Guidelines on the management of massive blood loss

Abstract

The guideline group was selected to be representative of UKbased medical experts and included the authors of previous recommendations. Preparation of the guidelines included a review of key literature, including Cochrane Database and MEDLINE and consultation with representatives of relevant specialties. Recommendations are based on appraisal of the relevant literature and expert consensus. The writing group produced the draft guideline, which was subsequently revised by consensus by members of the Transfusion Task Force of the British Committee for Standards in Haematology. The guideline was then reviewed by a sounding board of approximately 100 UK haematologists, the British Committee for Standards in Haematology (BCSH) and the British Society for Haematology Committee and comments incorporated where appropriate. Criteria used to quote levels and grades of evidence are as outlined in appendix 3 of the Procedure for Guidelines Commissioned by the BCSH (http:// www.bcshguidelines.com/process1.asp#App3). The objective of this guideline is to provide healthcare professionals with clear guidance on the management of massive blood loss. They do not address the specific problems associated with major obstetric haemorrhage; these are being addressed by the Royal College of Obstetricians. In all cases individual patient circumstances may dictate an alternative approach.