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Massive transfusion protocol (mtp) should be considered for cases of massive blood loss with profound hemorrhagic/hypovolemic shock or conditions of disseminated intravascular coagulopathy (dic). Massive transfusion, in support of massive hemorrhage protocols (mhps), is generally defined as the transfusion of greater than 8 red blood cell (rbc) units in an adult recipient in <24 hours or the acute transfusion of >4 rbc units within 1 hour. Massive transfusion protocols should be developed by a multidisciplinary committee that includes, at a minimum, representatives from

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Massive transfusion in the adult is defined as either replacement of >1 blood volume in 24 hours, or >50% of blood volume in four hours The use of a massive transfusion protocol in the hemorrhaging trauma patient is critical to their survival and emergency physicians are the rst line providers available to these patients as soon as they fi enter the hospital. Pediatric patients defined as transfusion of >40 ml/kg.

Blood product resuscitation is the standard of care for hemorrhagic shock

While most trauma patients requiring transfusion do not need a massive transfusion, mtp is defined as administering 10 units of prbcs within 24 hours Predictive indicators, including the assessment of blood consumption (abc) score, should guide mtp activation