1. SUPPORTING THE RUN
Blood Transfusion Services Role in Assisting with Patient Care during Massive Transfusion Events

2. NOTIFICATION OF MASSIVE PROTOCOL
BLOOD TRANSFUSION SERVICE NOTIFICATION
Receive phone call from medical team member: Lab requires Patient name and Medical Record Number
BTS staff perform Patient History Search for completed testing Completed type and screen procedure –crossmatched red cells No type and screen or testing not completed- unmatched red cells will be dispensed for patient
Partial testing complete = Group specific unmatched
No type and screen = O Rh Neg red cells and AB plasma

3. PREPARATION OF COMPONENTS
UPON BTS NOTIFICATION :
Prepare 6 units red cells and dispense to care area on demand Thaw 1500mls Plasma and dispense on demand Designate 1 unit of platelets and dispense on demand
Derivative products like Octaplex, Fibrinogen dispensed on request by physician
If patient has completed current type and screen, group specific red cells will be crossmatched and dispensed.
If patient does not have type and screen, red cells will be dispensed with instructions for physician’s signature on transfusion tags.
If patient has history of antibodies, an ABO/Rh discrepancy, or if there are blood inventory issues, BTS staff receives guidance from Hematopathologist on how they would like BTS staff to proceed with providing components.

4. NOTIFYING MEDICAL STAFF
BTS will confirm with medical staff when product is ready to dispense to patient area:
In the event that the patient has 10 red cells dispensed they are considered MASSIVELY transfused by the BTS lab, and will continue to receive red cells as dispensed, but may not be crossmatched.
Factors to consider- inventory levels, Rh of patient, Hempath support
Products other than red cells will continue to be dispensed as requested by medical staff.

5. ONGOING SUPPORT
If patient becomes truly massively transfused (receives 10 units of red cells in a 24 hour period), BTS staff will request a post massive sample for type and screen from patient care area within the 24 hours of the start of BTS massive transfusion This is due to transfused volume approximating or exceeding the recipients total blood volume- the pre-transfusion type and screen sample no longer represents the blood currently in the patient’s circulation.

6. Massive Transfusion STATS
Fiscal Year
# MT Activations
Lab  Activated
Physician Activated
Total RBCs (units)
Total Plasma (mL)
Total Platelets (dose)
Total Cryo (dose)
Other Products 97 70 27
1,667
242,900
185
258
Albumin, ATIII, DDAVP,PCC, rFVIIa, RiaSTAP,Vitamin K
120 84 36
1,334
288,250
247 32
ATIII, PCC, rFVIIa, RiaSTAP
105 67 38
1,213
273,000
172 16