TY - JOUR
T1 - The development and implementation of, and first years' experience with, a massive/emergency transfusion protocol (damage control hematology protocol) in a veterans affairs hospital
AU - Gehrie, Eric A.
AU - Tormey, Christopher A.
N1 - Publisher Copyright:
© AMSUS. All rights reserved.
PY - 2014
Y1 - 2014
N2 - Published reports of massive or emergency transfusion protocols (MTP/ETPs) focus primarily on large trauma centers. There is little guidance available in the literature to assist nontrauma, hospital-based blood banks in the development of an MTP/ETP for occasional bleeding emergencies. Here, we describe the design of an MTP/ETP at the Veterans Affairs Connecticut Healthcare System in West Haven. The MTP/ETP consists of a protocolized distribution of red blood cells (RBCs), fresh frozen plasma (FFP) and platelets (PLTs), with cryoprecipitate and recombinant factor VIIa also available. In the first year of operation, the MTP/ETP was activated five times on five separate patients. All of the MTP/ETP patients received RBCs, FFP, and PLTs. Two out of five patients received cryoprecipitate. None of the patients received recombinant factor VIIa. Four of the five patients who underwent MTP/ETP survived at least 21 days following the event. A total of 2 units of FFP and 4 units of RBCs issued as a part of the MTP/ETP were wasted. The development of an MTP/ETP at our Veterans Affairs hospital helped to ensure that patients requiring massive transfusion received RBCs, FFP, and PLTs in a protocolized fashion as part of their resuscitation with relatively little product wastage.
AB - Published reports of massive or emergency transfusion protocols (MTP/ETPs) focus primarily on large trauma centers. There is little guidance available in the literature to assist nontrauma, hospital-based blood banks in the development of an MTP/ETP for occasional bleeding emergencies. Here, we describe the design of an MTP/ETP at the Veterans Affairs Connecticut Healthcare System in West Haven. The MTP/ETP consists of a protocolized distribution of red blood cells (RBCs), fresh frozen plasma (FFP) and platelets (PLTs), with cryoprecipitate and recombinant factor VIIa also available. In the first year of operation, the MTP/ETP was activated five times on five separate patients. All of the MTP/ETP patients received RBCs, FFP, and PLTs. Two out of five patients received cryoprecipitate. None of the patients received recombinant factor VIIa. Four of the five patients who underwent MTP/ETP survived at least 21 days following the event. A total of 2 units of FFP and 4 units of RBCs issued as a part of the MTP/ETP were wasted. The development of an MTP/ETP at our Veterans Affairs hospital helped to ensure that patients requiring massive transfusion received RBCs, FFP, and PLTs in a protocolized fashion as part of their resuscitation with relatively little product wastage.
UR - http://www.scopus.com/inward/record.url?scp=84928501191&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84928501191&partnerID=8YFLogxK
U2 - 10.7205/MILMED-D-14-00045
DO - 10.7205/MILMED-D-14-00045
M3 - Article
C2 - 25269127
AN - SCOPUS:84928501191
SN - 0026-4075
VL - 179
SP - 1099
EP - 1105
JO - Military medicine
JF - Military medicine
IS - 10
ER -