Article Text
Abstract
Major trauma is a principal cause of morbidity and mortality in children. Severe haemorrhage is the second-leading cause of death in paediatric trauma, preceded by traumatic brain injury. Major haemorrhage protocols (MHPs), also known as ‘code red’ and ‘massive transfusion protocols’, are used to make large volumes of blood products rapidly available. Most recommendations for paediatric MHPs are extrapolated from adult data because of a lack of large, high-quality, prospective paediatric studies. However, applying adult data in a paediatric context requires caution due to differences in injury mechanisms and physiological responses between adults and children. Since major haemorrhage is a high-acuity low-occurrence event, MHP requires effective training, collaboration and communication among a large multidisciplinary team.
In this 15-minute consultation, we provide an evidence-based synthesis of the management principles of paediatric major haemorrhage.
- Paediatric Emergency Medicine
- Paediatrics
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Footnotes
X @spiroskarageo, @DennisRenMD, @danihalltweets
SK and DR contributed equally.
Contributors Study design: DR, SK and DH. Images/tables—DR and SK. Infographics—OH.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.