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Treatment is complex and resource‐intensive. Coagulopathy associated with trauma is a complex and highly lethal condition.
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#Massive transfusion protocol how to
The purpose of this review is to educate trauma and emergency medicine staff on the currently available diagnostic tools to assess coagulopathy, to provide an overview of the coagulopathy pathway, as well as provide examples of how to intervene and treat coagulopathy, including the use of crew resource management during mass transfusion protocol activations. The methods used to assess and detect if a patient is coagulopathic remain challenging, but tools have been developed to assist the practitioner to effectively manage and even quickly reverse the coagulopathy. The complexity of the coagulopathy pathway requires a deliberate and planned approach. In fact, it seen as frequently as 35% of the time. Keywords: hemorrhage, MTP, antifibrinolytics, coagulopathy, trauma, ratio, logistics, guidelines, hemostaticĬoagulopathy in trauma patients is a known contributor to death due to hemorrhage. Lastly, we will discuss the best design for an MTP, including ratio-based MTPs and MTPs based on the use of point-of-care coagulation diagnostic tools. Then, we will examine a wide selection of therapeutic products to support MTPs, including newly available products and the most suitable of the traditional products. This article will first discuss specific MTPs targeting different patient populations and current relevant international guidelines. As we come to further understand the positive and negative clinical impacts of transfusion-related factors, massive transfusion practice can be further refined. Much of the MTP literature comes from the trauma population, due to the fact that massive hemorrhage is the leading cause of preventable trauma-related death. The establishment and utilization of an optimal MTP is challenging given the ever-changing patient status during resuscitation efforts. There are many variables to consider when establishing an MTP, and studies have prospectively evaluated different scenarios and patient populations to establish the best practices to attain improved patient outcomes. Early optimal blood transfusion is essential to sustain organ perfusion and oxygenation. Yen-Michael S Hsu,1 Thorsten Haas,2 Melissa M Cushing1 1Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA 2Department of Anesthesia, University Children's Hospital Zurich, Zurich, Switzerland Abstract: Massive transfusion protocols (MTPs) are established to provide rapid blood replacement in a setting of severe hemorrhage.