The patient is closely monitored thereafter, and if more blood products are needed they are given in a 1:1:1 fashion. Most protocols start with 2 U PRBC, 2 U FFP, and 2 U plts upfront once MTP is activated. The goal of MTP is to rapidly provide blood products while also preventing the “ lethal triad” of acidosis, hypothermia, and coagulopathy that prolongs hemorrhage. 4 Units of PRBC in 10 Units of PRBC within 24 hours.Available on MDCalc and takes into account patient’s age as this will impact their relative scoring based on age-adjusted HR and BP normal ranges.This was found to be more sensitive in predicting need for MTP than ABC score but not validated in kids.HR divided by SBP equals shock index (HR/SBP=SI) Essentially if your HR becomes greater than your SBP, then this is bad (e.g.If patient meets 2 of these factors, then MTP should be considered Each of the following scores 1 point: penetrating mechanism, SBP120, positive FAST.Essentially, these tools state the obvious that if there is blunt or penetrating trauma in patients with hypotension and tachycardia, then you should be leaning towards MTP. There are two scoring systems for evaluating the need for MTP as well as one scoring system for pediatrics. Just a quick refresher on our ABCDEFGHI mnemonic for any trauma that walks through the door.Īfter completing the primary survey and obtaining history, we need to decide if patient meets criteria for MTP. By recognizing the severity of injury and intervening quickly by giving blood products upfront, MTP has been shown to decrease ICU length of stay, decrease ventilator length of use, decrease mortality rates, and has been shown to decrease the number of blood products needed over the entire length of stay. Massive Transfusion Protocol (MTP) is an important step in most trauma protocols.