Haemorrhage

Question 1

What is the major haemorrhage protocol

Answer 1

Call 2222 and state MH
1. Baseline bloods: FBC, G&S, clotting + Clauss fibrinogen
2. Consider tranexamic acid
- Trauma + <3h from injury → tranexamic acid 1g bolus over 10 minutes → IV infusion of 1g over 8h
- Non-traumatic: 1g bolus
3. Call transfusion unit
- State patient identifier and location
- O neg for women and O pos for men (group-specific if possible)
- Request agreed ratio of blood components (e.g. 6U RBC to 4U FFP)
- Send porter
4. If bleeding continues: consider FFP, cryoprecipitate

Question 2

What is given if after initial haemorrhage management the patient continues to bleed and the lab results have not returned

Answer 2

FFP 1L (4 units) per 6 units of red cells
Consider cryoprecipitate (2 pools)
Consider platelets (1 adult therapeutic dose)

Question 3

What is given if Hb continues to fall despite haemorrhage management

Answer 3

Red cells

Question 4

What is given in haemorrhage if PT ratio >1.5

Answer 4

FFP 15-20ml/mg

Question 5

What is given in haemorrhage if fibrinogen is <1.5g/L

Answer 5

Cryoprecipitate (2 pools)

Question 6

What is given in haemorrhage if paltelets <75x10^9

Answer 6

Platelets ATD