Implementation of massive transfusion protocol (MTP) for trauma

Introduction

Massive transfusion, the administration of 10 or more units of packed red blood cells (RBC) in less than 24 hours, can be a lifesaving therapy in the treatment of severe bleeding following injury. The rapid delivery and administration of large numbers of Packed Red Blood cells (PRBC), along with sufficient plasma and platelets is frequently a disorderly process. Establishment of MTP addresses this issue and has shown to reduce mortality and reduce the effects of coagulopathy associated with trauma.

Methods

Following a preliminary discussion with all the stake holders including the administrators, we implemented a protocol which supports the ratio of 1:1:1, of PRBC: FFP(Fresh Frozen Plasma) : Platelet. Each step of the process, from activation of protocol to termination was defined. The contents of boxes 1, 2 and 3 were Predetermined.

Conclusion

We hope to encourage the use of MTP in other centres in the country to achieve better results with post-trauma bleeding patients. The effectivenes of implementing such a protocol depends on the understanding and collaboration of each member responsible.

The Sri Lanka Journal of Surgery 2015; 33(2): 3-7