Unique Plan Description: Massive Blood Transfusion Protocol (JE)
Plan Selection Display: Massive Blood Transfusion Protocol (JE)
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2023-07-28 12:13:03
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2024-04-23 15:00:28
Available at all facilities: Yes

Massive Blood Transfusion Protocol (JE)
Vital Signs
	Vital Signs
		Q15 min for the duration of the Massive Blood Transfusion Protocol. The frequency may need to be increased based on the stability of the patient. Continuously monitor utilizing a core temperature probe with a goal of 96.8F.
Laboratory
	Crossmatch Red Blood Cells
		T;N, Stat, Need by STAT-Massive Txn, # to GIVE 4, No Requirements, # to HOLD 2, Emergency Release
	Frozen Plasma
		T;N, Stat, # to GIVE 2, # to HOLD 2, Need by STAT-Massive Txn, No Requirements, Emergency Release
	Platelet Pheresis
		T;N, # to GIVE 1, # to HOLD 2, Need by STAT-Massive Txn, No Requirements, Emergency Release
	CBC with Diff
		T;N, Stat, spec type = Blood
		T;N+30, Timed, spec type = Blood
		T;N+120, Timed, spec type = Blood
		T;N+180, Timed, spec type = Blood
		T;N+240, Timed, spec type = Blood
	Comprehensive Metabolic Panel
		T;N, Stat, spec type = Blood
		T;N+120, Timed, spec type = Blood
		T;N+240, Timed, spec type = Blood
	Lactate
		T;N, Stat, spec type = Blood
		T;N+120, Timed, spec type = Blood
		T;N+240, Timed, spec type = Blood
	Ionized Calcium
		T;N, Stat, spec type = Blood
		T;N+120, Timed, spec type = Blood
		T;N+240, Timed, spec type = Blood
		DIC profile to be done Stat includes the orders below for: Protime, PTT, Fibrinogen Level, D-Dimer, .SchistoDIC(NOTE)*
	INR - MH/WH/JE
		T;N, Stat, spec type = Blood
	PTT - MH/WH/JE
		T;N, Stat, spec type = Blood
	Fibrinogen Level - MH/WH/JE
		T;N, Stat, spec type = Blood
	D-Dimer - MH/WH/JE
		T;N, Stat, spec type = Blood
	.SchistoDIC
		T;N, Stat, spec type = Blood
		DIC profile to be done in 2 hours includes the orders below for: Protime, PTT, Fibrinogen Level, D-Dimer, .SchistoDIC(NOTE)*
	INR - MH/WH/JE
		T;N+120, Timed, spec type = Blood
	PTT - MH/WH/JE
		T;N+120, Timed, spec type = Blood
	Fibrinogen Level - MH/WH/JE
		T;N+120, Timed, spec type = Blood
	D-Dimer - MH/WH/JE
		T;N+120, Timed, spec type = Blood
	.SchistoDIC
		T;N+120, Timed, spec type = Blood
		DIC profile to be done in 4 hours includes the orders below for: Protime, PTT, Fibrinogen Level, D-Dimer, .SchistoDIC(NOTE)*
	INR - MH/WH/JE
		T;N+240, Timed, spec type = Blood
	PTT - MH/WH/JE
		T;N+240, Timed, spec type = Blood
	Fibrinogen Level - MH/WH/JE
		T;N+240, Timed, spec type = Blood
	D-Dimer - MH/WH/JE
		T;N+240, Timed, spec type = Blood
	.SchistoDIC
		T;N+240, Timed, spec type = Blood
IV Solutions
	Sodium Chloride 0.9%
		500 mL, IV, Routine, T;N, 1 Dose(s)/Time(s)
			Comment: To Run w/ Blood
Medications
	calcium chloride IVPB
		1,000 mg, INT, IVPB, Once, 200 ml/hr
			Comment: Give after the 4th unit of blood. Send to Bedside
Patient Care
	Intake and Output
		
	Warming Blanket
		T;N, Provide passive external rewarming including warmed blankets and increased ambient room temperature.
	Notify
		Blood bank to initiate massive blood transfusion protocol and with termination of MTP procedure
Therapies
	Continuous Pulse Oximetry Monitoring Check

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase