Infrastructure and clinical practice for the detection and management of trauma-associated haemorrhage and coagulopathy.
Purpose: Early detection and management of post-traumatic haemorrhage and coagulopathy have been associated with improved outcomes, but local infrastructures, logistics and clinical strategies may differ. Methods: To assess local differences in infrastructure, logistics and clinical management of tr...
| Published in: | European Journal of Trauma & Emergency Surgery Vol. 41; no. 4; pp. 413 - 421 |
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| Main Authors: | , , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Springer Nature
Aug2015
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109822897&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 109822897 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: Aug2015 vid: 41 iid: 4 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 109822897 108696690 10.1007/s00068-014-0455-y 109822897 ppf: 413 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Infrastructure and clinical practice for the detection and management of trauma-associated haemorrhage and coagulopathy. aug: au: Driessen, A. Schäfer, N. Albrecht, V. Schenk, M. Fröhlich, M. Stürmer, E. Maegele, M. affil: Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University (Campus Cologne-Merheim), Ostmerheimerstr. 200 51109 Cologne Germany sug: subj: Hemorrhage Diagnosis Blood Coagulation Disorders Diagnosis Emergency Care Methods Practice Patterns Human Funding Source Early Intervention Questionnaires Germany ab: Purpose: Early detection and management of post-traumatic haemorrhage and coagulopathy have been associated with improved outcomes, but local infrastructures, logistics and clinical strategies may differ. Methods: To assess local differences in infrastructure, logistics and clinical management of trauma-associated haemorrhage and coagulopathy, we have conducted a web-based survey amongst the delegates to the 15th European Congress of Trauma and Emergency Surgery (ECTES) and the 2nd World Trauma (WT) Congress held in Frankfurt, Germany, 25-27 May 2014. Results: 446/1,540 delegates completed the questionnaire yielding a response rate of 29 %. The majority specified to work as consultants/senior physicians (47.3 %) in general (36.1 %) or trauma/orthopaedic surgery (44.5 %) of level I (70 %) or level II (19 %) trauma centres. Clinical assessment (>80 %) and standard coagulation assays (74.6 %) are the most frequently used strategies for early detection and monitoring of bleeding trauma patients with coagulopathy. Only 30 % of the respondents declared to use extended coagulation assays to better characterise the bleeding and coagulopathy prompted by more individualised treatment concepts. Most trauma centres (69 %) have implemented local protocols based on international and national guidelines using conventional blood products, e.g. packed red blood cell concentrates (93.3 %), fresh frozen plasma concentrates (93.3 %) and platelet concentrates (83 %), and antifibrinolytics (100 %). 89 % considered the continuous intake of anticoagulants including 'new oral anticoagulants' and platelet inhibitors as an increasing threat to bleeding trauma patients. Conclusions: This study confirms differences in infrastructure, logistics and clinical practice for the detection and management of trauma-haemorrhage and trauma-associated coagulopathy amongst international centres. Ongoing work will focus on geographical differences. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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