Using the App

Major Haemorrhage Simulation

Premium tool. Open directly at /major-haemorrhage-simulation. The simulator has its own page; it is not currently listed on the /training-dashboard hub.

This is one of the most realistic high-pressure simulators on the platform. It puts you in the role of the Transfusion BMS during a live MHP activation.

What it does

• Simulates a phone call from theatre or A&E activating the Major Haemorrhage Protocol (MHP)
• Asks you to manage MTP pack preparation and delivery against a ticking clock
• Inserts realistic complications — analyser flag, unmatched antibody, supply shortage, fridge alarm, second concurrent activation
• Tracks your time to first pack and time to subsequent packs
• Shows your coagulopathy management — when to send extra cryoprecipitate, FFP, platelets
• Generates a post-event review including a SHOT-style incident summary

What gets tested

• Pre-MHP stock checks and rolling readiness
• Sample priority — emergency O-neg vs group-specific vs full crossmatch
• MTP pack composition — red cells / FFP / platelets / cryoprecipitate ratios
• Communication — who you call, in what order, with what data
• Backup workflows when the main analyser fails mid-MHP (see also Equipment Failure Simulator)
• Concurrent demands — handling routine work alongside the MHP
• Stand-down — when and how to formally end the MHP

MTP pack ratios

The simulator uses the NHS England MHP guidance ratios (and your local SOP where you provide it):

• Standard pack 1 — 4 units RBC + 4 units FFP
• Standard pack 2 — 4 units RBC + 4 units FFP + 1 ATD platelets + 2 units cryoprecipitate

Local variation is significant. The simulator will let you upload your Trust's MTP SOP for accurate practice.

Standards alignment

• NHS England MHP guidance — current edition
• NICE NG24 (Blood transfusion) — applicable transfusion-medicine principles
• JPAC Red Book — UK Blood Transfusion Services standards
• BBTS guidelines for major haemorrhage
• SHOT Annual Report — for incident reporting alignment
• ISO 15189:2022 quality framework

Bands and competency mapping

• Band 5 — execute the MHP, prepare MTP packs to SOP, communicate clearly
• Band 6 — manage complications, second-line product decisions, mentor more junior staff during the event
• Band 7 — service lead role, post-event audit, contribute to Trust MHP committee, revise SOP after learning events

Completed sessions are accepted as IBMS Specialist Portfolio evidence for Blood Transfusion candidates.

Common interview question themes

• "Walk me through your MHP from the moment the phone rings"
• "How do you decide between emergency O-neg and waiting for group-specific?"
• "What do you do if your analyser fails mid-MHP?"
• "How do you handle two concurrent MHP activations?"
• "Describe a post-MHP review you've been part of"

A solid preparation order: SHOT Cold Chain Simulator → Major Haemorrhage Simulation → Equipment Failure Simulator → Transfusion Reaction Simulator → AI Interview Coach for the Band-6 transfusion role.