GuidelinesOther guideline
Massive Transfusion Guidelines: Summary
Massive transfusion
- Recognise the need for massive transfusion.
- Declare the situation to the entire team.
- Notify Anaesthesia and Surgery consultant-on-call.
- Draw baseline blood specimens:
- FBC
- Creatinine, urea, electrolytes
- INR
- Cross-match tube (if not sent already)
- Keep the patient warm.
- Consider Tranexamic Acid (Cyclokapron) 1g IV over 10 minutes.
- Check with blood bankthat they have received an adequate cross-match specimen.
- Request Massive Transfusion Pack:
- 6 units packed red blood cells.
- 6 units FFP (fresh frozen plasma).
- 1 unit of random donor pooled platelets.
- Put request through as STAT and not ASAP.
- Ensure adequate large-bore high-capacity venous access.
- Ensure active warming of patient and IV fluids.
- Commence transfusion on arrival of products.
- Repeat “Massive Transfusion Pack” as necessary.
- Consider the addition of 10 units (1000iu) cryoprecipitate when ordering second and subsequent Massive Transfusion Packs.
- Before transferring to ICU, contact laboratory and send STAT blood for:
- FBC (Hb & platelet count)
- INR & PTT
- Fibrinogen levels
- Repeat Tranexamic Acid 1g in 200ml or 1000ml saline over 8 hrs in ICU.