About the podcast
Dr Tom Scorer is a consultant haematologist and the transfusion lead at Derriford Hospital, Plymouth.
Most of us will be broadly familiar with a massive transfusion protocol and are probably aware of the triggers for activating one. However knowning the components, the function of each of these components and their potential consequences is what Tom goes through. Tom begins with a brief overview on the evolution of transfusion in trauma over the past century and how practice is evolving. We then cover the idea of a protocolised “one-size-fits-all” balanced transfusion strategy initially which we may then tailor to the patient’s individual requirements.
Other areas include additional blood products, point of care coagulation testing and a brief look at the idea of coagulopathy in trauma as a combination of a consumptive element (using or losing our clotting factors), a dilutional element (replacing other elements over clotting factors) and the impact of the trauma itself.
Though TXA is discussed, it’s important to be aware that TXA has benefit in all traumatic haemorrhage, not just those patients needing massive transfusion (have a look at our TXA podcast for more info!).
This is a huge (or massive…) topic with a lot of detail. You’ll want to listen to this podcast in conjunction with our ones on haemorrhage control and TXA. As always, level 1 and 2 learning areas listed in the show notes along with useful resources.
Massive Transfusion Protocols – ThePTN podcast
Learning areas in this podcast:
- Recognise the indication for fluid resuscitation
- Knowledge of the different types of fluid available and which are appropriate in trauma and understands the indication for activation of the major haemorrhage protocol
Level 2:
- Indication for activation of the major haemorrhage protocol and knowledge of the positive benefits of undertaking this in a trauma setting
- Is able to use of POCT (point of care testing) relevant to the major haemorrhage patient
Links:
British Society for Haematology guideline: Haematological management of major haemorrhage here. (accessed 12/1/23)
British Society for Haematology guideline page: Investigation and management of acute transfusion reactions here. (accessed 12/1/23)
THE PTN 