How hemorrhage control became common sense

The Journal of Trauma and Acute Care Surgery
Alan James Hawk

Abstract

Just over 200 years ago, surgeons were puzzled that the use of the tourniquet to control hemorrhage as common sense during surgery was a relatively recent development. Within the last 20 years, much progress has been made to controlling hemorrhage in the prehospital context. Then, as now, it was surprising that progress on something that appeared obvious had occurred only recently, begging the question how controlling blood loss was common sense in a surgical context, but not for emergency treatment. This article is a historical survey of the evolution of the medical understanding of hemorrhage along with technological response. The danger of blood loss had historically been consistently underestimated as physicians looked at other explanations for symptoms of how the human body responded to trauma. As the danger from hemorrhage became apparent, even obvious, responsibility for hemorrhage control was delegated down from the surgeon to the paramedic and eventually to individual service members and civilian bystanders with training to "stop the bleed." Hippocratic medicine assumed that blood diffused centrifugally into periphery through arteries. William Harvey's observation in 1615 that blood ran through a closed circulatory sys...Continue Reading

References

Dec 5, 2012·The Journal of Trauma and Acute Care Surgery·Lorne H BlackbourneJohn B Holcomb

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Citations

Jul 6, 2019·The Journal of Trauma and Acute Care Surgery·Andrew DennisFaran Bokhari
Feb 13, 2020·Current Opinion in Anaesthesiology·Christine Schlömmer, Jens Meier

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