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Dolores Rincón Ferrari, M. Mar Felipe Correoso, Ángel Candela Toha" "autores" => array:3 [ 0 => array:4 [ "nombre" => "M. Dolores" "apellidos" => "Rincón Ferrari" "email" => array:1 [ 0 => "marilorincon@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M. Mar" "apellidos" => "Felipe Correoso" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Ángel" "apellidos" => "Candela Toha" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Hospital Universitario Virgen del Rocío, Sevilla, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Hospital de la Santa Creu i Sant Pau, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Hospital Universitario Ramón y Cajal, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Evaluación del grado de conocimiento del protocolo de transfusión masiva en cuatro hospitales españoles" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Massive transfusion (MT) is a critical point in the resuscitation of patients with massive haemorrhage (MH)<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> in which early and sustained transfusion of plasma, platelets and PRBCs in predefined ratios is advocated in order to prevent and/or treat associated coagulopathy.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">To ensure the rapid delivery of blood products, good coordination between the departments involved is necessary, and clinical practice guidelines recommend the development of massive transfusion protocols (MTPs).<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In addition to improving and homogenising clinical care, MTPs are associated with reduced morbidity and mortality in patients with MH.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">To ensure greater compliance, practitioners need to have a detailed understanding of MTPs and the organisation around them.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The aim of this study was to assess the degree of awareness of MTPs in order to identify those aspects that are not adequately fulfilled.</p><p id="par0030" class="elsevierStylePara elsevierViewall">For this purpose, a prospective, multicentre study was conducted, funded with research funds from the Instituto de Salud Carlos III with file number PI16/02165, which involved preparing a survey that included those actions applicable to a patient in haemorrhagic shock and which are contemplated in the MTPs.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The participating health centres were: Hospital de la Santa Creu i Sant Pau, Barcelona; Hospital Universitario Virgen del Rocío, Seville; Hospital Ramón y Cajal, Madrid, and Hospital Universitario Parc Taulí (Sabadell).</p><p id="par0040" class="elsevierStylePara elsevierViewall">A survey of 26 multiple-choice/single answer questions divided into 6 sections was conducted (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>):<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">I</span><p id="par0045" class="elsevierStylePara elsevierViewall">Logistics and organisation.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">II</span><p id="par0050" class="elsevierStylePara elsevierViewall">Activation and deactivation of the protocol.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">III</span><p id="par0055" class="elsevierStylePara elsevierViewall">Content/storage of blood products.</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">IV</span><p id="par0060" class="elsevierStylePara elsevierViewall">Prescription/administration of blood products.</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">V</span><p id="par0065" class="elsevierStylePara elsevierViewall">Request for blood tests.</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">VI</span><p id="par0070" class="elsevierStylePara elsevierViewall">Personal experience.</p></li></ul></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">The survey was sent by e-mail to those departments where the MTP was most active. The participating professionals were randomly selected from the entire department’s personnel, always considering a participation of at least 50% of the staff. The study period was 6 months.</p><p id="par0080" class="elsevierStylePara elsevierViewall">In terms of results, 283 surveys were answered, of which 281 were valid.</p><p id="par0085" class="elsevierStylePara elsevierViewall">The percentage of surveys answered by department was similar in the three centres, with the following distribution: anaesthesiology (30%), emergency (25%), intensive care (25%), haematology (8%), cardiac surgery (4.5%), orthopaedic surgery and traumatology (2.8%), vascular surgery (2%), gastroenterology (1.7%) and general surgery (1%).</p><p id="par0090" class="elsevierStylePara elsevierViewall">The average number of correctly answered questions was 13.25/20 questions.</p><p id="par0095" class="elsevierStylePara elsevierViewall">The lowest average number of correct answers was in medical departments (mean: 10.3 correct questions) and the highest in cardiac surgery (mean: 16.1 correct questions).</p><p id="par0100" class="elsevierStylePara elsevierViewall">The two questions with the lowest percentage of correct answers were number 2 (29% correct) and 12 (26% correct), and the question with the highest percentage of correct answers was 11 (90.81% correct).</p><p id="par0105" class="elsevierStylePara elsevierViewall">The two sections with the lowest number of correct answers were those related to the content/storage of blood products (55%) and to the prescription/administration of blood products (58%).</p><p id="par0110" class="elsevierStylePara elsevierViewall">The section with the highest hit rate was the blood test request section (87%), followed by the protocol activation/deactivation section (78%).</p><p id="par0115" class="elsevierStylePara elsevierViewall">It is important to know that only 54% of the respondents would know how to guide therapy with viscoelastic testing.</p><p id="par0120" class="elsevierStylePara elsevierViewall">This study has a number of limitations that need to be taken into account.</p><p id="par0125" class="elsevierStylePara elsevierViewall">Since the surveyed professional was present, he/she could have completed the survey with the help of a colleague who was more familiar with the MTP or by consulting the protocol, which would lead to a positive bias with respect to the degree of knowledge of the MTP.</p><p id="par0130" class="elsevierStylePara elsevierViewall">Despite the limitations of the survey, it can be concluded that there is insufficient knowledge of MTPs and that there is a need for better coordination of the teams involved in MH situations.</p><p id="par0135" class="elsevierStylePara elsevierViewall">Following the results of this study, a number of possible improvement measures are proposed:<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">-</span><p id="par0140" class="elsevierStylePara elsevierViewall">The periodic updating of the MTPs and their dissemination should be promoted by hospital transfusion committees.</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">-</span><p id="par0145" class="elsevierStylePara elsevierViewall">All MT cases in which non-compliance with the MTP is detected should be reviewed in a multidisciplinary manner, identifying problems and seeking solutions.</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">-</span><p id="par0150" class="elsevierStylePara elsevierViewall">In order to improve knowledge of MTPs, it is proposed that simulation teaching programmes incorporating massive haemorrhage scenarios be developed.</p></li></ul></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical considerations</span><p id="par0155" class="elsevierStylePara elsevierViewall">As the study was conducted anonymously in healthcare professionals and did not include patients, hospital ethics committees did not consider it necessary to approve it.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Study funding</span><p id="par0160" class="elsevierStylePara elsevierViewall">This study is funded by a <span class="elsevierStyleGrantSponsor" id="gs0005">national, multicentre research</span> grant from the research funds of the Instituto de Salud Carlos III, entitled "Evaluation of the degree of compliance and clinical impact of massive transfusion protocols (MTPs)" with file number PI16/02165.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflict of interest</span><p id="par0165" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Ethical considerations" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Study funding" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflict of interest" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">BB: blood bank; PCC: prothrombin complex concentrate; BPs: blood products; MTP: massive transfusion protocol; MT: massive transfusion; VET: viscoelastic testing.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Section \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Question \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">I. Logistics and organisation (1–7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1. How are blood samples transported from the health care departments to the BB and the laboratory? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2. When the MTP is activated, who is primarily responsible for the patient? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3. Who is responsible for communication between the healthcare dept. and the BB, laboratory, etc.? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4. How are BPs transported from the BB to the healthcare dept.? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5. After activation, how are requests for MT packages and blood tests identified? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6. Question regarding VET location and management. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7. Question regarding the determination of the patient's blood group. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">II. Protocol Activation and Deactivation (8–11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8. When can the MTP be activated? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9. Once activated, who is the decision-maker? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10. What does the MTP activating and deactivating process involve? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11. What information needs to be communicated to the BB after MTP activation? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">III. Content/storage of blood products (12–15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12. What do MT packages for children over 50 kg contain? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13. What documentation is enclosed in each MT package? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14. Question on storage of BPs in transport coolers. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15. What should we do when there is a backlog of unopened coolers (packages)? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">IV. Prescription/administration of blood products (16–18) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16. What should we take into account for the correct administration of plasma and platelets? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17. What is the main strategy proposed in the MTP for the management of coagulopathy? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18. Question on the indications for use of prohaemostatic drugs in the MTP (fibrinogen, PCC and tranexamic acid). \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">V. Request for blood tests (19–20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19. What should be included in the request for blood tests in a massive transfusion? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20. What is the optimal time to obtain the AB0 and Rh sample for BB? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">VI. Personal experience in the management of massive transfusions (21–26) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21. Would you be able to find the MTP on your hospital's intranet? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22. Do you think it would be useful to have a <span class="elsevierStyleItalic">checklist</span> of the main steps to follow after MTP activation? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23. What are the main reasons for not activating the MTP, even if criteria are met? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24. When the MTP was activated, did you guide the treatment with Rotem? If not, please indicate why. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25. When the MTP was activated, did you send the paper request specifically designed for these cases to the laboratory? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26. Have you ever been a member of the massive transfusion team? If yes, do you think there has been clear leadership from the <span class="elsevierStyleItalic">team-leader</span>? \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3333262.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Survey questions.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Transfusión en Urgencias: algo más que una transfusión de sangre" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Quintana-Díaz" 1 => "E.M. Andrés-Esteban" 2 => "J. Sánchez-Serrano" 3 => "A Martínez-Virto" 4 => "R Juárez-Vela" 5 => "J.A. 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Marini" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s13054-023-04386-w" "Revista" => array:5 [ "tituloSerie" => "Critical Care" "fecha" => "2023" "volumen" => "27" "paginaInicial" => "85" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/36872322" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Haematological management of major haemorrhage: A British Society for Haematology Guideline" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.J. Stanworth" 1 => "K. Dowling" 2 => "N. Curry" 3 => "H. Doughty" 4 => "B.J. Hunt" 5 => "L. Fraser" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/bjh.18275" "Revista" => array:6 [ "tituloSerie" => "Br J Haematol" "fecha" => "2022" "volumen" => "198" "paginaInicial" => "654" "paginaFinal" => "667" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35687716" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Transfusion strategies in bleeding critically ill adults: A clinical practice guideline from the European Society of Intensive Care Medicine" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.P.J. Vlaar" 1 => "J.C. Dionne" 2 => "S. Bruin" 3 => "M. Wijnberge" 4 => "S.J. Raasveld" 5 => "F.E.H.P. Van Baarle" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00134-021-06531-x" "Revista" => array:7 [ "tituloSerie" => "Intensive Care Med" "fecha" => "2022" "volumen" => "47" "paginaInicial" => "1368" "paginaFinal" => "1392" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34677620" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0272638616000159" "estado" => "S300" "issn" => "02726386" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Propuesta de protocolo de hemorragia masiva" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.P. Ortega García" 1 => "M.A. Chávez Ramírez" 2 => "J.A. Covarrubias Vela" 3 => "A.E. Díaz Hernández" 4 => "R.E. Guzmán Núques" 5 => "J.S. Espino Núñez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Med" "fecha" => "2018" "volumen" => "63" "paginaInicial" => "111" "paginaFinal" => "116" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000016100000007/v2_202311091450/S2387020623003716/v2_202311091450/en/main.assets" "Apartado" => array:4 [ "identificador" => "43311" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000016100000007/v2_202311091450/S2387020623003716/v2_202311091450/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623003716?idApp=UINPBA00004N" ]
Journal Information
Vol. 161. Issue 7.
Pages 312-313 (October 2023)
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Vol. 161. Issue 7.
Pages 312-313 (October 2023)
Scientific letter
Assessment of the degree of knowledge of the massive transfusion protocol in four Spanish hospitals
Evaluación del grado de conocimiento del protocolo de transfusión masiva en cuatro hospitales españoles
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