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Transfusion Handbook - 7.3: Transfusion management of major haemorrhage

Transfusion Handbook - 7.3: Transfusion management of major haemorrhage

Please note the Transfusion Handbook has not been updated since 2014 and requires review. Guidance within the Handbook may therefore be out of date with other current guidelines.

Major haemorrhage is variously defined as:
- Loss of more than one blood volume within 24 hours (around 70 mL/kg, >5 litres in a 70 kg adult)
- 50% of total blood volume lost in less than 3 hours
- Bleeding in excess of 150 mL/minute.

A pragmatic clinically based definition is bleeding which leads to a systolic blood pressure of less than 90 mm Hg or a heart rate of more than 110 beats per minute.

Early recognition and intervention is essential for survival. The immediate priorities are to control bleeding (surgery and interventional radiology) and maintain vital organ perfusion by transfusing blood and other fluids through a wide-bore intravenous catheter. Recent research has focused on major traumatic haemorrhage, influenced by the increased survival of military casualties using ‘damage control resuscitation’ and early transfusion of fresh plasma and red cells


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