Hi – Apologies for recent sluggish activity- I have been a busy Doc lately and working on what I hope are some good posts / resources for you all.
The first Big project I am wanting your feedback on is my “Massive Transfusion Protocol” which you can click here – or I have added as a permanent resource in the “Clinical Resources” section at the bottom of the blog.
Why have I decided to spend hours on this?
I have always found the current published Massive Bleeding Protocols to be either too simplistic or not descriptive enough. There are a few crucial decision points – such as” when to activate” – which are glossed over frequently.
Most protocols deal only with trauma – and in my world, the big bleeding happens on the labour ward, in theatre… etc NOT just in the ED resus bay.
So I have written a protocol for me – one which I can with a click on a page access and remind myself of the steps and “recipes” for resuscitaing in major trauma / bleeding. I have downgraded the role of platelets – because – we do not use them in smaller hospitals and the evidence is not great for empirical use.
I have tried to include some evidence in a ‘hidden’ way to keep it simple in a crisis – or you can read at your leisure later.
Be aware: this protocol relies heavily on your hospital having in place a system-wide approach to this emergency. Your lab have to have a predefined system, your surgeon should be aware of the protocol and the concepts associated with “damage control” operations. This is not the time to get into a territorial dispute, you need to have your chickens all lined up before it happens!
So please read it- this is my draft, I hope to make it more useful with your feedback.
Let me know what you think. Casey