Modern Massive Transfusion Protocols (MTPs) for trauma and major hemorrhage are based on the concept of **'damage control resuscitation'**, which aims to deliver blood products in ratios that approximate whole blood. The landmark PROPPR trial and others support a **1:1:1 ratio** of **red blood cells (RBCs) : plasma (FFP) : platelets**. This means for every 1 unit of RBCs, 1 unit of plasma and 1 unit of platelets (apheresis equivalent) are given. Some protocols use a **1:1 ratio of RBCs:FFP** as the core, with platelets added separately. The goal is to prevent and treat the **'lethal triad'** (hypothermia, acidosis, coagulopathy) by rapidly replacing lost volume, oxygen-carrying capacity, and clotting factors simultaneously. This balanced approach has been shown to improve survival and reduce deaths from exsanguination compared to older practices that relied heavily on crystalloids and RBCs alone. The ratios are often delivered in pre-packaged MTP boxes.

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Zambia

• ivwananji siwale – 29 pts

• Visual Pathway Lesions
• Positive and Negative Symptoms
• Hallucinations and Delusions
• Antipsychotic Medications
• Emergency: Environmental Emergencies