UMEM Educational Pearls

Category: Trauma

Title: Predicting mass transfusion with RABT

Keywords: trauma, whole blood, reduction, blood products, MHP, Shock index, RABT, hemorrhage (PubMed Search)

Posted: 3/19/2023 by Robert Flint, MD (Updated: 5/21/2024)
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Predicting the need for a mass hemorrhage protocol (MHP) activation is important both for individual patient outcome as well as for proper utilization of critical resources such as blood products and healthcare workers time and effort. These two studies look at using the RABT score to predict the need for mass transfusion. The RABT score is:

A 4-point score

blunt (0)/penetrating trauma (1),

shock index (hr/SBP)≥ 1 (1),

pelvic fracture (1)

FAST positive (1)

With a score >2 predictive of needing MHP.


These studies (one in Canadian trauma centers, the other in US trauma centers) validate the use of this score to predict the need for activation of a mass hemorrhage protocol.


1, Prediction of massive transfusion with the Revised Assessment of Bleeding and Transfusion (RABT) score at Canadian level I trauma centers  Karan D'Souza , Mathew Norman , Adam Greene , Colby J.F. Finney  Matthew T.S. Yan , Jacqueline D. Trudeau , Michelle P. Wong , Andrew Shih , Philip Dawe  Injury Volume 54, Issue 1, January 2023, Pages 19-24

2.2. Multicenter Validation of the Revised Assessment of Bleeding and Transfusion (RABT) Score for Predicting Massive Transfusion Kamil Hanna 1Charles Harris , Marc D Trust , Andrew Bernard , Carlos Brown , Mohammad Hamidi , Bellal Joseph  World J Surg  2020 Jun;44(6):1807-1816.  doi: 10.1007/s00268-020-05394-5.