Massive Transfusion Protocols: When to Turn On, and Off, the Fire Hose

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Massive transfusion protocols (MTP) guide management of severe hemorrhage with fixed-ratio transfusion of blood product. Implementation of these protocols in trauma settings has been associated with improved patient outcomes, reduction of blood production utilization and waste, and reduced transfusion complications. While adoption of MTP by academic medical centers has been robust, much practice variation exists around its initiation and termination. In this infographic, we compare 2 scoring systems used to inform the initiation of MTP, review common fixed ratios for MTP, and describe factors important to understand when terminating MTP.
FFP indicates fresh frozen plasma; MTP, massive transfusion protocols; PRBCs, packed red blood cells.
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