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Minimizing Time to Plasma Administration and Fresh Frozen Plasma Waste

A Multimodal Approach to Improve Massive Transfusion at a Level 1 Trauma Center

Hyatt, Wendy BSN, RN, CEN, TCRN; Yon, James R. MD; Haley-Andrews, Stephanie BSN, RN

doi: 10.1097/JTN.0000000000000460

Massive transfusion protocols are part of damage control resuscitation for hemorrhaging trauma patients with the goal of returning the patient to hemodynamic stability. It is essential that patients receive blood products immediately and in the proper ratios. At our metropolitan Level 1 trauma center, we identified several challenges to deploying massive transfusion rapidly and within the recommended ratio guidelines. In 2016, we implemented a quality improvement project addressing 4 opportunities: fresh frozen plasma (FFP) bag breakage, plasma options, blood bank equipment, and multidisciplinary policy revision. Implementing packaging and shipping improvements, utilization of new products, and updating protocols have resulted in a 50% decrease in FFP bag breakage rates, a dramatic decrease in time for patients receiving massive transfusion to receive plasma products (mean time 3.5 min), and patients being administered the recommended ratio of blood products.

UCHealth Highlands Ranch Hospital, Highlands Ranch, Colorado; and HealthONE Swedish Medical Center, Englewood, Colorado.

Correspondence: Wendy Hyatt, BSN, RN, CEN, TCRN, UCHealth Highlands Ranch Hospital, 1500 Park Central Dr, Highlands Ranch, CO 80129 (

The authors declare no conflict of interest.

Copyright © 2019 by the Society of Trauma Nurses.