The Korean Journal of Blood Transfusion : eISSN 2383-6881 / pISSN 1226-9336

Table. 1.

Table. 1.

Massive transfusion protocol

Massive transfusion protocol
1. Trauma emergency room
 1) Before blood type testing, “MTP initial box (packed RBC (pRBC) 2 units, fresh frozen plasma (FFP) 2 units)” is prescribed in the electronic medical record (EMR) system and enter “MTP” on prescription note.
 2) Notify the blood bank of the occurrence of MTP application and inform the name of the patient.
 3) Print out the [Emergency transfusion request form] provided by EMR system and check the “Massive transfusion” box and fill in the details. Send the request form and blood specimens required for ABO/Rh blood type test, unexpected antibody screening test, and crossmatching to the blood bank either directly or through the pneumatic tube delivery system.
 4) Pick up the requested blood products directly in the blood bank.
2. Blood bank
 1) Confirm the personal details and prescription contents of MTP patients.
 2) For 2 units of pRBC and FFP 2 units in storage, the blood type test and crossmatching are omitted and registered as ready blood. FFP should be thawed immediately.
 3) After inputting the ID number of blood recipient and blood bank worker in the EMR system, the blood products is released.
 4) Check the [Emergency transfusion request form] and perform ABO/Rh blood type test, unexpected antibody test, and crossmatching. If the patient’s condition is unstable and cannot be tested, continue to release O Rh+ RBCs and AB Rh+ type of FFPs/platelets/cryoprecipitates.
3. Trauma emergency room
 1) The initial MTP action is limited to one time. However, if additional transfusion is needed when blood type test is not complete, continue to prescribe MTP in the following order.
  (1) MTP1 Initial box: O Rh(+) pRBC 2 units, AB Rh(+) FFP 2 units
  (2) MTP Box 1: O Rh(+) pRBC 4 units, AB Rh(+) FFP 4 units, platelet 6 units, cryoprecipitate 2 units
  (3) MTP Box 2: O Rh(+) RBC 3 units, AB Rh(+) FFP 3 units, platelet 3 units, cryoprecipitate 1 unit
 2) After the blood type test and antibody screening tests are completed, they are sequentially switched to ‘emergency transfusion’ and ‘type & screen’ transfusion policy (in this case, an [Emergency transfusion request form] is omitted).
4. Blood bank
 1) If the blood product requests converted to ‘emergency transfusion’, the examiner release blood products only after the manual blood type test and crossmatching (saline phase).
 2) The determined blood type is registered as the final result.
 3) Follow the ‘emergency Transfusion’ policy until the result of antibody screening is confirmed, and proceed with transfusion according to ‘type & Screen’ if the antibody screening result is available.
Other: Blood bank storage
 The blood bank should have a sufficient amount of blood products through the Red Cross Blood Service in preparation for MTP application. If there is no inventory of platelets, notify the trauma emergency room about the approximate time available for blood supply.
Korean J Blood Transfus 2018;29:262-72 https://doi.org/10.17945/kjbt.2018.29.3.262
© 2018 Korean J Blood Transfus