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Tue Feb 12 16:49:18 GMT 2008

For what it's worth, I've appended the most recent version of our
Massive Transfusion Protocol (finalizing as I type; still technically a
DRAFT).  It includes default conditions for dispensing plasma.  I'd be
obliged for your collective kindly critiquing...

Also have attached a couple of documents we stole from Baltimore in
consideration of building Factor VII into our process.  Interesting
reading.

While we're on the subject, my hospital is struggling with ubiquitous
chronic community anticoagulation (there's warfarin in the drinking
water, and more patients on clopidogrel than multivitamins), which
conspires against our rural elderly (geography is destiny -- especially
when your blood won't clot).  If anyone would like to share their
approaches, we're all ears.  Just got a new platelet function analyzer,
and we're itchin' to use it!

Pret Bjorn, RN
EMMC Trauma Program
Bangor, ME USA

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Sise, Mike MD
Sent: Tuesday, February 12, 2008 10:56 AM
To: trauma-list at trauma.org
Subject: Who's doing 1:1 blood transfusions for shock?

To all,

Who's doing 1:1 fresh frozen plasma to packed RBCs transfusions and
limiting crystalloid for resuscitation in hemorrhagic shock? If you've
adopted it - why? If not - why? Any and all comments requested.

Mike Sise
San Diego

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Who's doing 1:1 blood transfusions for shock?