Hidden problems with bleeding in trauma patients

Clearly, the reasons for the blood loss of the patient described herein were multifactorial. In addition to the scalp and perineal lacerations, she had multiple bone fractures. Her hypothermic condition, head injury, and acidotic state were factors that could lead to coagulopathies. Lastly, multiple transfusions may have exacerbated the above problems both by hemodilution and further decreasing core temperature. Caring for patients like this one is a challenge to the trauma team and requires expert knowledge to anticipate, identify, and treat the wide variety of potential complications that can contribute to bleeding.