Appendix

Ratios:

What we call it	1:1:1 ratio
What’s in the pack	4:4:4 units 4 red bags 2 yellow bags (N.B. 4 x 300mL in VIC, 2 x 600mL elsewhere) 1 pooled white bag

Doses and increments:

	Dose and volume	Increment
RBC	1 bag at a time = 250-300mL Paeds: ½ x desired ↑Hb x TBW	10g/L
FFP	15mL/kg = 3 bags = 1L Paeds: 10-20mL/kg	-
Platelets	1 pooled bag = 300mL Paeds: 10mL/kg	20-40 x 10^9 / L
Cryo	3-4g = 1 unit 10 bags whole blood cryo 5 bags apheresis cryo Paeds: 5-10mL/kg	0.5-1g/L
Fibconc	5 units = 1g	0.4g/L ↑FIBTEM A5 2mm
TXA	1g over 10 mins load 1g over 8 hours infusion	-
rF7a	90mcg/kg	-

Hb threshold:

Population	Threshold
Most people	<70 yes (almost always) 70-100 maybe <100 no
Acute coronary syndrome	<80 yes 80-100 maybe >100 no (increases mortality)
Critically ill	<70 yes 70-90 maybe >90 no
Children	<70 yes 70-90 maybe >90 no

Platelet threshold:

Population	Threshold
General	<50
Invasive procedures in ICU	<50
TBI Brain surgery Eye surgery Neuraxial surgery	<100
Chemo and stem cell transplant	<10 <20 if risk factors i.e. bleeding, fever
Critically ill	<20

Reversal agents:

Warfarin	Vit K / PCC / FFP
Dabigatran	Idarucizumab
Xa inhibitors	Andexanet alpha
Everything	Ciraparantag

Damage control resuscitation:

· Damage control surgery

· Haemostatic resuscitation

· Permissive hypotension

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