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Strategies to Control Hemorrhage in the Trauma Patient

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The High-risk Surgical Patient

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Abstract

Traumatic hemorrhage is one of the leading causes of death. Additionally, hemorrhage is also a leading cause of preventable traumatic deaths. Trauma causes a significant healthcare financial burden and any effort to decrease traumatic mortality is a worthy cause. Improving outcomes in traumatic hemorrhage have proven to be extremely complex and multifaceted endeavor. Protocols, pharmaceutical adjuncts, surgical techniques, and management strategies have all been extensively researched in the realm of traumatic hemorrhage control.

The most important aspect of traumatic hemorrhage control is the time to definitive control. Regardless of the therapy initiated, mortality improves when bleeding stops sooner. Thus, the most beneficial strategies should be designed around controlling the hemorrhage as early as possible. Ongoing bleeding is associated with both increased morbidity and mortality in the trauma population. In order to achieve early hemorrhage control, point-of-care strategies, prehospital resuscitation, early definitive interventions, and quick surgical techniques should be employed. Prehospital evaluation and early intervention are necessary to promote the best chance of survival.

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Authors and Affiliations

  1. University of Southern California+Los Angeles Medical Center, Los Angeles, CA, USA

    Joshua Dilday

  2. Division of Acute Care Surgery, Department of Surgery, Center for Injury Science, University of Alabama at Birmingham, Birmingham, AL, USA

    John B. Holcomb

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  1. Dipartimento di Emergenza Urgenza, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Paolo Aseni

  2. Divisione di Cardiochirurgia, IRCCS Fondazione Policlinico San Matteo, Pavia, Pavia, Italy

    Antonino Massimiliano Grande

  3. Div. of Emerg. Surg., Abdominal Center, Helsinki University Hospital Meilahti, Helsinki, Finland

    Ari Leppäniemi

  4. Department of Pathophysiology and Transplantation, General Surgery and Trauma Team, University of Milano, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Osvaldo Chiara

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Dilday, J., Holcomb, J.B. (2023). Strategies to Control Hemorrhage in the Trauma Patient. In: Aseni, P., Grande, A.M., Leppäniemi, A., Chiara, O. (eds) The High-risk Surgical Patient. Springer, Cham. https://doi.org/10.1007/978-3-031-17273-1_78

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