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Modern transfusion practice uses blood collected using a preservative–anticoagulant combination (usually citrate phosphate dextrose or citrate phosphate dextrose adenine-1). The collected whole blood is tested for transfusion-transmitted diseases and most often separated into specific components supplied as standardized preparations termed “units” (Table 238-1).1 Transfusion in the ED typically is done for acute blood loss and/or circulatory shock using packed red blood cells (PRBCs), with increasing interest in using stored whole blood in severely bleeding patients.2 Coagulation factors derived from human plasma or manufactured with recombinant technology are used to treat hemorrhage associated with a deficiency of one or more factors or to reverse the effect of antithrombotic medications (see Chapter 239, “Thrombotics and Antithrombotics”) (Table 238-2).
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