We investigated the effect of administering a transfusion package encompassing 5 red blood cells (RBC), 5 fresh frozen plasma (FFP), and 2 platelet concentrates (PC) on clot formation and stability as evaluated by Thrombelastograph (TEG) in 10 patients presenting with massive bleeding. Blood was obtained before and after administering the transfusion packages. Six patients were hypocoagulable before administration of the transfusion package, whereas none of the patients were hypocoagulable after transfusion of up to 7 transfusion packages (p=0.01). In 8 patients damage control surgery was successful and 6 of these patients survived. The result indicates that an early balanced transfusion strategy maintains haemostatic competence in massively bleeding patients.