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Prehospital haemorrhage control

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https://www.readbyqxmd.com/read/27623805/prehospital-control-of-life-threatening-truncal-and-junctional-haemorrhage-is%C3%A2-the-ultimate-challenge-in-optimizing-trauma-care-a-review-of-treatment-options-and-their-applicability-in-the-civilian-trauma-setting
#1
REVIEW
S E van Oostendorp, E C T H Tan, L M G Geeraedts
INTRODUCTION: Exsanguination following trauma is potentially preventable. Extremity tourniquets have been successfully implemented in military and civilian prehospital care. Prehospital control of bleeding from the torso and junctional area's remains challenging but offers a great potential to improve survival rates. This review aims to provide an overview of potential treatment options in both clinical as preclinical state of research on truncal and junctional bleeding. Since many options have been developed for application in the military primarily, translation to the civilian situation is discussed...
September 13, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27294481/-recommendations-for-releasing-the-pelvic-binder-after-a-non-invasive-pelvic-stabilisation-procedure-under-emergency-room-conditions
#2
U Schweigkofler, B Wohlrath, T Paffrath, S Flohé, D Wincheringer, R Hoffmann, H Trentzsch
Severe brain, thoracic and intrapelvic injuries, as well as heavy bleeding, are the main causes of death in patients with major trauma. Unstable pelvic ring fractures can cause this bleeding and the so-called "C problem". This is usually due to haemorrhagic shock caused by the loss of large volumes of blood from the presacral venous plexus, iliac vessels and the fracture surfaces. Many clinical studies have shown that, in the preclinical setting, unstable pelvic ring injuries are often underestimated. The application of a non-invasive external pelvic ring stabilisation (pelvic binder) is therefore recommended if a pelvic fracture is possible...
June 13, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/27199140/bet-1-give-prehospital-blood-and-save-a-life
#3
Nicholas Scott, Sarah Sutton
A short cut review was carried out to establish whether prehospital blood transfusion in the trauma patient with active haemorrhage can reduce mortality. 11 directly relevant papers were found using the reported search strategy. Of these two presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. It is concluded that prehospital blood transfusion may reduce short-term mortality in these patients, but that the evidence level is low and further definitive randomised controlled trials are needed to prove benefit...
June 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/26830121/prehospital-use-of-hemostatic-dressings-in-emergency-medical-services-in-the-netherlands-a-prospective-study-of-66-cases
#4
Ruben Te Grotenhuis, Pierre M van Grunsven, Wim M J M Heutz, Edward C T H Tan
BACKGROUND: Uncontrolled haemorrhage is the leading cause of potentially preventable death in both civilian and military trauma patients. Animal studies and several case series have shown that hemostatic dressings reduce haemorrhage and might improve survival. One of these products is HemCon ChitoGauze(®). The objective of this study was to determine the effectiveness and safety of ChitoGauze in achieving hemostasis in massive traumatic bleeding in civilian emergency medical services...
May 2016: Injury
https://www.readbyqxmd.com/read/26772450/the-itclamp-in-the-management-of-prehospital-haemorrhage
#5
Edward C T H Tan, Joost H Peters, Jessica L Mckee, Michael J R Edwards
INTRODUCTION: Bleeding remains a leading cause of death in trauma patients. The iTClamp is a temporary wound closure device designed to control external bleeding within seconds of injury. We describe our experience using this device on 10 patients in the prehospital environment. METHODS: We have implemented the iTClamp for prehospital use through our physician-staffed helicopter emergency medical service (HEMS). Indications were massive bleeding that could not be controlled with an ordinary compressive bandage or a haemostatic bandage...
May 2016: Injury
https://www.readbyqxmd.com/read/26220293/prehospital-use-of-plasma-in-traumatic-hemorrhage-the-pupth-trial-study-protocol-for-a-randomised-controlled-trial
#6
RANDOMIZED CONTROLLED TRIAL
Penny S Reynolds, Mary Jane Michael, Emily D Cochran, Jacob A Wegelin, Bruce D Spiess
BACKGROUND: Severe traumatic injury and haemorrhagic shock are frequently associated with disruptions of coagulation function (such as trauma-induced coagulopathy TIC) and activation of inflammatory cascades. These pathologies may be exacerbated by current standard of care resuscitation protocols. Observational studies suggest early administration of plasma to severely-injured haemorrhaging patients may correct TIC, minimise inflammation, and improve survival. The proposed randomised clinical trial will evaluate the clinical effectiveness of pre-hospital plasma administration compared with standard- of-care crystalloid resuscitation in severely-injured patients with major traumatic haemorrhage...
2015: Trials
https://www.readbyqxmd.com/read/26143820/-wounded-in-action-the-platinum-ten-minutes-and-the-golden-hour
#7
Jean-Louis Daban, Elisabeth Falzone, Mathieu Boutonnet, Vincent Peigne, Bernard Lenoir
In the battlefield, the majority of casualties die within ten minutes of the trauma. Most injuries result from an explosion and haemorrhage plays a central role. To improve survival rates, the French Army Health Service has developed a chain of survival from the battlefield to France based on prehospital combat casualty care, forward medical support during the first hour and damage control surgery.
September 2014: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/25508259/-wounded-in-action-the-platinum-ten-minutes-and-the-golden-hour
#8
Jean-louis Daban, Elisabeth Falzone, Mathieu Boutonnet, Vincent Peigne, Bernard Lenoir
In the battlefield, the majority of casualties die within ten minutes of the trauma. Most injuries result from an explosion and haemorrhage plays a central role. To improve survival rates, the French Army Health Service has developed a chain of survival from the battlefield to France based on prehospital combat casualty care, forward medical support during the first hour and damage control surgery.
September 2014: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/25464628/-wounded-in-action-the-platinum-ten-minutes-and-the-golden-hour
#9
Jean-louis Daban, Elisabeth Falzone, Mathieu Boutonnet, Vincent Peigne, Bernard Lenoir
In the battlefield, the majority of casualties die within ten minutes of the trauma. Most injuries result from an explosion and haemorrhage plays a central role. To improve survival rates, the French Army Health Service has developed a chain of survival from the battlefield to France based on prehospital combat casualty care, forward medical support during the first hour and damage control surgery.
September 2014: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/24360668/fractures-of-the-pelvic-ring
#10
James Min-Leong Wong, Andrew Bucknill
Traumatic disruptions of the pelvic ring are high energy life threatening injuries. Management represents a significant challenge, particularly in the acute setting in the presence of severe haemorrhage. Initial management is focused on preserving life by controlling haemorrhage and associated injuries. Advances in prehospital care, surgery, interventional radiology and the introduction of treatment algorithms to streamline decision making have improved patient survival. As more patients with unstable pelvic injuries survive, the poor results associated with nonoperative management and increasing patient expectations of outcome are making surgical management of these fractures increasingly common...
December 2, 2013: Injury
https://www.readbyqxmd.com/read/23906957/identifying-future-unexpected-survivors-a-retrospective-cohort-study-of-fatal-injury-patterns-in-victims-of-improvised-explosive-devices
#11
James A G Singleton, Iain E Gibb, Nicholas C A Hunt, Anthony M J Bull, Jonathan C Clasper
OBJECTIVES: To identify potentially fatal injury patterns in explosive blast fatalities in order to focus research and mitigation strategies, to further improve survival rates from blast trauma. DESIGN: Retrospective cohort study. PARTICIPANTS: UK military personnel killed by improvised explosive device (IED) blasts in Afghanistan, November 2007-August 2010. SETTING: UK military deployment, through NATO, in support of the International Security Assistance Force (ISAF) mission in Afghanistan...
2013: BMJ Open
https://www.readbyqxmd.com/read/23896213/haemorrhagic-shock-therapeutic-management
#12
REVIEW
J-S David, C Spann, G Marcotte, B Reynaud, O Fontaine, M Lefèvre, V Piriou
The management of a patient in post-traumatic haemorrhagic shock will meet different logics that will apply from the prehospital setting. This implies that the patient has beneficiated from a "Play and Run" prehospital strategy and was sent to a centre adapted to his clinical condition capable of treating all haemorrhagic lesions. The therapeutic goals will be to control the bleeding by early use of tourniquet, pelvic girdle, haemostatic dressing, and after admission to the hospital, the implementation of surgical and/or radiological techniques, but also to address all the factors that will exacerbate bleeding...
July 2013: Annales Françaises D'anesthèsie et de Rèanimation
https://www.readbyqxmd.com/read/23243045/hypothermia-in-trauma
#13
REVIEW
Samuel Edwin Moffatt
Hypovolaemic shock that results through traumatically inflicted haemorrhage can have disastrous consequences for the victim. Initially the body can compensate for lost circulating volume, but as haemorrhage continues compensatory mechanisms fail and the patient's condition worsens significantly. Hypovolaemia results in the lethal triad, a combination of hypothermia, acidosis and coagulopathy, three factors that are interlinked and serve to worsen each other. The lethal triad is a form of vicious cycle, which unless broken will result in death...
December 2013: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/23164651/-prehospital-use-of-haemostatic-dressing-quikclot-acs-%C3%A2-for-hemorrhage-control-of-a-perineal-trauma
#14
S Travers, O Dubourg, L Ribeiro Parenti, H Lefort, S Albarello, L Domanski
First responders are sometimes confronted with external uncontrolled haemorrhage despite compression, bandages, and tourniquets. Several topical haemostatic agents were developed to try to face these situations. Their application was mainly described and studied in military environment. We report the case of a worker victim of an accident of construction site with hemorrhagic perineal trauma for whom the use of a haemostatic bandage QuikClot ACS+™ (Z-Medica) seemed to us particularly useful in prehospital setting...
December 2012: Annales Françaises D'anesthèsie et de Rèanimation
https://www.readbyqxmd.com/read/23161808/haemostatic-dressings-in-prehospital-care
#15
REVIEW
Adam Hewitt Smith, Colville Laird, Keith Porter, Mark Bloch
Massive haemorrhage still accounts for up to 40% of mortality after traumatic injury. The importance of limiting blood loss after injury in order to prevent its associated complications has led to rapid advances in the development of dressings for haemostatic control. Driven by recent military conflicts, there is increasing evidence to support their role in the civilian prehospital care environment. This review aims to summarise the key characteristics of the haemostatic dressings currently available on the market and provide an educational review of the published literature that supports their use...
October 2013: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/22362649/major-trauma-and-urban-cyclists-physiological-status-and-injury-profile
#16
Joanna Manson, Sian Cooper, Anita West, Elizabeth Foster, Elaine Cole, Nigel R M Tai
INTRODUCTION: Pedal cycling in cities has the potential to deliver significant health and economic benefits for individuals and society. Safety is the main concern for potential cyclists although the statistical risk of death is low. Little is known about the severity of injuries sustained by city cyclists and their outcome. AIM: The aim of this study was to characterise the physiological status and injury profile of cyclists admitted to our urban major trauma centre (MTC)...
January 2013: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/20603900/the-emergency-control-of-traumatic-maxillofacial-haemorrhage
#17
Tim Harris, Scott Rice, Beverley Watts, Gareth Davies
Maxillofacial trauma is common and may lead to haemorrhage that is associated with actual or impending airway compromise. This study briefly discusses the aetiology of midfacial haemorrhage and describes a simple effective technique of midface splintage for haemorrhage control, which may be applied in the prehospital and emergency environments. This technique has been used successfully by the London Helicopter Emergency Medical Service.
August 2010: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/19759831/first-things-first-effectiveness-and-scalability-of-a-basic-prehospital-trauma-care-program-for-lay-first-responders-in-kampala-uganda
#18
Sudha Jayaraman, Jacqueline R Mabweijano, Michael S Lipnick, Nolan Caldwell, Justin Miyamoto, Robert Wangoda, Cephas Mijumbi, Renee Hsia, Rochelle Dicker, Doruk Ozgediz
BACKGROUND: We previously showed that in the absence of a formal emergency system, lay people face a heavy burden of injuries in Kampala, Uganda, and we demonstrated the feasibility of a basic prehospital trauma course for lay people. This study tests the effectiveness of this course and estimates the costs and cost-effectiveness of scaling up this training. METHODS AND FINDINGS: For six months, we prospectively followed 307 trainees (police, taxi drivers, and community leaders) who completed a one-day basic prehospital trauma care program in 2008...
2009: PloS One
https://www.readbyqxmd.com/read/19135193/exsanguination-in-trauma-a-review-of-diagnostics-and-treatment-options
#19
REVIEW
L M G Geeraedts, H A H Kaasjager, A B van Vugt, J P M Frölke
Trauma patients with haemorrhagic shock who only transiently respond or do not respond to fluid therapy and/or the administration of blood products have exsanguinating injuries. Recognising shock due to (exsanguinating) haemorrhage in trauma is about constructing a synthesis of trauma mechanism, injuries, vital signs and the therapeutic response of the patient. The aim of prehospital care of bleeding trauma patients is to deliver the patient to a facility for definitive care within the shortest amount of time by rapid transport and minimise therapy to what is necessary to maintain adequate vital signs...
January 2009: Injury
https://www.readbyqxmd.com/read/18467882/developing-alternative-strategies-for-the-treatment-of-traumatic-haemorrhagic-shock
#20
REVIEW
Hannes G Lienhart, Karl H Lindner, Volker Wenzel
PURPOSE OF REVIEW: The optimal strategy of stabilizing haemodynamic function in uncontrolled traumatic haemorrhagic shock states is unclear. Although fluid replacement is established in controlled haemorrhagic shock, its use in uncontrolled haemorrhagic shock is controversial, because it may worsen bleeding. RECENT FINDINGS: In the refractory phase of severe haemorrhagic shock, arginine vasopressin has been shown to be beneficial in selected cases due to an increase in arterial blood pressure, shift of blood away from a subdiaphragmatic bleeding site towards the heart and brain, and decrease in fluid resuscitation requirements...
June 2008: Current Opinion in Critical Care
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