Please refer to your local Major Haemorrhage Protocol (MHP) for specific actions.
If haemorrhage continues and no blood results are available, local protocols may advise considering empirical transfusion (e.g. without blood results) of:
Regular communication with the laboratory is essential to prevent delays in the provision of these components. When bleeding is under control further transfusion should be guided by laboratory/viscoelastic test results.
Prothrombin complex concentrate (Octaplex, Beriplex)
Rapid effect, vitamin K required for ongoing warfarin reversal
factor II, VII, IX ,X; protein C, S.
Tranexamic acid (TXA)
Antifibrinolytic; By inhibiting fibrinolysis, the breakdown of clots is reduced.
Fibrinogen concentrate - Dried fibrinogen alternative to cryoprecipitate.
Phytomenadione (Vitamin K)