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Related Concept Videos

Coagulation01:09

Coagulation

The coagulation phase is a critical part of the body's process to prevent blood loss following injury to blood vessels. It involves chemical reactions that form a clot to seal the injured area. The clotting process begins shortly after injury, within 15-20 seconds for severe damage and 1-2 minutes for minor injuries.
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
Venous Thrombosis IV: Nursing Management01:30

Venous Thrombosis IV: Nursing Management

Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Introduction to Hemostasis01:05

Introduction to Hemostasis

Hemostasis is a complex physiological process that prevents excessive bleeding when a blood vessel is injured. It's crucial for maintaining the integrity of the circulatory system, as it ensures that our blood remains fluid while still within the vascular network and yet clots to prevent blood loss upon vessel injury.
The three phases of hemostasis involve many clotting factors present in plasma and several substances released by platelets and injured tissue cells. It is a fast, localized, and...
Extrinsic and Intrinsic Pathways of Hemostasis01:20

Extrinsic and Intrinsic Pathways of Hemostasis

Blood clotting or coagulation involves extrinsic and intrinsic pathways, which ultimately merge into the common pathway, forming a fibrin clot.
The Extrinsic Pathway
The extrinsic pathway of coagulation is typically initiated by tissue damage that exposes blood to tissue factor (TF), a protein released by the damaged tissue cells outside the blood vessels—this interaction with TF triggers biochemical reactions involving specific clotting factors. The key player here is Factor VII, which forms a...
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...

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Microfluidics in Assessing Platelet Function
06:47

Microfluidics in Assessing Platelet Function

Published on: November 8, 2024

Coagulation management in multiple trauma: a systematic review.

Heiko Lier1, Bernd W Böttiger, Jochen Hinkelbein

  • 1Department of Anaesthesiology and Intensive Care Medicine, University Hospital Cologne, Cologne, Germany. heiko.lier@uk-koeln.de

Intensive Care Medicine
|February 15, 2011
PubMed
Summary
This summary is machine-generated.

Trauma-induced coagulopathy requires immediate diagnosis and treatment. Guidelines recommend early massive transfusion protocols, temperature and acid-base management, and specific ratios of fresh frozen plasma to packed red blood cells for improved survival.

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Area of Science:

  • Emergency Medicine
  • Trauma Surgery
  • Hematology

Background:

  • Trauma-induced coagulopathy significantly impacts patient survival.
  • Improved understanding necessitates updated management strategies.

Purpose of the Study:

  • To provide evidence-based recommendations for coagulation management in trauma patients with active bleeding.
  • To outline strategies for diagnosing and treating coagulopathy in trauma.

Main Methods:

  • Systematic literature search of PubMed (January 2000 - August 2009).
  • Inclusion of 230 relevant articles for review.

Main Results:

  • Coagulopathy of trauma is a distinct condition influencing survival.
  • Immediate diagnosis and therapy are crucial upon emergency department admission.
  • Massive transfusion protocols, temperature, and acid-base balance are key management components.

Conclusions:

  • Maintain body temperature and treat acidaemia promptly.
  • Use fresh frozen plasma (FFP) to packed red blood cells (pRBC) ratio of 1:2-1:1 for massive transfusions.
  • Administer fibrinogen for levels <1.5 g/L; consider permissive hypotension (MAP ~65 mmHg) in actively bleeding patients (contraindicated in CNS injury, coronary heart disease, hypertension).
  • Monitor and treat hypocalcaemia (<0.9 mmol/L).
  • Target haemoglobin <10 g/L and haematocrit at 30% for actively bleeding patients.