OBJECTIVES To characterize contemporary use of tranexamic acid (TXA) in combat injury and to assess the effect of its administration on total blood product use, thromboembolic complications, and mortality. DESIGN Retrospective observational study comparing TXA administration with no TXA in patients receiving at least 1 unit of packed red blood cells. A subgroup of patients receiving massive t...

INTRODUCTION An assessment of practices and available medical devices during the treatment of a massive haemorrhage has been realised in the shock unit of our hospital. MATERIAL AND METHODS Parameters influencing transfusion flow rate have been identified. Medical devices and equipment to accelerate the flow rate were analyzed on the basis of manufacturers' data and users opinion in relation ...

BACKGROUND This retrospective, single centre study was conducted to investigate the efficacy of fibrinogen concentrate (FBNc) in decreasing blood requirements and reaching optimal fibrinogen level, in non-trauma, massively transfused, bleeding patients with coagulopathy. METHODS Over a 3-years period, all patients for whom a massive transfusion protocol was activated and had received ≥ 4 unit...

BACKGROUND The Joint Theater Trauma Registry database, begun early in Operation Iraqi Freedom and Operation Enduring Freedom, created a comprehensive repository of information that facilitated research efforts and produced rapid changes in clinical care. New clinical practice guidelines were adopted throughout the last decade. The damage-control resuscitation clinical practice guideline sought ...

BACKGROUND Prediction of blood transfusion needs and mortality for trauma patients in near real time is an unrealized goal. We hypothesized that analysis of pulse oximeter signals could predict blood transfusion and mortality as accurately as conventional vital signs (VSs). METHODS Continuous VS data were recorded for direct admission trauma patients with abnormal prehospital shock index (SI ...

BACKGROUND The purpose of this study was to review incidence, indications, complications, and the anesthetic management of emergency obstetric hysterectomies. METHODS This was a retrospective study of the cases of emergency obstetric hysterectomies performed at the Woman's Hospital over a 3 year period between January 2008 and December 2010. The indication for surgery, anesthetic management, ...

Introduction: Trauma-induced coagulopathy (TIC) is a form of unique to trauma patients and associated with increased mortality. The complexity incomplete understanding TIC have resulted in controversies regarding optimum management. This review aims summarise the pathophysiology appraise established emerging advances management TIC. Methods: narrative based on literature search (MEDLINE databas...

INTRODUCTION The recognition and management of hypovolemic shock still remain an important task during initial trauma assessment. Recently, we have questioned the validity of the Advanced Trauma Life Support (ATLS) classification of hypovolemic shock by demonstrating that the suggested combination of heart rate, systolic blood pressure and Glasgow Coma Scale displays substantial deficits in ref...

BACKGROUND United States Army Forward Surgical Teams (FSTs) consist of twenty personnel and are the Army's smallest surgical units. Currently, they provide the majority of resuscitative surgical care for combat casualties in Afghanistan where the mission of the FST has been further extended to include "split-based operations." The effectiveness of these 10-person teams is unknown and outcome da...

  Background: Reservation of blood leads to blood wastage if the blood is not transfused. Therefore, in some centers only blood type and screen are evaluated. In this study, the efficacy of a blood crossmatch-to-transfusion ratio was measured and then compared with the standard levels. Methods: This prospective study was conducted during one year in a university hospital. During this period, 39...