Major haemorrhage protocols

摘要: Major haemorrhage protocols are aimed at optimizing the care of patients suffering life-threatening bleeding. They should clearly set out responsibilities all staff involved including clinical and laboratory teams other support with explicit lines communication to a prompt response without delays. The emphasis is on ready access blood components limit coagulopathy in conjunction definitive methods controlling haemorrhage. High-quality evidence for early use tranexamic acid strongly supports inclusion this drug trauma obstetric Although national international guidelines recommend MHPs, they not drawbacks. Much their comes from studies haemorrhage, although principles widely applied settings, there lack data guide practice bleeding causes. Initial empirical replacement red cells plasma fixed ratios largely based experience military now common trauma, but approach might result overtreatment some patients. As hypofibrinogenaemia poor prognostic factor, fibrinogen deserves attention subject active research. Further examining targeted transfusion strategies near-patient testing, whole chilled platelets, expanding indications component prehospital setting. MHPs be reviewed regularly following local audit ongoing update reflect new research findings.