Attachment- UCH MTP Quick Guide * Procoagulants are an anesthesia department recommendation and are not a part of original UCH MTP Quick Guide Triggers for Activating Cooler Lab Hemostasis Post-MTP Activation MTP Contents Studies Care Designate a Cooler #1 Bleeding Deactivate Refer to the person 5u PRBCs labs Controlled MTP UCHealth Trauma responsible 5u FFP CBC, ABG, Deactivate Return cooler • TEG Resuscitation for activating 1u MTP with unused chart below for MTP apheresis BMP, Bleeding products to guidance on the 1. Primary platelets iCa, uncontrolled blood bank ABC score to Team Cooler #2 Lactate Continue MTP Draw labs Activate the MTP. 2. Intensivist 5u PRBCs B. Repeat labs Continued (CBC, PT, Team 5u FFP Q4h OR ooze, consider Fibrinogen, 3. ED, Alternate after each 1. FFP for BMP, iCa) Anesthesia coolers, #1 cooler INR>1.6 QID for 24h Activate MTP and #2, until C. Obtain 2. Platelets for Then, BID 1. Call blood MTP fibrinogen plt< 50K for 24h bank deactivated level after 3*. TXA w/in 3h (84444) Ordering 10u PRBCs of injury + 2. Identify Dept to pick Give cryo severe shock patient and up contents 10u for OR TEG confirmed MRN Blood 3. Initiate products <100 Trauma to be Page for transported 4*. rFVIIa MTP w/patient (100mcg/kg) if TXA ineffective activation 5*. Kcentra as guided by INR 25 U/kg (INR 2-4) 35 U/kg (INR 4-6) 50 U/kg (INR >6)
Attachment- UCH MTP Quick Guide Triggers for Activation Activating MTP Cooler Contents Lab Studies Hemostasis Post-MTP Care Refer to the UCHealth Trauma TEG Resuscitation chart below for guidance on the ABC score to Activate the MTP. Designate a person responsible for activating MTP 1. Primary Team 2. Intensivist Team 3. ED, Anesthesia Activate MTP 1. Call blood bank (84444) 2. Identify patient and MRN 3. Initiate Trauma Page for MTP activation Cooler #1 5u PRBCs 5u FFP 1u apheresis platelets Cooler #2 5u PRBCs 5u FFP Alternate coolers, #1 and #2, until MTP deactivated Ordering Dept to pick up contents Blood products to be transported w/patient labs • CBC, ABG, BMP, iCa, Lactate B. Repeat labs Q4h OR after each cooler C. Obtain fibrinogen level after 10u PRBCs Give cryo 10u for <100 Bleeding Controlled Deactivate MTP Bleeding uncontrolled Continue MTP Continued ooze, consider 1. FFP for INR>1.6 2. Platelets for plt< 50K 3*. TXA w/in 3h of injury + severe shock OR TEG confirmed 4*. rFVIIa (100mcg/kg) if TXA ineffective 5*. Kcentra as guided by INR 25 U/kg (INR 2-4) 35 U/kg (INR 4-6) 50 U/kg (INR >6) Deactivate MTP Return cooler with unused products to blood bank Draw labs (CBC, PT, Fibrinogen, BMP, iCa) QID for 24h Then, BID for 24h * Procoagulants are an anesthesia department recommendation and are not a part of original UCH MTP Quick Guide
Trauma%20Anesthesia%20Guidelines%20at%20UCH%20Final%20Revision.docx