A.
Immediately isolate the involved component using a clamp, luer cap, or a finger—wear sterile gloves if immediately available.
B.
If the drainage line is involved, monitor the circuit for signs of air entering the circuit and the patient for signs of an air embolism.
Treat accordingly. Then come back to this step.
C.
Replace the involved component.
D.
If there isn't a massive air entrance to the circuit, do NOT interrupt blood flow unless required to replace the broken or disconnected component.
E.
If EBF needs to be stopped to replace a component, first prepare the component to be replaced. Then clamp the return line and tubing before or after the connection site for a few seconds to replace the component. Use either the air-free and sterile or no-touch techniques.
F.
Estimate blood loss and replace with packed red blood cells (pRBC) if needed.
G.
Strictly monitor the patient for signs of complications or a new bleeding episode.
H.
Consider prophylactic antibiotics.
I.
Document the event and related procedures in the patient's chart.
J.
If applicable, report the incident in the ELSO registry.
This concludes Blood Out of Circuit.