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Integrated Compensatory Responses in a Human Model of Hemorrhage
Published on: November 20, 2016
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Torso hemorrhage: noncompressible? never say never
Lian-Yang Zhang1, Hua-Yu Zhang2
1Department of Trauma Surgery, War Trauma Medical Center, State Key Laboratory of Trauma, Burn and Combined Injury, Daping Hospital, Army Medical University, Chongqing, 400042, China.
European Journal of Medical Research
|March 6, 2024
Summary
Exsanguinating torso hemorrhage (TH) management is challenging. This review proposes subdividing noncompressible torso hemorrhage (NCTH) and emphasizes improving prehospital external bleeding control through education and device redesign.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Hemorrhage Control
Background:
- Exsanguinating torso hemorrhage (TH) poses significant challenges in military and civilian medicine.
- Conventional hemostatic techniques are inadequate for internal torso bleeding due to anatomical complexities.
- The concept of noncompressible torso hemorrhage (NCTH) has spurred development of new control methods.
Purpose of the Study:
- To review the evolution of external techniques for controlling NCTH.
- To address deficiencies in medical staff understanding of NCTH concepts and treatment.
- To propose a refined classification of torso hemorrhage and strategies for improved prehospital care.
Main Methods:
- Review of existing literature on torso hemorrhage and control techniques.
- Analysis of FDA-approved and investigational NCTH devices (e.g., junctional tourniquets, REBOA).
- Discussion of cognitive surveys on medical staff understanding of NCTH.
Main Results:
- Specialized tourniquets and REBOA offer solutions for NCTH.
- Medical personnel exhibit knowledge gaps regarding NCTH, partly due to terminology.
- Current NCTH classification may be overly simplistic.
Conclusions:
- A proposed subdivision of NCTH into 'compressible' and 'REBOA-controllable' categories is suggested.
- External NCTH control requires a comprehensive program including device improvement, education, and complication management.
- Specialized tourniquets remain crucial for prehospital TH management.
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