Bleeding control: Evolution in trauma care continues

Making sure each step is performed well will ensure the best outcome for your patient

It's perhaps too early to tell, but certainly this technology is part of an evolution in hemostasis.

With the advent of clot-promoting agents, the ability to control massive bleeding is going through a transformation. We have already seen recent advances in the re-introduction of tourniquets, abandoning older techniques of elevation and pressure points, and the increasing use of the aforementioned clotting agents.

Other changes on the horizon include oxygen use and active cooling measures.

What I really want to see is what we could provide after bleeding stops. In study after study, blood substitutes have shown miserable results — no changes in all cases, and actual harm in many. While the patient may survive the initial insult of rapid volume loss, having the cells remain in shock is not good for long term outcome. 

In the meantime, continue to optimize your trauma care. Preserve ventilation and perfusion. Choreograph your team so scene time is minimized.

Choose the safest, most effective transport mode. Early trauma center notification preps the next link in the trauma care continuum. Making sure each step is performed well will ensure the best outcome for your patient.

About the author

Art Hsieh, MA, NRP teaches in Northern California at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. An EMS provider since 1982, Art has served as a line medic, supervisor and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook writer, author of "EMT Exam for Dummies," has presented at conferences nationwide and continues to provide direct patient care regularly. Art is a member of the EMS1 Editorial Advisory Board. Contact Art at and connect with him on Facebook or Twitter.

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