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Trauma Activated Transfusion Algorithm (TATA)
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Transfusion Medicine Service Trauma Activated Transfusion Algorithm (TATA)
Further information is available by contacting the Medical Director of the Transfusion Medicine Service: Zbigniew.M.Szczepiorkowski, MD or the Blood Bank Medical Director, Nancy Dunbar M.D.
Identification of TATA Candidates:
  • Life threatening trauma presenting to the Emergency Room or OR
  • Used only for trauma patients to provide early and appropriate hemotherapy support primarily during the first 90 minutes post trauma
  • Activated only by trauma attending by calling the Blood Bank at 5-7207
  • The identification of candidates is made by the responsible Trauma Attending

Notification of Transfusion Service

The trauma attending physician responsible for the potential TATA candidate shall notify the Blood Bank (5-7207) that TATA is indicated. The Blood Bank will contact the Transfusion Medicine Physician who will review the situation. (Circulating RN in the OR may need to call on behalf of the trauma surgeon if surgeon is scrubbed)

Activation of Tier 2 and Tier 3 must be communicated to the Blood Bank (5-7207) by the surgeon, anesthesiologist, trauma MD, or Transfusion Medicine Physician when they are ready to proceed to the next Tier (Circulating RN may place the call on behalf of the surgeon or anesthesia provider)

Transportation

Transportation of blood components is coordinated by the local unit, using unit based runners or via Supply Chain Management (Patient Transportation/Distribution). If the unit is unable to contact Supply Chain Management to arrange for STAT transportation of blood product during the TATA, the unit will request that the blood bank notify the dispatcher for Supply Change Management.


Once the TATA is Activated

The Transfusion Medicine Physician shall proceed to the involved patient's location, notify the clinical staff in person, and supervise the transfusion needs of the patient from that point forward until, by agreement with the patient's physician, the TATA emergency is declared to be at an end. The TATA provides a coordinated hematologic resuscitation effort, including the use of frozen plasma, cryoprecipitate, platelets, and red blood cells

Specified 3 tier algorithm includes:

  • Tier 1 – 6 units RBC, 4 units thawed potentially incompatible group A plasma
  • Tier 2 – 3 units RBCs, 1 dose thawed plasma, 1 pack platelets
  • Tier 3 – 3 units RBCs, 1 dose thawed plasma, cryoprecipitate


  • Blood components (by Tier) must be ordered via eD-H in the OR after the algorithm is activated by using the following entries (search: "TATA"):
    • TATA - Tier 1
    • TATA - Tier 2
    • TATA - Tier 3

Note:  O Rh negative or O Rh positive units may be sent based upon patient status, gender, and age.

Goals

The goals of the TATA are:

  1. To focus responsibility for blood resuscitation on the Transfusion Medicine Physician
  2. To provide optimal blood component therapy for critically ill patients 
    (Typically blood components are provided using a ratio of 1:1:1 – Thawed plasma (TP): Platelets (PLT): Red Blood Cells (RBC) for the first 3 Tiers.)

Specific Protocol Guidelines

  1. Role of ED or Surgical Team
    1. TATA Protocol must be discontinued by the trauma physician, anesthesiologist, or Transfusion Medicine physician
    2. Once Tier 3 is completed, a discussion with trauma or anesthesia and the Transfusion Medicine physician is required to continue transfusion with specific, agreed upon components
    3. Provide direction to team members to order blood components via eD-H
    4. Obtain tests as indicated by the case

  2. Role of the Transfusion Medicine Physician acting as TATA Manager:
    1. Manage hematologic replacement therapy
    2. Direct Clinical Laboratory Sections to obtain top priority for tests in support of the patient
    3. Collaborate with anesthesia service to collect and follow laboratory test results as needed in order to drive blood component replacement

Trauma Activated Transfusion Algorithm Protocol, Page 6 of 6, TS VII O.2 (rev 03/20/12)

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