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I worked with NGO in Mosul last year during the fighting, and there was no
“massive transfusion” protocols because most resource poor countries do not
have access to the amount of blood required to do MTP.  We did use TXA and
permissive-hypotensive resuscitation for all our trauma patients, but did
not have access to blood at that level.  Same was true in Haiti after the
earthquake.  I would suggest you focus on TXA, even without blood there is
good data for it, and the concept of permissive-hypotension in the setting
of shock and trauma.

Hope that helps,
Mike Falk

P

On Mon, Aug 13, 2018 at 17:53 Burns, Carson <
[log in to unmask]> wrote:

> Hello all--
>
> I'm creating a lecture on pediatric heme/bleeding emergencies, and I'm
> looking for guidelines or resources on massive blood transfusion in
> resource-limited settings. Specifically, does anyone know (or where to
> find) guidelines on massive transfusion when 1) point-of-care lab testing
> is unavailable and 2) whole blood is the primary product?
>
> Thank you!
>
>
> Carson Burns, MD
> PEDIATRIC RESIDENT, R2
> Seattle Children's Hospital - University of Washington School of Medicine
> OFFICE    4800 Sand Point Way NE, Seattle, WA 98105
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> WWW.seattlechildrens.org
>
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