• This may be necessary for instance, for a severely anaemic baby.
• Such a baby is usually hypovolaemic and a straight transfusion is done as part of the exchange.

Steps/Considerations

1. Non-irradiated blood may be used as irradiation can result in unacceptable delay.
2. Once there is central venous or arterial access, the exchange can commence.

Suggested Equipment (use one catheter push-pull set up for guidance)

• 2 x 3 way taps
• A series of 10ml or 20 ml syringes filled with checked filtered blood.  Donor blood is tested as per recommended best practice.
• 2 x BC 538 extensions plus empty bottle

NB:  The exchange transfusion is not to commence until nursing and medical staff are in agreement that the circuit set-up is correct