Blood transfusion and the anaesthetist: management of massive haemorrhage

Summary 1. Hospitals must have a major haemorrhage protocol in place and this should include clinical, laboratory and logistic responses. 2. Immediate control of obvious bleeding is of paramount importance (pressure, tourniquet, haemostatic dressings). 3. The major haemorrhage protocol must be mobilised immediately when a massive haemorrhage situation is declared. 4. A fibrinogen < 1 g.l −1 or a prothrombin time (PT) and activated partial...