Massive Hemorrhage Protocol
“All hospitals shall have a protocol to guide management of a massively bleeding patient” –
Find resources to help your organization meet this Ontario recommendation.
Massive hemorrhage protocol survey: Marked variability and absent in one-third of hospitals in Ontario, Canada
Chin V, Cope S, Yeh CH, Thompson T, Nascimento B, Pavenski K, Callum J; QUEST Research Group. Massive hemorrhage protocol survey: Marked variability and absent in one-third of hospitals in Ontario, Canada. Injury. 2019 Jan;50(1):46-53. doi: 10.1016/j.injury.2018.11.026. Epub 2018 Nov 12. PMID: 30449459.
A Provincial Standardized Pediatric Massive Hemorrhage Protocol for Community or Tertiary Care Settings
Abstract submitted by Dr. Kimmo Murto et al. accepted to SPA-AAA Pediatric Anesthesiology
Provincial Massive Hemorrhage Toolkit
A comprehensive toolkit was developed to provide guidance for Ontario hospitals in the implementation of Ontario’s Recommendations for Massive Hemorrhage Protocol. The toolkit addresses select patient populations and differences in hospital sizes, resources and geographical challenges.
Released April 30, 2021
MHP 2.0 Symposium (2023)
MHP 1.0 Symposium (2021)
Ontario MHP: Guidance for small/remote hospitals
Dr. Jacob Pendergrast discusses the challenges of MHPs in smaller, more remote hospitals and provides guidance on appropriate modifications to the Ontario massive hemorrhage protocol.
March 10, 2022
Massive Hemorrhage Protocol
Provincial Recommendation Statements, version 2.0 March 2025
Simulation MHP #4 Trauma in a Community Hospital
In association with SCORE. Dr. Jesse Guscott & Dr. Gregg Bolton, Collingwood General & Marine Hospital
Simulation MHP #3 Pediatric Case
Massive Hemorrhage Protocol activation in a community hospital setting. Dr. Kimmo Murto, Children’s Hospital of Eastern Ontario, Ottawa
Simulation MHP #2 GI Bleed
Massive Hemorrhage Protocol activation in an academic hospital setting Dr. Jordan Tarshis, Sunnybrook Health Sciences Centre, Toronto
Simulation MHP #1 Trauma Case
Massive Hemorrhage Protocol activation in an academic hospital setting Dr. Andrew Petrosoniak, St. Michael’s Hospital, Toronto
MHP Generic Power Point
This slide deck was created to be used by hospitals to present (at TC/MAC/Grand Rounds etc.) elements of the provincial MHP and explains how it can be adapted for your […]
Massive Hemorrhage Protocol e-learning module: Training slides for communication
This educational module will explain the important role hospital communications plays in MHP when activating Code Transfusion as overhead page.
Massive Hemorrhage Protocol e-learning module: Training slides for Porters
This educational module will explain the role of the porter during an MHP.
Massive Hemorrhage Protocol e-learning module: Training slides for MLTs
This educational module will review the role of the Medical Laboratory Technologist during an MHP.
MHP Quality Metrics
Included in the Massive Hemorrhage Protocol (MHP) are 8 Quality Metrics for local hospital and/or provincial reporting using an electronic survey/database for data entry. The reporting of quality metrics promotes improvement and increases transparancy within the healthcare system. Standardized quality metrics have been developed for the Provincial Massive Hemorrhage Protocol to help assess and improve specific activities over time at individual hospitals and will allow for peer benchmarking
