CPT® Code 36440

1. Indications

Push transfusion is indicated in specific clinical scenarios where rapid blood replacement is necessary for patients who are 2 years of age or younger. The following conditions may warrant this procedure:

• Blood Loss Due to Injury The procedure is performed to replace blood lost as a result of traumatic injuries.
• Surgical Procedures It is indicated when a patient has lost blood during surgical interventions.
• Sickle Cell Disease Push transfusion may be necessary for patients experiencing complications related to sickle cell disease, which can lead to anemia and other critical conditions.
• Treatment for Malignant Neoplasms This procedure is also indicated for patients undergoing treatment for cancers, where blood loss may occur due to the disease or its treatment.

2. Procedure

The push transfusion procedure involves several critical steps to ensure safe and effective administration of blood. The following outlines the procedural steps:

• Step 1: Establishing IV Access The first step involves either utilizing a previously established intravenous line or placing a new IV line to facilitate the transfusion. This is crucial for ensuring that the blood can be delivered directly into the bloodstream.
• Step 2: Medication Administration Before the transfusion begins, any medications that have been ordered by the physician are administered to the patient. This step is important for preparing the patient and minimizing potential adverse reactions during the transfusion.
• Step 3: Blood Transfusion The blood is then administered using the push technique. This involves delivering the blood rapidly over a short period, typically less than 15 minutes. The healthcare provider must ensure that the blood is infused correctly and monitor the flow rate to avoid complications.
• Step 4: Monitoring Throughout the transfusion, the child is closely monitored for any signs of adverse reactions, such as fever, chills, or allergic responses. Continuous observation is essential to ensure the patient's safety during and after the procedure.

3. Post-Procedure

After the push transfusion is completed, the patient continues to be monitored for any delayed reactions or complications. Healthcare providers will assess vital signs and observe the patient for any signs of discomfort or adverse effects. It is important to document the transfusion details, including the volume of blood transfused and the patient's response. Depending on the patient's condition, further medical interventions may be required, and follow-up care should be arranged to ensure ongoing health and recovery.