From
StayCurrentMD
Update Course Rewind: Massive Transfusion Protocol 2023
With Dr. Katie Russell & Dr. Mira Godagal · hosted by Dr. M. Goudi
Part of
Gunshot Wound 4 items
Chapter 1 of 5 · Case-Based Learning
MTP activation timing
Case presentation and initial MTP activation decision
Expert statements on this page
No expert statements were drawn from this page.
Host summaries · secondary, not cited in answers
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
There is adult data to support starting with FFP in trauma resuscitation
Blood can usually be returned to the blood bank unless you spike the bag
Whole blood for pediatric trauma needs to be irradiated, which creates blood bank implementation challenges
Most trauma coolers that come to the bay do not have platelets initially
The best definition for massive transfusion in kids is 40 ml/kg of any blood product over 24 hours
Activating MTP threshold is different than the definition of massive transfusion
There is great pediatric data on whole blood for trauma resuscitation
Kids bleed whole blood, making balanced resuscitation important
The MTP team consists of a trauma APP running the team and an ER nurse who knows how to run the Belmont rapid infuser
After implementing an MTP team, balanced resuscitation rates improved from 25% to 85%
Pre-hospital transfusion could reduce mortality according to recent data
There is evidence to support pre-hospital TXA use
Using TXA in MTP should be combined with rapid viscoelastic testing (ROTEM or TEG) to directly target resuscitation goals
After 20 ml/kg of blood within an hour, you should activate the MTP according to the MATIC trial investigators
The more fresh frozen plasma (FFP) you give, the lower your mortality is in balanced resuscitation
The closer you are to 1:1:1 ratio is better and this has been shown in kids, not just adult data