In damage control resuscitation (DCR) for massive hemorrhage, which laboratory parameter best predicts the need to activate a massive transfusion protocol (1:1:1 ratio of PRBC:FFP:platelets)?
- A Hemoglobin < 8 g/dL
- B Assessment of Blood Consumption (ABC) score ≥ 2 ✓
- C Lactate > 4 mmol/L alone
- D INR > 1.5 alone
Explanation
The Assessment of Blood Consumption (ABC) score uses four bedside parameters (penetrating mechanism, HR >120/min, SBP ≤90 mmHg, positive FAST), with a score ≥2 predicting the need for massive transfusion with good sensitivity and specificity. It enables early activation of the MTP without waiting for lab results. A hemoglobin below 8 g/dL alone does not indicate coagulopathic hemorrhage needing 1:1:1 ratios. Lactate and INR are useful but require laboratory processing time. The ABC score is validated for immediate bedside activation of massive transfusion protocols in trauma.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.