Citation

Lier H, Bernhard M, Knapp J, Buschmann C, Bretschneider I, Hossfeld B. Anaesthesist 2017; 66(11): 867-878.

Vernacular Title

Ansätze zur prähospitalen Gerinnungstherapie : Aktuelle Übersicht für die zivile Notfallmedizin.

Affiliation

Arbeitsgruppe "Taktische Medizin" des Arbeitskreises Notfallmedizin, Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin, Nürnberg, Deutschland.

Copyright

(Copyright © 2017, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00101-017-0350-0

PMID

28785773

Abstract

Severe bleeding is a typical result of traumatic injuries. Hemorrhage is responsible for almost 50% of deaths within the first 6 h after trauma. Appropriate bleeding control and coagulation therapy depends on an integrated concept of local hemostasis by primary pressure with the hands, compression, and tourniquets accompanied by prevention of hypothermia, acidosis and hypocalcemia. Additionally, permissive hypotension is accepted for suitable patients and tranexamic acid should be administered early. Multiple publications prove that prehospital transfusion of blood products (e. g. red blood cells and plasma) and coagulation factors (e. g. fibrinogen) is feasible and safe, but only required for <5% of polytrauma patients in the civilian setting.

Language: de

Keywords

Bleeding; Bleeding management; Out-of-hospital therapy; Tranexamic acid; Trauma