Massive Haemorrhage

Multiple definitions including: bleeding patient with signs of shock, bleeding which has already prompted use of emergency O Rh(D) negative red cells

Aetiology

  • Traumatic bleeding
  • Underlying medical condition e.g. haemophilia
  • Infection e.g. Ebola

Management

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Supportive

  • Blood component support
    • Red cells - maintain tisue oxygenation
    • FFP - replace coagulation factors and help maintain coagulation close to normal
    • Platelets - correct thrombocytopenia
    • Cryoprecipitate - replace fibrinogen
  • Follow major haemorrhage protocol
  • Must consider thromboprophylaxis once bleeding controlled

Definitive

  • Stop the bleeding