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Blood Transfusion Consent 2006-2023
Normal Saline 30ml per hour (16, 18 or 20 gauge cannula)
5. Pre medicate with: (check all that apply)
□ Acetaminophen (Tylenol) 650 mg P.O. X 1 dose
□ Diphenhydramine (Benadryl) 25 or 50 (circle one) mg
I.V. X 1 dose
□ Diphenhydramine (Benadryl) 25 or 50 (circle one) mg PO x 1 dose
□ Furosemide (Lasix) 10 or 20 or 40 mg (circle one) mg IV x 1 dose
□ Methylprednisolone (Solu-Medrol) 40 mg IV x 1 dose
□ Other________________________
6. Transfuse each unit over 2 hours or ____________________...
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