solution (max rate 4mL/Min) with
suitable intravenous set.
Preferred needle gauge - 22-24
Volume - 10-30 mL

COMPOSITION
Factor IX Freeze dried Factor IX deficiency (hemophilia Not required Filter - none required, filtered Product is obtained from
concentrations of B), also known as Christmas during preparation by pharmacy. Pharmacy; each bottle of
Recombinant factor IX disease factor IX is labeled with
coagulation factor For IV use only. Visually inspect activity expressed in
IX for particulate matter or international units
discoloration prior to
(Benefit) administration. Administer using
tubing provided. Adjust the rate
of administration based on the
patient’s comfort level.
Volume - 10-30 mL
Normal serum Plasma proteins Hypovolemic shock associated Not applicable Filter – Some products may Product is obtained from
albumin (NSA) available in 5% or with or without acute blood loss; require filtration; refer to package Pharmacy
25% cerebral edema; insert. For IV use only. Visually
25% and 5% and cardiopulmonary bypass inspect for particulate matter or There is a risk of
plasma protein discoloration prior to infectious disease
fraction (PPF) 5% administration. Do not begin transmission
administration more than 4 hours
Albumin
after the container has been
entered. Once the transfusion is
started it must be completed
within 4 hours.

age and patient dependent.
Rate - dependent on product,

concentration and patient’s
condition; see package insert.
Do NOT hang longer than 4
hours.
Volume - 25% NSA, 50 and 100

mL; 5% NSA, 250 and 500 mL;
5% PPF, 250 and 500 mL

COMPOSITION
Irradiated blood Irradiated at a Congenital immunodeficiency Product specific; see Product specific; see packed red Crossmatch compatibility
products: dose of 25 Gy states: severe combined packed red cells or cells or platelet apheresis and HLA match take
(2,500 rads) immunodeficiency syndrome, platelet concentrates administration preference over ABO and
RBCs, RBCs thymic hypoplasia, Wiskott- RH for platelets
(leukodepleted and Aldrich syndrome, Lenier’s
washed), platelets disease, 5’ Nucleotidase
deficiency
Infants less than 4 months old:
Neonatal transfusions,
intrauterine transfusions,
exchange transfusions, cardiac
surgery (except ECMO)
Acquired immunodeficiency
states: ANC < 500 (any reason),
highly immunosuppressive
chemo, BMT (mobilization
chemotherapy to 100 days post-
transplant, then check with
physician)
Other: directed donor products

from relatives, any HLA matched
platelet product

PEDIATRIC TRANSFUSION GUIDELINES

COMPOSITION
Packed red cells RBCs, Increase red cell mass and Recipient Donor Filter - standard pediatric blood All pediatric packs of
(RBCs) leukocyte oxygen carrying capacity; filter RBCs are pre-storage
reduced WBCs (negligible), generally indicated when Hgb is O O leukodepleted so
platelets and 8 gm or Hct 24 Preferred needle gauge - 18-24 leukofilter is not required
plasma (minimal) A A, O age and patient dependent. for transfusion
Decrease risk for
AB AB, A, B, O Rate - TKO x 15 minutes, then
alloimmunization to leukocyte or
HLA antigens and CMV infuse remaining volume over 1
B B, O
transmission; reduce incidence to 2 hours, or as ordered. Each mL/Kg given should
of febrile transfusion reactions. Rh+ Rh+, Rh- Transfusion time is increase the hematocrit by
approximately 2-5 mL/Kg hr for 1% or 10mL/Kg should
Rh- Rh- children Do NOT hang longer raise the Hgb 3g/dL
than 4 hours.
In some cases, Rh+ blood
can be given to Rh- Volume - as ordered. Maximum
recipients dose for single transfusion is 15
mL/Kg
Red blood cells- RBCs, minimal Same as RBCs plus decrease Same as RBCs Same as RBCs Expiration time of unit is
washed WBCs, no plasma, risk for alloimmunization to 24 hours after saline
no platelets leukocyte or HLA antigens; washing; Hct of product is
reduce incidence of urticarial and 70-80%; contains viable
anaphylactic reactions to plasma lymphocytes and can
proteins; only ordered when induce GVHD
reactions not controllable with
meds and leukodepleted
products

COMPOSITION
Autologous blood RBCs, WBCs, and Increase red cell mass and Complete ABO-Rh Filter - standard pediatric blood Same as RBCs; 2-hour
plasma; patient oxygen carrying capacity compatibility since blood filter reinfusion is OK unless
has donated own was donated by patient patient is volume sensitive
blood prior to prior to procedure Preferred needle gauge - 18-24
surgical procedure age and patient dependent.

infuse remaining volume over 1
to 2 hours, or as ordered. Do
NOT hang longer than 4 hours.
Volume - as ordered
Plasma: Plasma, with Hemorrhagic condition Recipient Donor Filter - standard pediatric blood Expiration time of product
clotting factors associated with a clotting factor filter is 24 hours after thawing if
Fresh frozen deficiency; with (PT 18, INR > O O, A, B, AB used for Factor VIII
plasma (FFP), Preferred needle gauge - 18-24
1.5, or PTT  60) reverse A A, AB
replacement; must be
frozen plasma (FP) age and patient dependent. used within 5 days of
excessive anticoagulant therapy;
bleeding complications due to B B, AB thawing for other
liver disease indications
as fast as tolerated
AB AB
(5-10 mL/min). Do NOT hang
longer than 4 hours. Dose is determined based
on laboratory assays of
Volume - actual volume is printed
coagulation function
on product bag.

COMPOSITION
Platelet Platelets, plasma, To control or prevent bleeding Recipient Donor Filter - standard pediatric blood Prophylactic pre-
small numbers of associated with deficiencies in filter or leukocyte reduction filter transfusion medications
apheresis RBCs and WBCs platelet number (count < 5,000 - O O, A, B, AB (per physician order) (e.g., antihistamine and/or
10,000 chronic, < 50,000 preop) acetaminophen) may be
A A, AB, O, B Preferred needle gauge - 18-24
or function; not usually effective given to decrease
in conditions of rapid platelet age and patient dependent incidence of chills, fever
B B, AB, O, A
destruction (e.g., ITP and DIC) and allergic reactions;
AB AB, A, B, O repeated transfusions may
remaining volume within 20-30
lead to alloimmunization
ABO incompatible minutes (5-10 mL/min)
to HLA and other antigens
platelets can be used if
Volume - as ordered and result in development
not grossly contaminated
of a refractory state
with red cells. RH factor
manifested by
is significant only when
unresponsiveness to
platelets from Rh+ donor
platelet transfusion;
are used in a Rh- female
expect an increase in
of childbearing age (≤50
platelet count from 20,000
years)
- 30,000 per pheresis unit
Platelets Same as Same as random-donor platelets; Same as platelet Same as platelet apheresis Prophylactic pre-
apheresis used for patients unresponsive to apheresis concentrates concentrates transfusion medications
HLA-matched platelets but with random donor platelet may be given; advance
some donor HLA concentrates because of HLA scheduling to obtain HLA-
antigen in alloimmunization; used for matched platelets is
common with patients who have had transplant required; plateletapheresis
recipient; product within last year or are scheduled products expire five days
is tissue matched for future transplant after collection; HLA
typing should be drawn
before
immunosuppressive
therapy is started; all HLA
matched platelets must be
irradiated

COMPOSITION
Platelets Same as Same as random donor platelets Same as platelet Same as platelet apheresis Advanced scheduling
apheresis but used for patients who are apheresis concentrates concentrates required - 24 hours to
crossmatched platelets but unresponsive to random donor process and test product;
crossmatched with apheresis or HLA matched compatible products not
patient’s serum platelet products; platelet always available; HLA
antibody screen is positive antibody and platelet
antibody screens should
be done prior to
transfusion; new clot tube
specimen required for
each order
Cryoprecipitate Factor VIII, von Treatment of hypofibrinogenemia ABO grouping may be Filter - standard pediatric blood Cryoprecipitate is stored
Willebrand’s (fibrinogen < 100 mg/dl) and Von disregarded; product has filter frozen and must be
(AHF) factor, factor XIII, Willebrand’s disease; may be negligible amounts of thawed prior to use;
fibrinogen; product used in hemophilia A but Factor plasma Preferred needle gauge - 18-24 maximum patient benefit if
is frozen VIII concentrate preferred age and patient dependent used within 2 hours; one
unit (bag) yields a
minimum of 80 units of
as fast as tolerated (5-10
Factor VIII and 100-350
mL/min)
mg of fibrinogen
Volume - as ordered;
preparations are reconstituted
with NS; total volume is recorded
on bag

COMPOSITION
Factor VIII Freeze dried Factor VIII deficiency (hemophilia Not required Filter - filtered during preparation; Product is obtained from
Antihemophilic factor VIII A); some of newer concentrates follow package instructions to Pharmacy; each bottle of
Factor (AHF) can be used in von Willebrand’s reconstitute at room temperature. AHF is labeled with
disease; prepared from pooled Use plastic disposable syringes, activity expressed in
Von Willibrand plasma, heat treated as proteins adhere to glass. international units
Factor Visually inspect for particulate
matter or discoloration prior to There is a risk of
(Humate P) infectious disease
administration. Administer within
3 hours of reconstitution. Slowly transmission
infuse the solution (max rate 4
mL/min) with suitable
intravenous administration set. 1 Unit/Kg of Factor VIII
should increase plasma
Factor VIII level 2 %
Volume - 10-30 mL
Factor IX Freeze dried Factor IX deficiency (hemophilia Not required Filter - none required, filtered Product is obtained from
concentrations of B), also known as Christmas during preparation by pharmacy. Pharmacy; each bottle of
Recombinant factor IX disease factor IX is labeled with
coagulation factor For IV use only. Visually inspect activity expressed in
IX for particulate matter or international units; risk of
discoloration prior to transmission of infectious
(Benefit) administration. Administer using disease is reduced, but
tubing provided. Adjust the rate not eliminated by
of administration based on the processing
patient’s comfort level.
unit/Kg of Factor IX should

Preferred needle gauge - 20-24 increase plasma Factor IX
level 1%.
Volume -10-30 mL

COMPOSITION
Normal serum Plasma proteins Hypovolemic shock associated Not applicable Filter - Some products may Product is obtained from
available in 5% or with or without acute blood loss; require filtration; refer to package Pharmacy
albumin (NSA) 25% 25% cerebral edema; insert. For IV use only. Visually
and 5% and cardiopulmonary bypass inspect for particulate matter or There is a risk of
plasma protein discoloration prior to infectious disease
fraction (PPF) 5% administration. Do not begin transmission
Albumin
within 4 hours.

age and patient dependent
Rate - dependent on product,

concentration and patient’s
condition; see package insert.
5% solution: 1 - 10 cc/minute or
more rapidly if patient in shock;
25% solution: 0.2 - 0.4 cc/minute
Do NOT hang longer than 4
hours.
Volume - 25% NSA, 50 and 100

mL; 5% NSA, 250 and 500 mL;
5% PPF, 250 and 500 mL.
Peds: 1g/kg = 20 mL/Kg (5%

sol.) or 4 mL/Kg (25% sol.)

COMPOSITION
Irradiated blood Irradiated at a Congenital immunodeficiency Product specific; see Product specific; see packed red Crossmatch compatibility
products: dose of 25 Gy states: severe combined packed red cells or cells or platelet pheresis and HLA match take
(2,500 rads) immunodeficiency syndrome, platelet concentrates administration preference over ABO and
RBCs, RBCs thymic hypoplasia, Wiskott- RH for platelets
(leukodepleted and Aldrich syndrome, Lenier’s
washed), platelets disease, 5’ Nucleotidase
deficiency
Infants less than 4 months old:
Neonatal transfusions,
intrauterine transfusions,
exchange transfusions, cardiac
surgery (except ECMO)
Acquired immunodeficiency
states: ANC < 500 (any reason),
highly immunosuppressive
chemo, BMT (mobilization
chemotherapy to 100 days post-
transplant, then check with
physician)
Other: directed donor products

from relatives, any HLA matched
platelet product

Granulocytes Will be irradiated, Granulocyte count below Same as for RBCs since Will be given on several High risk for transfusion
(WBCs) usually contain 500l/mL, failure of antibiotic the transfusion will have consecutive days to raise WBC reaction. Patient can
some RBCs resolution of bacterial sepsis, RBCs count. have a severe transfusion
(product will look fever for 24-48 hours reaction to any WBC
red) unresponsive to appropriate Product must be Do not use leukopore or transfusion, not just the
antibiotic therapy crossmatched microaggregate filter first transfusion
Use standard 170 - 260 micron Shelf life of WBCs after
blood filter donor collection is 24
hours
Resuspend cells every 30
minutes during transfusion Prophylactic pre-
transfusion medications
(antihistamine and/or
acetaminophen) may be
given to decrease the
incidence of allergic
reactions
Aburetrol should be used

when transfusing WBCs if
blood transfusion tubing is
not compatible with
infusion pump
Patient should be in an
intensive care setting. VS
to include T, P, R, and BP
should be taken before
the transfusion, every 15
minutes during the
transfusion and at
completion of the
transfusion
Separate administration of
WBC and amphotericn B
by at least 6 hours from
the completion of one
product to the start of the
second product

NEONATAL TRANSFUSION GUIDELINES
ORDERED PREPARATION INDICATIONS FOR USE ABO-RH ADMINISTRATION SPECIAL

COMPONENT AND COMPATIBILITY CONSIDERATIONS
COMPOSITION
Packed red cells RBCs, 1. Hemoglobin <13 g/dl or Recipient Donor Filter - If packaged in a syringe, All packs of RBCs for
(RBCs) leukocyte hematocrit 40% in an infant: blood product has been filtered neonates are pre-
reduced WBCs (negligible), a. requiring assisted O O by blood bank leukodepleted so
platelets and ventilation and leukofilter is not required
plasma (minimal) supplemental oxygen A A, O Preferred needle gauge – 24 - 26 for transfusion. Standard
b. with severe pulmonary gauge and patient dependent filter is still required if the
disease, cyanotic heart AB AB, A, B,
product has not been
disease, or heart Rate - Infuse volume over 2 to 4
NeoRBC28 is B B, O filtered by blood bank
failure hours, or as ordered. Start rate at
leukoreduced, c. ECMO slowest rate possible for first 15
Rh+ Rh+, Rh-
irradiated blood 2. Hemoglobin/hematocrit < 10 minutes and then increase rate
product > 5 days < g/dl or 30% Rh- Rh-
28 days a. significant apnea Volume – 10-15 mL/kg or as
b. poor weight gain ordered
3. Hemoglobin/hematocrit < 8
g/dl or 24% in stable newborn
with clinical manifestations of
anemia
4. Acute blood loss > 10% of
total blood volume
5. Phlebotomy losses >5-10% of
blood volume
Red blood cells- RBCs, minimal Decrease risk for alloimmunization Same as RBCs Same as RBCs Expiration time is 24 hours
washed WBCs, no plasma, to leukocyte or HLA antigens; after saline wash.
no platelets ECMO circuit priming; rarely for Contains viable
hyperkalemic patient lymphocytes and can
induce GVHD

COMPOSITION
Plasma: Plasma, with 1. PT INR > 1.5, Recipient Donor Filter - standard pediatric blood Expiration time of product
clotting factors aPTT>60seconds, or factor filter is 24 hours after thawing if
Fresh frozen plasma assay<25% and active O O, A, B, AB used for Factor VIII
(FFP) bleeding, or anticipated Preferred needle gauge - 24 – 26 replacement; must be
major surgery/invasive A A, AB gauge and patient dependent used within 5 days of
procedure within 24 hours thawing for other
2. Diffuse microvascular B B, AB Rate -
indications. Usual starting
bleeding and PT/PTT not AB AB Infuse volume over 30 min.-2 dose is 10 - 15 mL/Kg
available
3. Plasma exchange in hours dependent on patient’s (raises the overall level of
TTP/HUS (or cryo-poor FP) status. (Usual rates as ordered: clotting factor activity by
4. Emergency reversal of 5 mL/Kg/hr or 2 mL/Kg /hr for 20 - 30 %)
bleeding associated with cardiac dysfunction & severe
Group AB is preferred for
Coumadin anemia). May be pushed in
all neonates
5. Protein C, protein S certain circumstances
deficiency, or ATIII
deficiency if purified Volume – 10-15 mL/kg every 12-
concentrate not available 24 hrs as indicated
6. Initial stabilization on ECMO
circuit

COMPOSITION
Platelet Platelets, plasma, Infants <=37 weeks gestation: ABO compatible Filter -If packaged in a syringe, Prophylactic pre-
small numbers of products will be used blood product has been filtered transfusion medications
apheresis RBCs and WBCs 1. < 50,000/ul in stable infant by blood bank may be given
2. <100,000/ul in sick infant:
a. ECMO Preferred needle gauge - 24 – 26
b. Active bleeding gauge and patient dependent
NeoPlt is c. Invasive procedure
Leukoreduced, Rate – Infuse volume within 30-
CMV negative, Infants>=37 weeks: 60 minutes
irradiated
1. <100,000/ul with active Volume – 10-15 mL/ kg or as
bleeding ordered
2. <50,000/ul with need for
invasive procedure
3. <20,000/ul in non-bleeding
patient with failure of platelet
production and risk factors
such as coagulopathy, sepsis,
fever,etc.
4. <20,000 in non-bleeding
patient with failure of platelet
production
5. Bleeding with qualitative
platelet defect regardless of
platelet count
6. Diffuse microvascular
bleeding following cardiac
bypass, regardless of platelet
count

COMPOSITION
Cryoprecipitate Factor VIII, von 1. Hypofibrinogenemia Group AB is used for all Filter - standard pediatric blood Cryoprecipitate is stored
Willebrand’s (fibrinogen < 100 mg/dl) and: neonates filter If packaged in a syringe, frozen and must be
(AHF) factor, factor XIII, a. active bleeding blood product has been filtered thawed prior to use;
fibrinogen; product b. anticipated surgery or by blood bank maximum patient benefit if
is frozen major invasive procedure used within 2 hours; one
2. Factor XIII deficiency Preferred needle gauge – 24 - 26 unit = 8-12mL total.
3. Uremia with bleeding gauge and patient dependent Yields a minimum of 80
unresponsive to non-
units of Factor VIII and mg
transfusion therapy Rate - may be given IV push or
4. Fibrin glue of 100-350 mg of
infuse volume over 1 hour
5. Active bleeding and fibrinogen
Hemophilia A or vWD when Volume - order 1/3 unit for < 1.0
purified factor concentrates Kg infants; 1/2 unit for 1.5 kg, 1
not available unit for Term ECMO patient
Granulocytes
Refer to Pediatric
Transfusion
Guidelines
Normal serum Plasma proteins 1. Hypoalbunemia Not applicable Filter - Some products may Product is obtained from
available in 5% or 2. Cardiopulmonary bypass require filtration; refer to package Pharmacy
albumin (NSA) 25% 25% (ECMO) insert. For IV use only. Visually
and 5% and plasma 3. No clinical benefit of using inspect for particulate matter or There is a risk of
protein fraction albumin over saline for discoloration prior to infectious disease
(PPF) 5% hypovolemia administration. Do not begin transmission
Albumin
within 4 hours
Preferred needle gauge - 24 – 26

gauge age and patient
dependent
Replacement volume is 10-

20mL/kg/dose

Adult Transfusion Guidelines

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Adult Transfusion Guidelines

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ADULT TRANSFUSION GUIDELINES

ORDERED PREPARATION INDICATIONS FOR USE ABO-RH COMPATIBILITY ADMINISTRATION SPECIAL

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Rate - Same as RBCs

Volume - Same as RBCs

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Volume - actual volume is printed

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Preferred needle gauge - 22-24

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Preferred needle gauge - 20-24

Preferred needle gauge - 18-24

Rate - dependent on product,

Volume - 25% NSA, 50 and 100

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Infants less than 4 months old:

Other: directed donor products

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ORDERED PREPARATION INDICATIONS FOR USE ABO-RH COMPATIBILITY ADMINISTRATION SPECIAL

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Rate - TKO x 15 minutes, then

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unit/Kg of Factor IX should

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Preferred needle gauge - 18-24

Rate - dependent on product,

Volume - 25% NSA, 50 and 100

Peds: 1g/kg = 20 mL/Kg (5%

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Infants less than 4 months old:

Other: directed donor products

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Aburetrol should be used

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ORDERED PREPARATION INDICATIONS FOR USE ABO-RH ADMINISTRATION SPECIAL

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Preferred needle gauge - 24 – 26

Replacement volume is 10-

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