Hello,

The hospital I work at is wanting to become a Level II trauma center. I was wondering if anyone can point me in the right direction for the standards for transfusion services. Thanks

Not much more blood banking for a T2 designation ...

You may have to up your Oneg inventory a bit, and make sure you have a workable Emergency Release process in place !!

Who will designate your facility as a level II trauma center? That will dictate some of the expectations. If it is the state they may have a set of expectations specific to you. On the other hand if it is the Academy of Surgeons then their expectations will be a little different. I would work closely with your facility Trauma Coordinator. They should have all of the information you will need. We just completed our inspection by the Academy of Surgeons and it was pretty painless. The biggest issue we had was that we don't have a massive transfusion protocol as such but we were able to convince the inspection team that what we did have was sufficient.

Why do so many organizations want a "massive transfusion" protocol. I don't have one either, but, since we do immediate spin xm's (for the most part), it seems to satisfy that need.

Some "massive transfusion" protocols I have seen give timelines for testing(INR, PTT, Fib, CBC) and product support (PC,FFP, Plt and Cryo). Personnaly I feel a physician should have the where-with-all to order his/her own testing and order product based on those results!

Janet, that was exactly our stance. It is ancient history when we used to issue 1 FFP for every 6 RBCs and such nonsense. Some how that has not made it to some of these groups. I know a number of facilities have such protocols but I suspect they are more to pacify an inspector than anything else. When we were preparing for our inspection I did a fair amount of research in the literature and found quite a diverse number of protocols and most had vey little in common and even fewer had any supporting documentation.

Our State regulations require a "massive transfusion policy".

Our massive transfusion policy states that the Trauma team will determine blood orders for patients who get more than 10 units 'based on test results' or something like that.

It really doesn't mean anything, except that 'we have a policy'.

I work in a level one trauma center and MTP is a pretty big deal for us. We do ordered "shipments" of products and these can go on for hours. We're also a teaching hospital and frankly I don't think these docs would have a clue how to proportion product orders in a stressful situation like that. We recently started electronic crossmatching as well so we can get those shipments ready and out the door pretty quickly too.

MTP can be a hassle but I think it's effective.