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  • Print publication year: 2019
  • Online publication date: August 2019

Chapter 3 - Transfusion in Trauma


Hemorrhage is a leading cause of death in trauma, following head injury. Shock is defined by inadequate tissue perfusion with hemodynamic instability and organ dysfunction.110 In trauma, the most common cause of shock is due to acute hemorrhage. Advanced Trauma Life Support (ATLS) describes four classes of hemorrhage,1 but these are not relevant to real world practice, due to different injury types (blunt vs. penetrating), age (due to blunted physiologic responses in the elderly), comorbidities, and medication use (beta blockade reduces the chance of tachycardia in response to decreased blood pressure).614 Bradycardia may also be seen in hemorrhage, due to several causes including vagal stimulation and failure to mount a tachycardic response.13,14