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, Hayel Salem Alonazi 1, Alanoud Nasser Alsubaie 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
Background: Hemorrhage remains a leading cause of preventable mortality in emergency medicine, particularly in trauma settings where it accounts for nearly 40% of trauma-related deaths. The condition presents across a spectrum of severity, from minor capillary bleeding to life-threatening vascular injuries, with outcomes heavily dependent on timely recognition and intervention. This review examines current strategies for hemorrhage management in emergency practice, focusing on etiology, diagnostic approaches, and evidence-based treatment protocols to optimize patient outcomes. Methods: A comprehensive analysis of peer-reviewed literature was conducted, incorporating clinical guidelines and recent studies on hemorrhage classification, pathophysiology, and interprofessional management. Emphasis was placed on anatomic-specific bleeding patterns, resuscitation strategies, and complications. Results: Key findings include: (1) Hemorrhage manifests differently by anatomic location (intracranial, thoracic, abdominal, retroperitoneal, orthopedic), each requiring tailored diagnostic approaches; (2) The 1:1:1 transfusion ratio (PRBCs:FFP:platelets) demonstrates superior outcomes in major hemorrhage; (3) Early tranexamic acid administration reduces mortality in traumatic bleeding; (4) Interprofessional team management improves survival rates. Diagnostic imaging selection (CT, FAST, angiography) must balance urgency with accuracy, while hemodynamic targets vary by hemorrhage type (MAP >65 mmHg for general cases, SBP >120 mmHg for TBI). Conclusion: Effective hemorrhage control requires rapid anatomic localization, damage control resuscitation, and interdisciplinary coordination. Standardized protocols and team training significantly improve outcomes in this time-critical condition.
Keywords: hemorrhage control, trauma resuscitation, hemorrhagic shock, transfusion protocols, interprofessional management
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