MTP
The clinical condition marked by evidence of, or concern for severe hypoperfusion secondary to acute hemorrhage
What is Massive Hemorrhage?
Orders MTP when indicated
Who is the Provider
MTP/Emergent Release Blood (Uncrossmatched Blood) Form and/ or a patient sticker with two patient identifiers
What is needed to retrieve the MTP packs from transfusion services
2 - Packed Red Cells
2 - Thawed Plasma **
2 - Packed Red Cells
2 - Thawed Plasma
1 - Platelet Apheresis
What is MTP Pack #1?
Notification of termination of MTP to transfusion services is done by...
Who is Provider or Accountable RN
The transfusion of a total adult blood volume, 10 or more red blood cell products within 24 hours, or the anticipated need to do so or The transfusion of half an adult’s blood volume in 4 hours, 4 units of red blood cell products in 4 hours or the anticipated need to do so.
What is Adult Massive Blood Transfusion?
Critical care on Rapid Response responds to MTP and the other unit not on Rapids retrieves the Belmont rapid infuser. If an OB MTP is called a Birthing Center Rn also responds along with critical care RNs.
What is when a MTP is needed on another unit besides Critical Care?
Activation and type of MTP,whether the patient is male or female and patient identification if known (name and medical record number) , If the patient is transfered to another unit, discontiuation of MTP and additional blood products that may be needed outside of the MTP packs, and any blood products sent with a patient to the Operating Room, Critical Care unit, or facility the patient is being transferred to.
What is communication needed with transfusion services that is funneled through the accountable RN?
2 - Packed Red Cells
2 - Thawed Plasma **
2 - Packed Red Cells
2 - Thawed Plasma
2 - Cryoprecipitate Pooled Units *
What is MTP pack #3?
PT/PTT INR, Fibrinogen, CBC with platelets, BMP, Lactic Acid and ABG
What are labs to be drawn 4 hours from completion of the MTP protocol, and then every 6 hours for 24 hours as ordered by a provider?
Patients presenting with severe or massive OB Hemorrhage or requiring acute massive transfusion, >4units PRBCs during the active phase of blood loss at any point of the entire OB stay.
What is Massive Transfusion OB?
MTP/Emergent Release Blood (Uncrossmatched Blood) Form
What is the form that is signed by the provider indication the need for O neg or O pos uncrossmatched blood and also the form the runner needs to take to blood bank to retrieve MTP pack #1?
Person who picks up MTP pack #1 that has the completed MTP/Emergent Release Blood (uncrossmatched blood form.
Who is the designated runner?
Blood products that cannot go through the Belmont rapid infuser.
What is Platlets and Cryopercipitate?
Verify the patient identification, blood type, unit number and expiration date by...
What is by Accountable RN with a 2nd RN or Provider?
Restoration of organ perfusion and adequate tissue oxygenation confirmed by urinary output, CNS function, skin color, permissive hypotension with maintained SBP>90
What is MTP Goal?
PT/PTT with INR (Light Blue), Fibrinogen (Light Blue), Type and Screen and Crossmatch (Pink Tops x2), CBC with Platelet Count (No diff, Lavender), BMP (Light Green), Lactic Acid (Grey on ICE), ABG, Teg ( Blue Top x2 must be taken to lab immediately)
What is the MTP order set labs that needs to be drawn prior to starting Massive Transfusion and every hour (minus Type and Cross) during MTP?
For all males and females over 50
What is type O positvie
When Fresh Frozen Plasma is not ready...
What is proceed with PRBCs untill it is ready?
Emergent MTP documented...
What is in the Vital Signs box
Massive blood loss with profound hemorrhagic/hypovolemic shock + FAST exam, Altered mental status and decreased urine output
What are indications for MTP?
Medical Alert MTP Adult, MTP Pediatric, MTP Trauma or MTP OB
What is called overhead by switchboard once they have been notified of MTP?
For females age 50 and younger
What is O negative red cells
Ensure that all blood products remain in the closed cooler when not being transfused except...
What is Platelets and Cryopercipitate?
The type and volume of blood products when they are transfused including stop and start times for each unit.
What is what needs to be documented for each blood product?