When should the massive transfusion protocol be activated?

The activation of the massive transfusion protocol is critical in managing obstetric emergencies when there is a significant risk of maternal hemorrhage. The indication for activating this protocol is primarily based on the physiological response to bleeding, particularly the hemodynamic status of the patient.

A systolic blood pressure below 90 mm Hg is indicative of significant hypovolemia and suggests that the mother may be in shock due to severe blood loss. This hemodynamic instability necessitates prompt intervention, including the administration of large volumes of blood products to restore circulating volume and improve perfusion. The massive transfusion protocol streamlines the process for obtaining and administering blood products, ensuring timely treatment to potentially save the mother’s life.

While maternal age and mode of delivery may have implications for risk factors associated with bleeding, they do not directly trigger the need for a massive transfusion protocol. Similarly, the cessation of bleeding with cryoprecipitate does not indicate a need for a massive transfusion protocol; rather, it may suggest that the bleeding is under control and does not require such an urgent response.