I think that as for the cryo not being in the protocol, that a physician would have to make a determination of whether there is a rapidly progressing consumptive coagulopathy process going on in order to justify jumping from just plasma to cryo.

 

As for holding on platelets, I think that as platelets are already being consumed from the initial trauma, the idea is to replace them before secondary bleeding begins in internal organs or brain or whatever from a rapidly dropping count.

 

Scott

Ours is 4 RBC:4 FFP and a Plt Pher for every 8 RBC for trauma with Cryo only as requested.  Initially our OB protocol was to include Cryo pool per every 8 RBC's based on "California Maternal Quality Care Collaborative guidelines".  We ended up wasting a lot of Cryo for our OB Massive Protocol patients, so our OB committee agreed to switch to Cryo only as requested.