What is the pediatric (>5 y/o with no evidence of puberty) whole blood dose?

• A. 10 ml/kg
• B. 15 ml/kg
• C. 20 ml/kg
• D. 5 ml/kg

Answer: (B)

In pediatric transfusion, you dose whole blood by weight to rapidly restore circulating volume and deliver coagulation factors. For a child older than five who is prepubertal, the recommended initial dose is about 15 ml per kilogram. This amount provides enough intravascular volume and oxygen-carrying capacity while including plasma and clotting factors, which helps with both resuscitation and hemostasis.

Giving too little, such as a small 5 ml/kg dose, would not adequately restore volume or improve perfusion. A 10 ml/kg dose is more typical for red blood cell transfusions and wouldn’t supply the plasma and coagulation components of whole blood. A larger 20 ml/kg dose increases the risk of volume overload in a child of this size and age, and isn’t necessary as the initial resuscitation dose. Thus, 15 ml/kg strikes the right balance for initial whole blood resuscitation in this patient group.