Table 4 Treatment pathway checklist
From: Management of bleeding and coagulopathy following major trauma: an updated European guideline
| Treatment phase | Yes | No | N/A | Reason for variance | |
|---|---|---|---|---|---|
| Initial assessment and management | |||||
| Extent of traumatic hemorrhage assessed | □ | □ | □ | ||
| Patient in shock with identified source of bleeding treated immediately | □ | □ | □ | ||
| Patient in shock with unidentified source of bleeding sent for further investigation | □ | □ | □ | ||
| Coagulation, haematocrit, serum lactate, base deficit assessed | □ | □ | □ | ||
| Antifibrinolytic therapy initiated | □ | □ | □ | ||
| Patient history of anticoagulant therapy assessed (vitamin K antagonists, antiplatelet agents, oral anticoagulants) | □ | □ | □ | ||
| Resuscitation | |||||
| Systolic blood pressure of 80 to 100 mmHg achieved in absence of TBI | □ | □ | □ | ||
| Measures to achieve normothermia implemented | □ | □ | □ | ||
| Target Hb level 7 to 9 g/dL achieved | □ | □ | □ | ||
| Surgical intervention | |||||
| Abdominal bleeding control achieved | □ | □ | □ | ||
| Pelvic ring closed and stabilised | □ | □ | □ | ||
| Peritoneal packing, angiographic embolisation or surgical bleeding control completed in haemodynamically unstable patient | □ | □ | □ | ||
| Damage control surgery performed in haemodynamically unstable patient | □ | □ | □ | ||
| Local haemostatic measures applied | □ | □ | □ | ||
| Thromboprophylactic therapy recommended | □ | □ | □ | ||
| Coagulation management | |||||
| Coagulation, haematocrit, serum lactate, base deficit, calcium reassessed | □ | □ | □ | ||
| Target fibrinogen level 1.5 to 2 g/L achieved | □ | □ | □ | ||
| Target platelet level achieved | □ | □ | □ | ||
| Prothrombin complex concentrate administered if indicated due to vitamin-K antagonist or viscoelastic monitoring | □ | □ | □ | ||