Anaesthesia & ICUEmergency Medicine
Major Haemorrhage Protocol
Activate MHP, balanced 1:1:1 ratio, TXA, identify + treat source, monitor.
Source: NICE NG24; UK MHP guidelines
Step 1 of ~3
info
Activate MHP
Single phone call to blood bank + lab (e.g. dial 2222 + state 'major haemorrhage').
Triggers: actual or anticipated 4 RBC in <4h, blood loss >150 mL/min, >50% blood volume in 3h, major trauma with shock.
Lab activates: pre-pack (4–6 RBC + 4 FFP + 1 ATD platelets); subsequent packs every 30 min until deactivated; emergency O-negative if pre-cross-match.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Adrenaline (Anaphylaxis Protocol) · Auto-injector / IM adrenaline for anaphylaxis
- Potassium chloride with calcium chloride sodium chloride and sodium lactate · Balanced crystalloid IV fluid
- Dairy products · Nutritional source (calcium, protein, vitamin D)
- Tranexamic Acid (Surgical / Trauma Haemorrhage) · Antifibrinolytic (Haemostatic)
Pathways
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Anaphylaxis Under Anaesthesia · AAGBI 2018; NAP6
- Malignant Hyperthermia · AAGBI 2011; MHAUS
- Local Anaesthetic Systemic Toxicity (LAST) · AAGBI 2010; ASRA 2017
- Spinal Anaesthesia Hypotension Management · AAGBI; ASA
- Postoperative Nausea & Vomiting · Society for Ambulatory Anesthesia 2020; AAGBI
Decision support only. Always apply local guidelines and clinical judgement.