**5. Benefits of emergency blood transfusion protocols**

EBT protocols facilitate the efficient ordering and transport of blood products for patients with moderate to severe hemorrhage. These protocols also ensure that an ongoing supply of blood products arrives at the patient's bedside until hemostatic control is achieved. Many hospitals have established an MTP. In obstetrics, 95% of hospitals with a postpartum hemorrhage protocol possess an MTP [32]. An MTP is traditionally defined as more than 10 units of pRBCs in 24 h or more than four units of pRBCs in 1 h.

An MTP can be used to manage severe maternal hemorrhage and improve patient safety. In their study, Shields et al. showed a faster resolution of maternal bleeding, the use of fewer blood products, and a 60% decline in the rate of DIC with the use of MTP [33]. In addition, the establishment of an MTP protocol led to both physicians and nursing staff reporting improved clinical knowledge and comfort level with responding to significant bleeding events.

Health-care providers have varying experience levels in dealing with EBT and MBT. The relatively low frequency with which MBT is encountered limits the accumulation of experience with severe hemorrhage. This suggests that standardized interventions are critical in order to achieve an optimal outcome. One way to gain experience and familiarity with standardized EBT protocols is through simulation.
