Causes & Recognition
Common causes of massive hemorrhage in the military setting include trauma, blast injuries, IED explosions, and ____?
What are gunshot wounds
This is the first step in management of massive hemorrhage.
What is direct pressure on the bleed or tourniquet application
This is the primary surgical intervention for massive hemorrhage control in the abdomen.
What is a damage control laparotomy
These are the primary goals of DCR
What are hemorrhage control, restore perfusion, prevention of lethal diamond.
This is the preferred blood product for initial resuscitation in DCR
what is LTOWB
Name the 6 main clinical signs of massive hemorrhage in a patient.
Hypotension, tachycardia, pallor, cool extremities, AMS, and signs of shock
This is the recommended fluid resuscitation strategy for patients with massive hemorrhage?
What is early admin of blood products, including PRBCs, FFP, and platelets
Pelvic binders ____ pelvic fractures and ___ pelvic hemorrhage.
what is stabilize and reduce
These are the components of the lethal diamond in trauma
This blood product is used to correct coagulopathy and provide clotting factors
What is FFP
This type of exam may be utilized in evaluation of massive hemorrhage in the trauma patient.
What is a FAST exam
TXA is used to reduce bleeding and improve outcomes by inhibiting what?
What is fibrinolysis
This intervention can be used as a temporary measure to occlude the aorta and control hemorrhage in patients with non-compressible torso injuries
What is REBOA
This is the recommended ration of PRBCs to FFP in DCR.
What is 1:1 ratio
___ are transfused to correct thrombocytopenia and improve clot formation.
What is Platelets
Which laboratory tests are commonly used to assess massive bleeding?
Hemoglobin, hematocrit, PLT, PT, aPTT, and fibrinogen
These (3) are potential complications associated with aggressive fluid resuscitation
Fluid overload, dilution coagulopathy, and exacerbation of hemorrhagic shock
These (3) are potential complications associated with DCS in MH.
abdominal compartment syndrome, post-op bleeding, and infection
Two grams of TXA should be given within this many hours
This is the recommended ratio of blood products for DCR in the hemorrhaging patient.
1:1:1 PRBCs, FFP, and PLT
This refers to the time after injury when prompt medical intervention is vital for improving outcomes and preventing death.
What is the Golden Hour
This principle involves maintaining a lower than normal blood pressure to avoid disruption clot formation and worsening bleeding until definitive control is taken.
What is permissive hypotension
What surgical technique can be utilized to control bleeding from solid organ injuries or vascular injuries in patients with massive hemorrhage
This medication should be given IV/IO after the first unit of blood product and with ongoing resuscitation after every 4 units of blood products
What is calcium
This product is used to correct fibrinogen deficiency and promote clot formation
what is cryoprecipitate