Massive transfusion protocols involve the use of balanced transfusion (including PRBCs and clotting factors), in efforts to avoid dilutional coagulopathy.Hypocalcemia-induced coagulopathy (due to citrate in blood products).Hypothermia from transfusion of cold products.Dilution of clotting factors (including platelets and fibrinogen).Patients with severe hemorrhage may develop refractory hemorrhage due to a collection of factors:.Introduction to massive transfusion protocol (MTP)Ĭoncept of a massive transfusion protocol (MTP) Stop MTP when patient is hemodynamically stable.Target lower than typical MAP, pending source control.Follow temperature, consider pre-emptive warming (e.g., with heated air blankets).For intubated patients, adjust ventilator to optimize pH.Review anticoagulant medications & consider reversal Consider in renal failure, thrombocytopenia, or antiplatelet drugs.May continue infusion at a rate of 1 gram over 8 hours – especially in obstetric or early traumatic hemorrhage.Consider 1 gram IV, if difficulty achieving hemostasis.Follow iCa if possible, target normal to mildly elevated iCa (e.g., ~1-3 mM).1-2 gram Ca chloride or 3-6 grams Ca gluconate per MTP round (6 units PRBC).Fibrinogen may be especially important in obstetric hemorrhage.
Massive Transfusion Protocol Checklist ✅ labs (order them, but don't delay treatment while you wait)
The FIR was registered at the doctor’s request against persons who used the MTP kit illegally. “When I made enquiries her husband (Ravi) he admitted that he had bought the MTP kit from his friend Virender for ₹450, who got it from another person in Mohali, Punjab, but his name was not disclosed by Ravi,” Sahu added She gave a handwritten statement regarding the same,” Sahu said. When asked what she had taken for conception “she said she was six to seven weeks pregnant and her husband had bought the kit through a friend named Virender, a resident of Kurukshetra. Later, it was learnt that the patient’s husband had bought the kit for her, confirmed Dr Jyoti Sahu, gynaecologist SDH, Kalka.Īfter she was admitted the patient was in need of treatment “evacuate the products of conception”. Senior medical officer Dharmender from Kalka informed the police that a patient (name withheld), who was married to Ravi Kumar from Rathpur Colony in Pinjore, Panchkula, had visited the SDH, Kalka, on October 17 at 9.59am with a “history of intake of MTP kit at home and retained products of conception (RPOC) as confirmed by staff at a diagnostic centre.” The Kalka police registered a case under the Medical Termination of Pregnancy Act, 1971, on Thursday, after woman tried to destroy her foetus using an abortion kit.Ī case under section 3, 4, 5 (2) of the Act was registered at the Kalka police station.
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