In this episode of The Internet Book of Critical Care Podcast, Josh and Adam discuss Massive Transfusion Protocols (MTP), emphasizing the importance of an organized approach to patients experiencing rapid blood loss to avoid complications like dilution of clotting factors, hypothermia, acidosis, and hypocalcemia. They explore the challenges of initiating MTP, the differences between textbook approaches and real-life scenarios, and the application of trauma literature to non-trauma situations such as GI bleeds and obstetric hemorrhages. The discussion covers practical aspects such as vascular access, procedural concerns, blood product ratios (one-to-one-to-one), the role of fibrinogen and TXA, and the importance of addressing pre-existing coagulopathies. They also highlight the significance of source control, maintaining adequate calcium levels, avoiding acidosis and hypothermia, and achieving a balanced blood pressure to optimize patient outcomes during massive transfusions.
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