Transfusion Medicine Service
Massive Transfusion Protocol (MTP)
Further information is available by contacting the Medical Director of the Transfusion Medicine Service:
or the Blood Bank Medical Director, Nancy Dunbar M.D.
Identification of MTP Candidates:
- Life threatening trauma presenting to the Emergency Room – see Trauma Activated
TATA information link
- Unexpected surgical blood emergencies
- Medical Emergencies potentially requiring extensive blood support
The identification of candidates is made by the responsible Surgical or Anesthesia staff. The protocol is
automatically activated by the Blood Bank on transfusion of a volume of red cells
equal to the patient's red cell mass within a 24 hour period.
Notification of Transfusion Service
The physician, or designee, responsible for the potential MTP candidate shall notify the
Blood Bank (5-7207) that MTP is indicated. The Blood Bank will contact the Transfusion Medicine Physician.
Once the MTP 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 MTP emergency is declared to be at an end. The MTP provides a coordinated hematologic resuscitation
effort, including the use of thawed plasma, cryoprecipitate, platelets, and red blood cells. Prioritization, coordination,
and monitoring of laboratory tests are another element of the MTP.
Note: O Rh negative or O Rh positive units may be sent based upon patient status, gender, and age.
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 products during the MTP, the unit will request that the Blood Bank notify
the dispatcher for Supply Change Management. The OSC (Outpatient Surgery Center) will be responsible to provide
their own couriers.
The goals of the MTP are:
- To focus responsibility for guidance of blood resuscitation on the Transfusion Medicine Service Physician
- To standardize laboratory monitoring for the benefit of clinical staff in crisis situations
- To provide optimal blood component therapy for critically ill patients
Specific Protocol Guidelines
- Role of Surgical - Medical Team
Obtain tests as indicated by the case
Obtain laboratory consultation for known coagulopathies pre-MTP
Notify the Blood Bank of potential MTP
- Role of Anesthesia Service
Repeat specific coagulation tests after appropriate factor replacements
Order specific blood components via eD-H
- Role of the Transfusion Medicine Physician
Manage hematologic replacement therapy
Direct Clinical Laboratory Sections to obtain top priority for tests in support of the patient
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