Critical care in emergency department: massive haemorrhage in trauma

Emergency Medicine Journal : EMJ
Tushar MahambreyPatrick A Nee

Abstract

Inadequate resuscitation of major haemorrhage is an important cause of avoidable death in severely injured patients. Early recognition of blood loss, control of bleeding and restoration of circulating volume are critical to the management of trauma shock, and transfusion of blood components is a key intervention. Vital signs may be inadequate to determine the need for transfusion, and resuscitation regimens targeting vital signs may be harmful in the context of uncontrolled bleeding. This article addresses current concepts in haemostatic resuscitation. Recent guidelines on the diagnosis and treatment of coagulopathy in major trauma, and the role of component and adjuvant therapies, are considered. Finally, the potential role of thromboelastography and rotational thromboelastometry are discussed.

Citations

Oct 24, 2015·Emergency Medicine Journal : EMJ·J E SmithP A F Hunt
Apr 3, 2016·Best Practice & Research. Clinical Anaesthesiology·Oliver M Theusinger, Donat R Spahn
Jun 12, 2016·American Journal of Physiology. Gastrointestinal and Liver Physiology·Geeta RaoVibhudutta Awasthi
Jan 18, 2014·Critical Care Medicine·Hans Knotzer, Werner Pajk
Jan 1, 2014·Current Opinion in Anaesthesiology·Oliver M TheusingerDonat R Spahn
Oct 15, 2014·Current Opinion in Critical Care·Oliver M TheusingerDonat R Spahn

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