What ABC score activates massive transfusion protocol?

ABC score (1 point each): penetrating mechanism, SBP ≤90, HR ≥120, FAST positive; score ≥2 indicates MTP activation; sensitivity 75%, specificity 86% for requiring ≥10 units RBC in 24h.

What is the optimal blood product ratio in MTP?

PROPPR trial: 1:1:1 (pRBC:FFP:Platelets) showed improved 24h survival and more patients achieving hemostasis vs 2:1:1; target 1:1:1 ratio empirically; adjust based on TEG/ROTEM results.

What is the role of tranexamic acid in hemorrhagic shock?

Tranexamic acid (TXA) within 3 hours of injury: 1g IV over 10 min, then 1g over 8h (CRASH-2 trial); reduces mortality by preventing hyperfibrinolysis; TXA after 3h increases mortality; CRASH-3 extended benefit to TBI.

When should cryoprecipitate vs fibrinogen concentrate be given?

Cryoprecipitate 10 units per pack raises fibrinogen ~0.7 g/L; fibrinogen target ≥1.5-2.0 g/L during hemorrhage; Haemocomplettan (fibrinogen concentrate) provides precise fibrinogen dosing and is preferred when available.

What point-of-care coagulation tests guide MTP product selection?

TEG (thromboelastography) and ROTEM provide real-time viscoelastic coagulation data; clot initiation (R/CT), clot strength (MA/MCF), and fibrinolysis (LY30/ML) guide targeted resuscitation with FFP, cryoprecipitate, platelets, or TXA.

Massive Transfusion Protocol (MTP) Activation Criteria and Product Ratio

Calculates MTP activation score using ABC score (4 parameters) and defines balanced resuscitation ratios (pRBC:FFP:platelets 1:1:1), fibrinogen replacement, and tranexamic acid dosing for hemorrhagic shock.

Weight

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Clinical Guidance

BMI is a screening measure of body size, not a direct measure of body fat. The standard WHO categories are underweight (<18.5), normal (18.5–24.9), overweight (25–29.9), and obese (≥30).

BMI can overestimate body fat in athletes with high muscle mass and underestimate it in older adults with low muscle mass. Interpret it alongside waist circumference and clinical context rather than as a standalone diagnosis.

⚕ Clinical Disclaimer: These calculators are for educational and reference purposes only. Always verify results with qualified clinical judgment and current clinical guidelines. Do not use as a sole basis for medical decisions.

How It Works

Each component has a specific meaning:

Defines balanced resuscitation ratios — The defines balanced resuscitation ratios recorded for the patient or scenario being assessed.
Fibrinogen replacement — The fibrinogen replacement recorded for the patient or scenario being assessed.
Tranexamic acid dosing — The tranexamic acid dosing recorded for the patient or scenario being assessed.

Note: Interpret the mtp protocol result against the clinical thresholds and context described above.

How to Use

Enter the defines balanced resuscitation ratios, fibrinogen replacement, tranexamic acid dosing for the patient or scenario you are assessing. Calculates MTP activation score using ABC score (4 parameters) and defines balanced resuscitation ratios (pRBC:FFP:platelets 1:1:1), fibrinogen replacement, and tranexamic acid dosing for hemorrhagic shock. Use the mtp protocol result to inform your clinical assessment.

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