EMCrit Podcast 13 – Trauma Resus II: Massive Transfusion

On this podcast,

I recap from last show, especially the concept of bare minimum normotension (called erroneously permissive hypotension by just about everyone else) and why we should keep the MAP higher if there is suspected elevations in intracranial pressure

I then talk about massive transfusion. This is probably the best strategy for a patient that will require greater than 8-10 units of PRBCs.

What may be the best review of the topic is by Spinella and Holcomb:

(Blood Reviews 2009;23:231-240)

I talk about

  • 1:1:1 transfusion
  • PCC, Factor VIIa, Cryo
  • Calcium
  • IV Access

coming up in the next few podcasts: Sedatives for Intubation, Trauma Airway Management, The Crashing A-fib patient

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Comments

  1. Kenneth henriette says:

    how about the place of tranxenamic acid in this algorithm,
    regards,
    Ken

    • We’re doing a whole podcast on TXA in the next few weeks, but in GB it costs a few quid, in my hospital $100 per gram ($200 per patient). Have no idea why we are getting reamed on this generic drug in the US.

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