Massive Hemorrhage Protocol MHP 2.0 and its implementation

Massive hemorrhage care succeeds—or fails—not on the strength of evidence alone, but on whether that evidence can be acted on in real time, in real settings, by real teams. That reality framed this panel discussion led by Dr. Andrew Petrosoniak, alongside transfusion medicine leaders from across Canada, as they unpacked Ontario’s updated Massive Hemorrhage Protocol (MHP) and what implementation actually looks like on the ground.

The discussion highlights how the updates accommodate the need for rural and regional hospitals where immediate access to advanced diagnostics or subspecialty support may not be available, the role of point-of-care coagulation testing and the challenges that comes with, possibility of hypocalcemia which is common in massive hemorrhage and clinically consequential, and thinking about hemorrhage care beyond trauma, including obstetrics, surgery, gastrointestinal hemorrhage, and critical care scenarios.