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Critical Bleeding

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The content for this Critical Bleeding course is based on the national Patient Blood Management Guidelines: Module 1 Critical Bleeding/Massive Transfusion. It is designed for medical practitioners, nurses and midwives, transfusion laboratory technicians, and other healthcare workers involved in critical bleeding situations.

If your role involves prescribing a transfusion, administering blood and monitoring patients during and after a transfusion, it is recommended that you complete the Clinical Transfusion Practice course.

Learning modules

  1. Understanding Critical Bleeding
  2. Identifying and Stopping Critical Bleeding
  3. Fluid Resuscitation and Pharmacotherapy
  4. Massive Transfusion Protocol

This course takes on average three hours to complete.

‘Once you think you are in a clinical situation where you may have critical bleeding, there are three things that are immediately mandated; how to identify the bleeding, then how to stop the bleeding and how to restore the patient’s circulation and maintain it. Associate Professor Larry McNicol, Anaesthetist

Course Details

M1 – Understanding Critical Bleeding

On completion of this module you should be able to:

  • state the definition of critical bleeding and massive transfusion, and identify the relevance of the conditions and their clinical consequences including potential development of the lethal triad
  • identify the body’s response to blood loss and classes of shock, and apply this knowledge to the assessment of clinical scenarios
  • recognise the changes in haemostasis and metabolic parameters that occur in association with critical bleeding and massive transfusion and the testing available to assess coagulopathy.

M2 – Identifying and Stopping Critical Bleeding

On completion of this module you should be able to:

  • assess and recognise critical bleeding, and its potential to be present in clinical situations
  • identify approaches to stop critical bleeding
  • identify the initial basic resuscitation, management and baseline monitoring steps to be applied to patients experiencing critical bleeding.

M3 – Fluid Resuscitation and Pharmacotherapy

On completion of this module you should be able to:

  • review the use of intravenous fluid resuscitation in critical bleeding/massive transfusion
  • revise basic transfusion testing methods and provision of red cell support
  • review the use of blood component replacement therapy for the prevention and management of coagulopathy in critical bleeding/massive transfusion
  • recognise the place of transfusion sparing strategies, including cell salvage and prescription of pharmacological agents, in the effective management of critical bleeding.

M4 – Massive Transfusion Protocol (MTP)

On completion of this module you should be able to:

  • identify the key elements of a MTP
  • compare the similarities between your hospital guidelines to manage critical bleeding patients and the Patient Blood Management Guidelines: Module One – Critical Bleeding/Massive Transfusion MTP template
  • describe how an MTP is and/or may be implemented in your work setting
  • reflect on your potential role in a critical bleeding situation when an MTP may be activated
  • recognise strategies to develop effective communication within high performing teams, and apply this knowledge to the implementation of an MTP.


This course was released Oct 2012.
The content is based on current clinical guidelines, other evidence-based material and/or expert opinion. We regularly review our courses to reflect any changes in these source materials.

Endorsement & CPD

BloodSafe eLearning Australia seeks endorsement and allocation of CPD points for courses from medical, nursing and midwifery colleges, societies and healthcare organisations. Further information on professional organisations and CPD points is provided below.


International Society of Blood Transfusion (ISBT)

Continuing Professional Development (CPD)

NMBoard_web Nursing and Midwifery Board of Australia
Under continuing professional development (CPD) standards set by the Nursing and Midwifery Board of Australia one hour of active learning equals one hour of CPD. User evaluation of the Critical Bleeding course, demonstrates that on average it takes approximately three hours to complete all four modules in this package. Therefore it is recommended that three hours be recorded for the purpose of self-directed CPD.
ANZCA logo_2014 Australian and New Zealand College of Anaesthetists (ANZCA)
Participants in the ANZCA CPD Program may claim this online major haemorrhage course as an emergency response activity in their CPD portfolio.
Recognition code: ER-17-MH-011
Recognition expiry 30 June 2020
Other Professions and Medical Specialties
User evaluation of the Critical Bleeding course, demonstrates that on average it takes approximately three  hours to complete all four modules in this package. Therefore it is recommended that three hours be recorded for the purpose of CPD.


There is an online assessment of six multiple choice questions at the end of each module within the

Critical Bleeding course.

A minimum grade of 66% (four out of six questions correct) is required to complete each module.

A certificate will be automatically emailed to your registered email address after you have successfully

completed the assessment for all modules.

If you don’t pass a module assessment, you can redo it as many times as you need. It is recommended

you revisit the learning content because the assessment questions may change for each attempt.

You must complete the assessment for this course within three months. If not, then the assessment will need to be commenced again.

You can see a summary of the courses and modules you have successfully completed in My certificates

or via the Course certificates link on the My courses page.

Development Team

Project Team

Dr Amanda Thomson: Medical Writer/Editor
Mr Ian Bone: Educational and Creative Designer
Ms Shelly Abbott: Clinical Education Officer
Ms Trudi Verrall: Clinical Education Lead
Ms Michele Wood: Program Manager


Peer Review Group

Thanks to Associate Professor Craig French, Dr Chris Hogan, Associate Professor Tony Joseph, Dr Tristan Leech, Associate Professor Larry McNicol, Dr Eamon Raith, Dr Mark Schoeman and the wider group of health professionals who provided evaluation and feedback during the development process.


Subject Matter Experts

Dr Amanda Thomson, Professor Russell Gruen, Dr Tristan Leech, Dr Eamon Raith, Dr Mark Schoeman, Dr Cathy Bernard, Dr Richard Cracknell, Associate Prof Mark Dean, Associate Professor Tony Joseph, Dr David Mah, Dr Jennie Martin and Dr Richard Seigne


Expert Interviews

Thanks to Associate Professor Craig French, Dr Chris Hogan, Professor Russell Gruen, Associate Professor Larry McNicol and Dr Mark Schoeman for their willingness to be a part of this course.


Others Involved in Clinical Videos

Motorcycle victim: Todd Gray

Plumber: David Wilson

Plumber’s wife: Jenny Phillips

Joshua Abbott, Annie Arnold, Anjima Basumatari, Elaine Bell, Robyn Brodie, Stephen Byrne, Justin Cash, Philip Coward, Catherine Ebel, Norelle Edgecombe, Jessica Gannon, Jane Haley, Neville Hoffmann, Dr Jonathon Hopkinson, Dr Vanessa Hughes, Karen Johnson, Joanne Jones, Melanie Mather, Kaye McLoughlin, Linley Meyer, Dr Matthew O’Connor, Paul Patiniott, Tracy Phillpot, Danielle Sanders, Mark Scicluna, Tom Traino



BloodSafe eLearning Australia wish to thank the staff of the Emergency Department, Royal Adelaide Hospital; DOSA/Day Surgery Unit and Rogerson Operating Theatres, Women’s and Children’s Hospital; Practice Based Laboratories, School of Nursing and Midwifery, University of South Australia particularly Dr Barbara Parker, Louise McGee and Ralf Senff; the IMVS Transfusion Service, Women’s and Children’s Hospital and Craig Ravlich at Flinders Medical Centre Radiology Department, the Sykes/Arnold Family for the use of their property for filming and the South Australian Ambulance Service, particularly Kate Fawcett, Craig Murphy and Mary Threlfo (ambulance officers)


Educational Design

Ian Bone


Production Team

Production Studio: Digital Media Unit, Centre for Education and Training, Women’s and Children’s Health Network, Adelaide, South Australia.
Interactive Design and Development: Peter Bailes
Graphic Design: Erin Baldock and Carolyn Gliddon
Photography: Ian Bone, Greg Opie, Chris Sprod and Carly Emerson
Video Photography and production: Ian Bone and Greg Opie
Product Assistant: Veronic Asz
Editor: Helen Snoswell
Learning Management System: Brightcookie Pty Ltd


Funding for BloodSafe eLearning Australia has been provided by all Australian Governments via the National Blood Authority