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Category: Volume 07 Issue 12 December 2019
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Title: Outcome of Early Activation of Massive Transfusion Protocol (MTP) in Trauma

Authors: Dr Santoshkumar G Thakur, Dr Vishal C Bhatt, Dr Vernica Kala

 DOI: https://dx.doi.org/10.18535/jmscr/v7i12.06

Abstract

Background: Trauma and subsequent hemorrhagic shock continues to remain one of the biggest causes of mortality and significant morbidity in India. Patients presenting with significant blood loss following trauma often succumb due to either the scarcity or complete unavailability of blood products. Several studies continue to demonstrate the superiority of using blood and blood products as a resuscitative fluid in improving overall outcomes and various parameters including length of hospital stay in patients suffering from traumatic hemorrhagic shock.

Aims: Our study attempted to understand the role of a simple scoring system to predict an early activation of Massive Transfusion Protocols (MTP)in polytrauma patients. Additionally we descriptively analysed the nature of injuries of such patients and documented the 6 hour and 24 hour mortality of patients who received blood products via MTP.

Methodology: The study was a retrospective observational study conducted in MGM Medical College and Hospital, Navi Mumbai, and included all polytrauma patients who aged 18 and above who presented to the emergency department (ED) and received MTP between January 2019 and March 2019. The results were compiled and analysed.

Results: A total of 20 patients received blood products in the form of MTP. The protocol was activated in the ED itself for all the included patients. The average ABC score was3.15. 80% patients had orthopaedic injuries with long bone fractures with 40% presenting with polytrauma. MTP was activated within 1 hour for most patients.

Conclusions: Prompt use of the ABC score for trauma patients is highly predictive of the need for transfusion in hemorrhagic shock. Polytrauma patients require significantly higher amounts of  blood products to achieve stable hemodynamics. ED survival increases significantly following activation of MTP.

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Corresponding Author

Dr Santoshkumar G Thakur