Comprehensive Management of Hemorrhage in Emergency Medicine: Etiology, Diagnosis, and Evidence-Based Interventions
Ibrahim Hussain A Alanazi 1*, Bandar Zaben Alharbi 1, Magliah, Rami Fawzi 1, Ibrahim Muhammad Al-Arej 1, Mohammed Raja' Alharithi 1, Mohammed Ibraheem Alshalan 1, Saad Alwan Alshehri 1, Al Duheem, Bader Sughayir D 1, Faisal Nasser S, Alharbi 1, Yousef Sulaiman Alharbi 1, Muteb Majed Fahad Albaqami 1
Journal of Angiotherapy 8(1) 1-8 https://doi.org/10.25163/angiotherapy.8110226
Submitted: 06 November 2023 Revised: 11 January 2024 Published: 14 January 2024
Abstract
Hemorrhage remains a leading cause of preventable death in emergency medicine, responsible for nearly 40% of trauma-related fatalities. It presents across a wide severity spectrum, from minor bleeding to catastrophic vascular injuries, with patient outcomes closely tied to the speed and accuracy of diagnosis and intervention. This review synthesizes current strategies for hemorrhage management, emphasizing etiology, diagnostic methods, and evidence-based treatment approaches. A comprehensive analysis of peer-reviewed literature, clinical guidelines, and recent studies was performed, with particular focus on anatomic-specific bleeding patterns, resuscitation strategies, and associated complications. Key findings highlight that hemorrhage characteristics vary by location—intracranial, thoracic, abdominal, retroperitoneal, or orthopedic—requiring tailored diagnostic approaches. The 1:1:1 transfusion ratio of packed red blood cells, fresh frozen plasma, and platelets improves survival in major hemorrhage, and early tranexamic acid administration reduces mortality in traumatic bleeding. Effective hemorrhage control also benefits from interprofessional team coordination, with appropriate imaging (CT, FAST, angiography) carefully selected based on clinical urgency. Hemodynamic targets differ by hemorrhage type, with general cases requiring a mean arterial pressure above 65 mmHg and traumatic brain injury patients needing a systolic blood pressure above 120 mmHg. Ultimately, optimizing outcomes in hemorrhagic emergencies demands rapid anatomic localization, damage control resuscitation, interdisciplinary teamwork, and adherence to standardized protocols.
Keywords: hemorrhage control, trauma resuscitation, hemorrhagic shock, transfusion protocols, interprofessional management
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