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Table 4 Treatment pathway checklist

From: The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition

Treatment phase Yes No N/A Reason for variance
Initial assessment and management     
  Extent of traumatic haemorrhage 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 80–90 mmHg achieved in absence of traumatic brain injury ☐ ☐ ☐  
  Measures to achieve normothermia implemented ☐ ☐ ☐  
  Target haemoglobin level 7–9 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 1.5–2 g/l achieved ☐ ☐ ☐  
  Target platelet level achieved ☐ ☐ ☐  
  Prothrombin complex concentrate administered if indicated due to vitamin K antagonist, oral anticoagulant or evidence from viscoelastic monitoring ☐ ☐ ☐  
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Critical Care

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