Massive blood loss in trauma patients

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An injured and bleeding patient who is pale, confused, hypotensive, and anuric is an obvious candidate for transfusion to counteract hemorrhagic shock. However, not all patients with shock have such classic signs, at least not until hemodynamic compromise becomes severe. The authors summarize the basic principles of patient evaluation and care in emergency situations. They also describe some adverse consequences of massive transfusions and present tips on how to avoid or minimize them.

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Notes on contributors

Gordon R. Phillips

Gordon R. Phillips III, MD: Donald R. Kauder, MD C. William Schwab, MD: Dr Phillips (left) and Dr Kauder (middle) are assistant professors of surgery and Dr Schwab (right) is professor of surgery and chief, division of traumatology and surgical critical care, University of Pennsylvania School of Medicine, Philadelphia. Their research interests include trauma resuscitation, blood use in resuscitation, and treatment of intraoperative coagulopathy.

Donald R. Kauder

Gordon R. Phillips III, MD: Donald R. Kauder, MD C. William Schwab, MD: Dr Phillips (left) and Dr Kauder (middle) are assistant professors of surgery and Dr Schwab (right) is professor of surgery and chief, division of traumatology and surgical critical care, University of Pennsylvania School of Medicine, Philadelphia. Their research interests include trauma resuscitation, blood use in resuscitation, and treatment of intraoperative coagulopathy.

C. William Schwab

Gordon R. Phillips III, MD: Donald R. Kauder, MD C. William Schwab, MD: Dr Phillips (left) and Dr Kauder (middle) are assistant professors of surgery and Dr Schwab (right) is professor of surgery and chief, division of traumatology and surgical critical care, University of Pennsylvania School of Medicine, Philadelphia. Their research interests include trauma resuscitation, blood use in resuscitation, and treatment of intraoperative coagulopathy.