Chapter 29. Massive Blood Loss

  1. Michael F. Murphy MD, FRCP, FRCPath Professor Consultant Haematologist3,4 and
  2. Derwood H. Pamphilon MD, MRCPCH, FRCP, FRCPath Consultant Haematologist Honorary Clinical Reader5,6
  1. Beverley J. Hunt MD, FRCP, FRCPath Professor Consultant1,2

Published Online: 5 MAY 2009

DOI: 10.1002/9781444311761.ch29

Practical Transfusion Medicine, Third Edition

Practical Transfusion Medicine, Third Edition

How to Cite

Hunt, B. J. (2009) Massive Blood Loss, in Practical Transfusion Medicine, Third Edition (eds M. F. Murphy and D. H. Pamphilon), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444311761.ch29

Editor Information

  1. 3

    University of Oxford, Oxford, UK

  2. 4

    NHS Blood and Transplant and Department of Haematology, John Radcliffe Hospital, Oxford, UK

  3. 5

    NHS Blood and Transplant, Bristol, UK

  4. 6

    Department of Cellular and Molecular Medicine, University of Bristol, Bristol, UK

Author Information

  1. 1

    Kings College, London, UK

  2. 2

    Departments of Haematology, Pathology and Rheumatology, Guy's and St Thomas' NHS Foundation Trust, London, UK

Publication History

  1. Published Online: 5 MAY 2009
  2. Published Print: 14 APR 2009

ISBN Information

Print ISBN: 9781405181969

Online ISBN: 9781444311761



  • massive blood loss;
  • massive tissue factor exposure;
  • adequate analgesia;
  • isotonic and hypertonic crystalloids;
  • hypothermia;
  • haemostatic components;
  • coagulation factor;
  • fibrinogen and cryoprecipitate


This chapter contains sections titled:

  • Definition and burden of massive blood loss

  • Physiological response of coagulation to blood loss

  • Management of bleeding

  • Fluid management

  • Prevention of hypothermia and strategies for re-warming

  • Blood component use

  • Use of RBC transfusion in trauma

  • Summary of practical haematological management of a bleeding patient

  • Organisation of transfusion for patients with trauma and for major accidents

  • The future

  • Conclusions

  • Key points

  • Further reading