Abstract
Background: Locally adapted MTP is recommended to deliver blood products to patients with critical bleeding to improve outcomes.1 Method: Retrospective study of MTPs in a non-major trauma centre (Nepean Hospital) between January 2018 to October 2019. Clinical outcomes were retrieved from electronic medical records. Results: There were 102 MTP activations during the study period. Non-trauma related bleeding accounted for 96.1%, with gastrointestinal (38.2%) and obstetric (21.6%) sources most common. Of first shipments, all four units of red cells (RC) were used in 79.4% of activations, and all four fresh frozen plasma (FFP) were used in 80%. An FFP:RC ratio of 1:1–1:2 was achieved in 85.3% of activations that required ≥4 RCs. Average product non-utilisation rate was 0.73 RC and 0.59 FFP per activation. Overall, 16.3% of MTPs required ≥10 RCs within 24 hours (62.5% of these were gastrointestinal related bleeding). Mortality at 24-hours and 30-days was 3.9% and 11.8% respectively. Discussion: This study highlights differing indications of MTP activation and severity of clinical status compared to major trauma centres.2 The impact of MTP and transfusion ratios on clinical outcomes in this population remains unclear.3 Further research is needed to optimise product usage, particularly for gastrointestinal and obstetric related bleeding.
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