Korean J Blood Transfus.  2024 Aug;35(2):113-120. 10.17945/kjbt.2024.35.2.113.

A Case Study on Simulation Training for Operational Improvements in the Massive Transfusion Protocol

• Choi S
• Wee J
• Jung H
• Cho YS

• KMID: 2558984
• DOI: http://doi.org/10.17945/kjbt.2024.35.2.113

Abstract

Many medical institutions have adopted a massive transfusion protocol (MTP) for the effective management of hemorrhagic shock. However, in medical institutions where severe trauma patients are infrequently admitted, the use of MTP is rare, potentially leading to deficiencies in staff proficiency and confidence when responding to severe hemorrhage events. This study introduced simulation training to improve staff skills and confidence and assess the current state of the MTP. Healthcare professionals, including physicians, nurses, medical technologist, and support staff from emergency medical center and blood bank, participated in two simulation training sessions. The Red Blood Cell (RBC) turnaround time (TAT) failed to meet the 5-minute target in both sessions, with recorded times of 10 minutes and 9 minutes, respectively. The fresh frozen plasma (FFP) TAT exceeded the 20-minute target in the first session but achieved the goal with a time of 19 minutes in the second session. Consequently, the RBC TAT target was adjusted to a more realistic 10 minutes. Operational changes, such as installing a blood product refrigerator in the emergency department and prioritizing MTP activities, were suggested to further reduce TAT. Simulation-based training can improve compliance with MTP procedures and increase staff confidence. For institutions where MTP activation is infrequent, regular simulation training and the dissemination of educational materials are crucial to ensuring a prompt and accurate response in actual severe hemorrhage events.

Keyword

Massive transfusion protocol; Hemorrhagic shock; Simulation training; Blood bank; Emergency response