Massive transfusion or massive confusion?

Massive transfusion (MT) is a life-saving therapy in situations of major hemorrhage. Objectives: To review the practices of massive transfusion in Tunisia and to propose a massive transfusion protocol.An analytical observational study based on a questionnaire was conducted.It included 124 clinicians. The majority (62%) were anesthesiologists or emergency physicians. The initial order was for the majority of participants (N=69) made of red blood cells (RGC) and fresh frozen plasma (FFP). The ratio of FFP to RGC was 1:2 for 51% of participants. Respectively 23.5% and 9.6% of the participants transfused platelets and fibrinogen concentrates without waiting for the results of the biological examinations. The use of tranexamic acid was routinely indicated by 60.5% of clinicians. A restrictive transfusion strategy was adopted by the majority (86.3%).The professional practices of TM in Tunisia are heterogeneous. In the absence of a clear institutionalized procedure for this therapy, a TM protocol was proposed.