Monitoring of hemostasis in emergency medicine

Abstract

Exsanguination is still a major cause of death in severely injured patients [1]. Trauma-associated bleeding diathesis, overt at admission to the trauma unit, correlates with the severity of trauma and mortality [2, 3]. Sufficient hemostatic management is critical to the successful resuscitation of the severely injured patient, second in importance only to adequate ventilation. Despite intense efforts to elucidate the pathomechanism and control the process, trauma-associated coagulopathy remains a challenge in the treatment of trauma patients. In this light, monitoring of hemostasis should confirm and specify the clinical diagnosis of bleeding diathesis, guide goal-directed therapy, and possibly predict consecutive transfusion requirements at admission. The present chapter reviews routine laboratory tests and viscoelastic point-of-care hemostasis monitoring as a means of hemostasis monitoring in the emergency setting, as well as relevant pathomechanisms, and therapeutic approaches. © 2007 Springer Science + Business Media Inc.