Journal of Angiotherapy
Angiogenesis, Inflammation & Therapeutics | Online ISSN  2207-872X
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Contents Vol 8 (1)

Comprehensive Management of Hemorrhage in Trauma Care: A Multidisciplinary Approach

Mishari Abdullah Alajery 1, Faisal Hamed Almalki 1, Ahmed Abdu Khormi 1, Salem Mohamed AL Farshan 1, Abdullah Mohammed Qahtanl 1, Reem Mahmoud Nashar 1, Barakat Shumailan Alazmiy 1, Majed khalid Aljarallah 1, Ali Suliman Al Aloula 1, Abeer Abdu Jaafari 1, Asma Jadid Alanazi 1, Khadeja Abdullah Alhomod 1, Arwa Abdullah Alhamed 1, Khloud Awadh Alhizan 1, Khlood Khaldan Alharbi 1, Shalah Hmoud Al Harbi 1*

+ Author Affiliations

Journal of Angiotherapy 8 (1) 1-8 https://doi.org/10.25163/angiotherapy.8110096

Submitted: 04 October 2023 Revised: 15 January 2024  Published: 15 January 2024 

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Abstract

Background: Hemorrhage remains a critical clinical challenge, particularly in trauma care, where it is a leading cause of morbidity and mortality. Rapid identification of hemorrhage severity and timely intervention are crucial for improving patient outcomes. The management of hemorrhage involves a multifaceted approach, including early detection, accurate diagnostic tools, and collaboration among healthcare professionals in emergency and trauma settings. Pharmacists, nurses, and emergency providers all play essential roles in optimizing hemorrhage care. Methods: This review examines the current trends in hemorrhage management, focusing on trauma and cerebrovascular hemorrhage. We analyze the severity classification system used to guide clinical decision-making, from Class I (minimal intervention) to Class IV (aggressive resuscitation). The role of diagnostic imaging, including non-contrast CT and FAST scans, in detecting hemorrhage is also discussed. Additionally, the involvement of pharmacists in managing coagulopathies and ensuring appropriate drug therapy is highlighted. Clinical outcomes are evaluated in the context of balanced transfusion protocols, including the 1:1:1 ratio of packed red blood cells, fresh frozen plasma, and platelets. Results: A collaborative, multidisciplinary approach involving emergency providers, pharmacists, and nursing staff is essential for the effective management of hemorrhage. Early detection through diagnostic tools like CT scans and ultrasound leads to timely interventions such as surgical exploration and transfusions. The application of the 1:1:1 transfusion protocol has been shown to improve survival rates in trauma patients. In addition, the use of tourniquets and direct pressure has been proven effective in reducing mortality from hemorrhagic shock. The role of pharmacists in managing drug therapy, including blood products and medications for coagulopathies, significantly impacts patient outcomes. Conclusion: Effective hemorrhage management in trauma care requires a well-coordinated, multidisciplinary approach to ensure rapid diagnosis and intervention. Timely recognition of hemorrhage severity, accurate diagnostic imaging, and the implementation of transfusion protocols are critical components of trauma care. Pharmacists and nurses play crucial roles in optimizing treatment, while early interventions such as fluid resuscitation and hemorrhage control measures can dramatically improve patient survival. The findings underscore the importance of teamwork, specialized expertise, and systematic approaches to managing hemorrhage in trauma settings.

Keywords: hemorrhage, trauma care, early recognition, multidisciplinary approach, hemorrhagic shock

References

Aboudara, M., & Maldonado, F. (2019). Update in the management of pleural effusions. Medical Clinics of North America, 103(3), 475-485. https://doi.org/10.1016/j.mcna.2019.01.003

Agarwal, S., Zhou, T., & Frontera, J. (2019). Journal club: Association between aspirin dose and subarachnoid hemorrhage from saccular aneurysms: A case-control study. Neurology, 92(19), 920-922. https://doi.org/10.1212/WNL.0000000000007230

Baekgaard, J. S., Eskesen, T. G., Lee, J. M., Yeh, D. D., Kaafarani, H. M. A., Fagenholz, P. J., Avery, L., Saillant, N., King, D. R., & Velmahos, G. C. (2019). Spontaneous retroperitoneal and rectus sheath hemorrhage—Management, risk factors, and outcomes. World Journal of Surgery, 43(8), 1890-1897. https://doi.org/10.1007/s00268-019-05044-2

Carmichael, H., Steward, L., Peltz, E. D., Wright, F. L., & Velopulos, C. G. (2019). Preventable death and interpersonal violence in the United States: Who can be saved? Journal of Trauma and Acute Care Surgery, 87(1), 200-204. https://doi.org/10.1097/TA.0000000000002386

Dhakal, P., Wang, L., Gardiner, J., Shrotriya, S., Sharma, M., & Rayamajhi, S. (2019). Effectiveness of sequential compression devices in prevention of venous thromboembolism in medically ill hospitalized patients: A retrospective cohort study. Turkish Journal of Haematology, 36(3), 193-198. https://doi.org/10.4274/tjh.2018.0287

Foucher, C. D., & Tubben, R. E. (2023). Lactic acidosis. StatPearls [Internet]. StatPearls Publishing. https://www.statpearls.com/ArticleLibrary/viewarticle/24598

Gross, B. A., Jankowitz, B. T., & Friedlander, R. M. (2019). Cerebral intraparenchymal hemorrhage: A review. JAMA, 321(13), 1295-1303. https://doi.org/10.1001/jama.2019.0851

Hegvik, J. R., Spilman, S. K., Olson, S. D., Gilchrist, C. A., & Sidwell, R. A. (2017). Effective hospital-wide education in hemorrhage control. Journal of the American College of Surgeons, 224(5), 796-799.e1. https://doi.org/10.1016/j.jamcollsurg.2017.02.013

Kauvar, D. S., Lefering, R., & Wade, C. E. (2006). Impact of hemorrhage on trauma outcome: An overview of epidemiology, clinical presentations, and therapeutic considerations. Journal of Trauma, 60(6 Suppl), S3-11. https://doi.org/10.1097/01.ta.0000219347.77958.9e

Kim, D. S., Kong, M. H., Jang, S. Y., Kim, J. H., Kang, D. S., & Song, K. Y. (2013). The usefulness of brain magnetic resonance imaging with mild head injury and the negative findings of brain computed tomography. Journal of Korean Neurosurgical Society, 54(2), 100-106. https://doi.org/10.3340/jkns.2013.54.2.100

Lazarev, A., Golokhvast, K., & Borozda, I. (2019). Review of the problems of diagnosis of endopelvic hemorrhage, its intensity, volume, and duration, and treatment methods of circulatory injuries and surgical hemostasis after pelvic fractures. Emergency Medicine International, 2019, 2514146. https://doi.org/10.1155/2019/2514146

Lee, S. U., Kim, T., Kwon, O. K., Bang, J. S., Ban, S. P., Byoun, H. S., & Oh, C. W. (2020). Trends in the incidence and treatment of cerebrovascular diseases in Korea: Part I. Intracranial aneurysm, intracerebral hemorrhage, and arteriovenous malformation. Journal of Korean Neurosurgical Society, 63(1), 56-68. https://doi.org/10.3340/jkns.2019.0115

Mackenzie, M. J., Hiranandani, R., Wang, D., Fung, T., & Lang, E. (2017). Determinants of computed tomography head scan ordering for patients with low-risk headache in the emergency department. Cureus, 9(10), e1760. https://doi.org/10.7759/cureus.1760

Matano, F., Fujiki, Y., Mizunari, T., Koketsu, K., Tamaki, T., Murai, Y., Yokota, H., & Morita, A. (2019). Serum glucose and potassium ratio as risk factors for cerebral vasospasm after aneurysmal subarachnoid hemorrhage. Journal of Stroke and Cerebrovascular Diseases, 28(7), 1951-1957. https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.01.036

Nixon, G., Blattner, K., Muirhead, J., Finnie, W., Lawrenson, R., & Kerse, N. (2018). Scope of point-of-care ultrasound practice in rural New Zealand. Journal of Primary Health Care, 10(3), 224-236. https://doi.org/10.1071/HC17044

Palmer, L. (2017). Fluid management in patients with trauma: Restrictive versus liberal approach. Veterinary Clinics of North America: Small Animal Practice, 47(2), 397-410. https://doi.org/10.1016/j.cvsm.2017.01.004

Pontius, E., & Vieth, J. T. (2019). Complications in early pregnancy. Emergency Medicine Clinics of North America, 37(2), 219-237. https://doi.org/10.1016/j.emc.2019.01.003

Rubano, E., Mehta, N., Caputo, W., Paladino, L., & Sinert, R. (2013). Systematic review: Emergency department bedside ultrasonography for diagnosing suspected abdominal aortic aneurysm. Academic Emergency Medicine, 20(2), 128-138. https://doi.org/10.1111/acem.12032

Vulliamy, P., Thaventhiran, A. J., & Davenport, R. A. (2019). What’s new for trauma hemorrhage management? British Journal of Hospital Medicine (London), 80(5), 268-273. https://doi.org/10.12968/hmed.2019.80.5.268

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