Blood transfusions

Question 1

Massive transfusion protocol (MTP) indications

Answer 1

1) Requires >1/2 blood volume replacement in <4hours
2) Requires entire blood volume replacement in <24hrs
3) Major obstetric, GI or surgical bleed
4) Severe thoracic, pelvic or multiple long bone trauma

Question 2

MTP bloods (repeat every 30 mins)

Answer 2

FBE 
UEC
Calcium 
ABG
Coags 
Fibrinogen 
Group & hold (+ correct forms + notify blood bank)

Question 3

MTP parameter targets

Answer 3

Temp: >35
pH: >7.2 (base excess 1.1
Plts: >50 x 10^9
PT: <1.5x normal limit 
Fibrinogen <1.0

Question 4

MTP typical blood replacement regimen

Answer 4

1:1:1 ratio PRBC:FFP:Plts
1 bag platelets equivelent to 4 units PRBC

+ Cryoprecipitate if fibrinogen drops <1.0