This guideline updates the Patient Blood Management Guidelines: Module 1 Critical bleeding/massive transfusion (2011).

It aims to provide updated clinical guidance for health professionals providing immediate in-hospital care for adults with critical bleeding, including the use of a major haemorrhage protocol (MHP) to guide the use of blood components, blood products and blood conservation strategies.

The clinical guidance is based on scientific evidence and consensus among clinical experts. The NBA gratefully acknowledges the dedication and expertise provided by the multidisciplinary Clinical/Consumer Reference Group.

The guideline was published on 10 August 2023 in electronic format and on MAGICapp, a web-based platform for guidelines.

This guideline is maintained on MAGICapp. The electronic version on MAGICapp and the PDF version below are the approved version and most current. Any downloaded or printed version is current only for the day it was printed or saved.


Any updates to the guideline will be acknowledged here. To keep up to date with the latest changes to this guideline, click subscribe on the MAGICapp website.

Major haemorrhage protocol (MHP) template

An editable template to be adapted to local institutional requirements and resources.

Summary of clinical guidance

Our quick reference guide comprises a:

  • summary of the recommendations developed by the CRG, based on a systematic review of evidence
  • summary of the good practice statements that were developed by the CRG through an expert consensus process
  • MHP template, which is designed to be adapted to meet local needs and resources.

To make a handy booklet, print the A5 file double-sided on the ‘short edge’ and fold the 2 pages.

College and society endorsements

We greatly appreciate and acknowledge the input received from the clinical community in producing the guideline. We are pleased to acknowledge that the following organisation has formally endorsed the guideline:

  • Australian & New Zealand Society of Blood Transfusion

PBM updates

Keep up to date with updates on patient blood management and our guidelines by subscribing to the PBM mailing list through BloodPortal(Opens in a new tab/window).


Get in touch

We welcome feedback on this guideline to inform future reviews or the development of materials to support implementation.


Last updated: 04 Apr 2024