When should the massive transfusion protocol be activated?

MTP activation criteria include: transfusion of ≥10 units pRBC in 24 hours, ABC score ≥2 (penetrating mechanism, SBP ≤90, HR ≥120, positive FAST), or clinical gestalt of ongoing uncontrolled hemorrhage with hemodynamic instability.

What is the evidence for 1:1:1 ratio?

The PROPPR trial (2015) demonstrated that 1:1:1 (pRBC:FFP:platelets) vs 2:1:1 achieved hemostasis more often (86% vs 78%, p=0.006) and reduced 24-hour and 30-day mortality with no increase in adverse events.

What role does tranexamic acid (TXA) play in MTP?

TXA 1g IV over 10 minutes, followed by 1g over 8 hours, reduces mortality in trauma hemorrhage when given within 3 hours of injury (CRASH-2 trial). TXA is contraindicated if >3 hours from injury or if injury is primarily fibrinolysis-independent.

Massive Transfusion Protocol 1:1:1 Ratio Calculator

Calculates blood product ratios for massive transfusion protocol (MTP): 1:1:1 ratio of packed red blood cells (pRBC) : fresh frozen plasma (FFP) : apheresis platelets. Includes activation criteria (>10 units pRBC in 24h, or shock index >1 with ongoing hemorrhage) and TXA dosing.

Use the full interactive calculator below, or

Related Calculators

Transfusion Trigger

Medical

Platelet Transfusion Threshold

Medical

Cryoprecipitate Fibrinogen Dose

Medical

Massive Transfusion Protocol 1:1:1 Ratio Calculator

Related Calculators

Frequently Asked Questions

When should the massive transfusion protocol be activated?

What is the evidence for 1:1:1 ratio?

What role does tranexamic acid (TXA) play in MTP?