Management of traumatic haemorrhage – the US perspective

Summary As compared with European practice, the American approach to resuscitation from traumatic haemorrhage de‐emphasises pre‐hospital interventions in favour of rapid transport to definitive care; limits initial surgical interventions under the damage control model; uses crystalloid as the initial fluid of choice; and follows an empiric 1:1:1 approach to transfusion with red cells, plasma and platelets in hemodynamically unstable and actively bleeding patients. The use of bedside visco‐elastic testing to guide coagulation support is not as widespread as in Europe, while the early administration of tranexamic acid is more selective.