Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast Episode 31: Massive Transfusion with Dr. Stephen Freiberg
Feb 2, 2017
Dr. Stephen Freiberg, a chief resident, discusses the highlights of massive transfusion in anesthesia settings, covering when and how to do it, complications, and management strategies. The podcast addresses issues like hyperkalemia, hypocalcemia, hypothermia, coagulopathy in trauma patients, and transfusion-associated circulatory overload (TACO). It emphasizes the importance of standardized protocols, early initiation of transfusion, and implementing massive transfusion protocols in trauma resuscitation.
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Bleeding Drives Early Trauma Mortality
- Hemorrhage is the leading cause of early death in trauma and consumes disproportionate blood resources.
- Three percent of civilian trauma patients account for about 70% of blood use in trauma centers.
Activate MTP Early
- Activate your institution's massive transfusion protocol early when ongoing major bleeding is likely.
- Protocols mobilize resources and guide damage-control resuscitation to improve outcomes.
Get Large-Bore Peripheral Access
- Prioritize two large-bore peripheral IVs in the upper extremities for rapid infusion.
- Use 14-gauge peripheral lines and rapid infusers for high flow instead of relying on long central lines.