All plasma transfusions should be guided by clotting results taken within the previous 24 hours. The decision to transfuse plasma must be made following discussion with a Consultant Haematologist (HOW bleep 922) unless part of the major haemorrhage protocol. The main indication for the transfusion of plasma is to correct deficiencies of clotting factors, for which specific concentrate is not available, in patients with active bleeding. The plasma issued within the Trust is Octaplas. This is a pooled virally inactivated blood component and comes in a standard unit size of 200mls per unit; therefore 3 or 4 units are initially administered to the patient.
Indications for use:-
Therapeutic for Bleeding
Prophylactic to prevent bleeding
Initial dose of plasma is 10-15 ml per Kg of body weight e.g. 650 to 975 for 65 Kg patient. Subsequent doses must be dependent on laboratory results and patient's clinical response.
Do not use Octaplas to correct abnormal coagulation in patients who:-
For patients undergoing elective surgery with an INR > 2.0, the surgery should be delayed until the INR has returned to normal.
Prior to first administration of plasma, blood samples should be taken for: -
For subsequent doses blood samples should be taken for:-
All requests, with the exception of major haemorrhage, must go through the Consultant Haematologist on bleep 922 during routine working hours or through switchboard out-of-hours. The Transfusion laboratory must be contacted once authority for use of plasma has been obtained.
The following information must be given:-
Allow 40 minutes for thawing. Plasma is placed in the plasma fridge in South Wing and is collected by portering staff. All must be delivered immediately to the clinical area.