Developing and implementing a protocol for major haemorrhage

This article presents the author's experience, in the role of a transfusion practitioner (TP), of developing and implementing a major haemorrhage protocol. A definition is given for the term 'major haemorrhage' in conjunction with the incidence of and outcomes for people experiencing excessive blood loss. The advantages and disadvantages of clinical protocols are discussed. Rather than reject the use of protocols because of issues of compliance and resourcing, these should be acknowledged in order to better inform the development and implementation of a protocol. With reference to the specific design of a major haemorrhage protocol for use in an acute NHS trust, a detailed explanation of the stages involved in developing a protocol is given. This is followed by a summary of the standard recommendations specified for protocol implementation. The findings from an audit showed on average that the time to the first transfusion was 26 minutes less for patients in the post-protocol group compared to the pre-protocol group.