en تروما Trauma مروری Review <span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">Background and Aim:</span></span></b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""> Uncontrolled hemorrhage is a leading cause of preventable death in trauma. The Massive Transfusion Protocol provides a standardized strategy for damage control resuscitation. While Massive Transfusion Protocol medical protocols are well-established, the specific nursing challenges in coordinating these complex processes remain underexplored in the literature. Successful implementation requires complex interprofessional coordination, with nurses playing a pivotal role as the largest professional group involved in activation and execution. This narrative review identifies nursing challenges in team coordination, communication, and documentation during Massive Transfusion Protocol implementation and presents evidence-based solutions.<br> <b>Methods:</b> A structured literature search was conducted across PubMed, Scopus, Web of Science, CINAHL, SID, and Magiran for articles published between 2015 and 2026. Inclusion criteria comprised studies focusing on Massive Transfusion Protocol implementation in trauma centers that examined the nursing role, published in English or Persian.<br> <b>Results:</b> Identified challenges fell into three domains: team coordination (inappropriate activation, delays in blood product access, role ambiguity); communication (deficiencies in closed-loop communication, unclear hierarchy, interdepartmental challenges); and documentation (incomplete records, discrepancies between clinical and blood bank documentation).<br> <b>Conclusion:</b> Massive Transfusion Protocol success depends heavily on human factors, communication structures, and nursing documentation processes. Evidence-based solutions include preemptive activation systems, closed-loop communication, simulation-based training, and integrated documentation systems. Trauma nurses require empowerment in team leadership and interprofessional communication management.</span></span></span></span><br> <span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">&nbsp;Key words:</span></span></b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""> Documentation, Interprofessional relations, Massive transfusion protocol, Patient care team, Trauma nursing</span></span></span></span> Documentation, Interprofessional relations, Massive transfusion protocol, Patient care team, Trauma nursing 0 0 http://jsurgery.bums.ac.ir/browse.php?a_code=A-10-556-3&slc_lang=en&sid=1 Seyed Mostafa Mohsenizadeh MohsenizadehM@bums.ac.ir 100319475328460012707 100319475328460012707 No Assistant Professor of Nursing, Department of Nursing, Qaen Faculty of Medical Sciences, Birjand University of Medical Sciences, Birjand, Iran. Hoda Salehi hodasalehi@bums.ac.ir 100319475328460012708 0009-0006-3238-766X Yes Instructor of Medical Surgical Nursing, Department of Nursing, Qaen Faculty of Medical Sciences, Birjand University of Medical Sciences, Birjand, Iran.