External Haemorrhage; Roadside to Resus

Managing external haemorrhage is easy right?! Then why does haemorrhage remain a major cause of death from trauma worldwide? Ok, some of that is from internal sources, but….

No one should die from compressible external haemorrhage

With the right treatment applied in a timely fashion, the vast majority of these bleeds can be stopped. But with new advances like haemostatic agents, changing advice surrounding tourniquet use and practice changing evidence coming out of conflict zones can mean it’s difficult to remain current with the latest best practice.

So what options are available to us, how do we use them and what’s the evidence. Here’s the line-up for this months’ podcast:

• Haemorrhage control ladder
• Evidence based guidelines on haemorrhage control
• Direct pressure
• Enhanced pressure dressings
• Haemostatic agents and wound packing
• Tourniquets
• Case studies

As always we welcome feedback via the website or on Twitter and we look forward to your engagement.

Enjoy!

Simon, Rob & James

 

References & Further Reading

Bennett, B. L & Littlejohn, L. (2014) Review of new topical hemostatic dressings for combat casualty care. Military Medicine. Volume 179, number 5, pp497-514.

Lee, C., Porter, K. M & Hodgetts, T. J. (2007) Tourniquet use in the civilian prehospital setting. Emergency Medicine Journal. Volume 24, pp584-7. 

Nutbeam, T & Boylan, M. (2013) ABC of prehospital emergency medicine. Wiley Blackwell. London.

Shokrollahi, K., Sharma, H & Gakhar, H. (2008) A technique for temporary control of haemorrhage. The Journal of Emergency Medicine. Volume 34, number 3, pp319-20.

Trauma! Extremity Arterial Hemorrhage; LITFL 

The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition. Rolf Rossaint. Critical Care 2016.

NICE 2016. Major Trauma; Assessment and Initial Management

FPHC 2017; Position statement on the application of Tourniquets