Major haemorrhage is a clinical emergency that results in morbidity and mortality: practice guidance is important to reduce these risks. Delayed recognition of bleeding continues to be one factor for adverse outcomes in the management of major haemorrhage, as described in a recent SHOT report.5

This guideline mandates a multidisciplinary approach involving the close working between laboratories, and clinical departments enabling a timely, targeted approach to transfusion support.

The following sections consider the evidence for practice by components, major haemorrhage protocols (MHPs) and specific clinical settings.

Declaration of Interests

The BSH paid the expenses incurred during the writing of this guidance. None of the authors had conflicts of interest to declare. All authors have made a declaration of interests to the BSH and Task Force Chairs which may be viewed on request.