ABC Score for Massive Transfusion

• Massive transfusion protocols are institution-specific, but often are 1:1:1 or 1:1:2 for fresh frozen plasma, platelets, and packed red blood cells (Holcomb 2015).
• Remember, the ABC Score does not indicate if trauma patients should receive blood, only if they should receive blood through a massive transfusion protocol.
• The score can be repeated as the patient’s clinical exam changes. Repeating vitals and FAST can change a patient’s ABC Score.
• Familiarity with your institution’s massive transfusion protocol will reduce delays in activation and administration of blood products.

• The most widely accepted definition of massive transfusion is the administration of ≥10 units of pRBCs in the first 24 hours.  
• Institutions may have different ratios of blood products as a part of their massive transfusion protocol (MTP).
• Activation of MTP triggers the release of pRBCs, platelets, and fresh frozen plasma at frequent intervals until it is called off. 

Chances of survival increase with early initiation of massive transfusion in severely injured patients. Identification and activation should not be delayed in critical trauma patients.