Management of haemorrhage in major trauma

Major trauma is a significant cause of death worldwide, leading to 5 million deaths annually. A large proportion of deaths are due to bleeding, with haemorrhage accounting for 80% of deaths in the operating theatre and 40% of all deaths from trauma within the UK. Treatment approaches to the management of major haemorrhage have transformed during recent decades, based mainly on retrospective evidence. Contemporary approaches emphasize rapid control of bleeding, early management of coagulopathy, maintenance of adequate perfusion, and minimizing the inflammatory response. Developments in the early resuscitation phase and prevention or early management of coagulopathy combined with better understanding of point-of-care diagnostic tests are leading to more targeted interventions for haemorrhage control resulting in improved patient outcomes and less demand for blood products.