MASSIVE TRANSFUSION PROTOCOL WHEN TO INITIATE IT?
ABC (assessment of blood consumption) score >2- each assigned 1 point
penetrating torso injury
Shock index >1.4 (HR/sBP)
active bleeding requiring multiple transfusions
WHAT DOES IT CONSIST OF?
1:1:1 ratio of RBC:Plasma:Platelets
TO PREP FOR BLOOD ARRIVAL
2 large bore IVs
baseline labs- cbc, type and screen, Pt/PTT/INR, fibrinogen, BMP with magnesium
prepare the Belmont- rapid transfusion and warmer to prevent hypothermia
If trauma patient give Tranexamic acid 1gm IV over 10 minutes and then 1gm IV over 8 hours.
Repeat labs every hour checking for electrolyte abnormalities. CORRECT THEM!
Ensure patient is not hypothermic