New Best Practice Protocols

The new best practice protocol, Management of Blood Loss and Transfusions Following TAVR is available on This protocol covers the factors that can contribute to a bleeding event after TAVR and outlines strategies that can reduce bleeding and the rate of transfusion. It also includes a flow chart for aiding in decision-making for red blood cell transfusion.

The MISHC TAVR Groin Bleed Best Practice Protocol and the Radial and Ulnar Access Bleed Best Practice Protocol are now available on

Visit the “Quality Improvement” tab on our website and then click on “Best Practices.” Links to both protocols are available. Click to download a zip file of resources including a PDF which can be printed at letter size or pocket-card size. You’ll also find jpg versions for easy download to smartphone picture files. 

The groin bleed protocol includes instructions to stop bleeding as well as instructions for assessing for instability, volume resuscitating, and diagnostic testing. It also includes information on specific anti-platelet and anti-coagulant issues and other special considerations. 

The radial/ulnar access bleed protocol includes step-by-step instructions to aid in stopping bleeding and information on specific anti-platelet and anti-coagulant management issues.

We encourage you to print and share these with your teams.

Thank you to the MISHC Best Practice Protocol Task Force for their work on these resources.