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Massive Transfusion Protocol

The massive transfusion protocol (MTP) is activated when a patient receives 4 or more units of red blood cells within 1 hour and ongoing substantial transfusion need is expected. When activated, it triggers notifications to key departments and provides guidelines for initial and subsequent transfusions of blood products including red blood cells, plasma, and platelets. The protocol outlines criteria for discontinuing MTP and closing out orders.

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32 views1 page

Massive Transfusion Protocol

The massive transfusion protocol (MTP) is activated when a patient receives 4 or more units of red blood cells within 1 hour and ongoing substantial transfusion need is expected. When activated, it triggers notifications to key departments and provides guidelines for initial and subsequent transfusions of blood products including red blood cells, plasma, and platelets. The protocol outlines criteria for discontinuing MTP and closing out orders.

Uploaded by

draymanhussiennotion
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Massive Transfusion Protocol

Activate MTP if:


Transfusion of greater than or equal to 4 red blood cell units within 1 hour when ongoing
substantial need is expected

Paging will inform Transfusion Medicine Doctor On-Call that the MTP has been activated.
They will also notify Transport, Blood Bank, and CBS.

If Patient is anticoagulated If Patient is not anticoagulated

Refer to EPR Begin Transfusion

Transfuse the first Massive Transfusion Pack:


(It will be available from hospital Blood Bank in two separate components)
 5 units red blood cells will be ready within 15 minutes (Red Cooler)
 1000 ml plasma & 1 adult dose of platelets will be ready within 30 minutes (Blue Cooler)

Consider platelet transfusion if the patient is known to be thrombocytopenic (less


than 50x109/L) or if platelet dysfunction is suspected (eg patient on clopidogrel,
glycoprotein IIb/IIIa inhibitors or post cardiopulmonary bypass)
Record ___dose(s) of adult pooled platelets in EPR. (Usual practice is 1 adult dose)

If additional products are needed in the 1st MTP order: Consider additional plasma if initial INR is greater than 2.0, or coagulopathy is highly
suspected)
Fax a Request for Release Form #F160-INV-03, to Blood Bank 204-237-2494 Record ___ml of frozen plasma in EPR. (Usual dose is 15mL/kg or 1000-1500 ml)

If the corrected serum calcium is less than 2.1 mmol/L, or if the arterial blood gas
ionic calcium is less than 1.15 mmol/L, then administer after the 1.15 mmol/L

Calcium chloride 1 gram IV (1geam/10ml syringe) via a central line preferred, over 5
minutes.
Or
Calcium gluconate 2 grams IV (20 ml of 1g/20ml) via a peripheral line, or central line
over 5 minutes each

Record Tranexamic acid ____mg (usual 1000mg)


Transfuse subsequent Massive Transfusion Packs as they arrive.
Record IV Bolus over ____(usual 10 minutes),
Packs will be ready or pick up hourly and will contain: Then ____mg/hr (usual 125 mg/hr) IV for _____ hours (usual 8 hours)

 5 units of red blood cells (red cooler)


 1000ml frozen plasma (blue cooler)
 1 adult dose of platelets (plastic bag attached to blue cooler)

Priority for order of transfusion is frozen plasma, followed by platelets,


If additional and then
Red Blood Cells, RBC’s
Platelets, Frozen Plasma or Cryoprecipitate are needed:

Fax a Request for Release Form #F160-INV-03, to Blood Bank 204-237-2494

As soon as ONE of the following criteria has been satisfied:

 Patient has stopped bleeding or bleeding is under control


 Patient has died or resuscitation efforts have been withdrawn.

Close Out Orders


1. Inform unit staff to call the hospital Blood Bank and Patient Transport to communicate that the MTP has ended.
Blood Bank # 204-237-2470
2. Promptly return unused blood products to the hospital blood bank.
3. Complete ROT’s and return to Blood Bank.
4. Complete the evaluations contained in the Massive Transfusion printed package. Return the debrief form to the Patient Safety
Officer via interdepartmental mail.

September 2015 Rev 1

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