In a 1:1:1 transfusion strategy, which components are included?

• A. RBCs, plasma, and platelets
• B. Plasma, RBCs, and platelets in a 1:1:1 ratio
• C. Plasma, RBCs, and cryoprecipitate
• D. RBCs, plasma, and albumin

Answer: (B)

Balanced transfusion during major bleeding aims to replace all critical blood components at roughly equal parts. In a 1:1:1 approach you administer red blood cells, plasma, and platelets in equal portions. This combination addresses oxygen delivery (RBCs), coagulation factors (plasma), and platelet function (platelets) to support hemostasis while restoring circulating volume. It helps prevent dilutional coagulopathy that can occur when only red cells are transfused or when coagulation components lag behind ongoing blood loss. Albumin isn’t part of this protocol, and cryoprecipitate isn’t routinely included in the basic 1:1:1 mix—though it may be added if fibrinogen levels are low.