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SEVERE HEMORRHAGE

Practice Points

Severity Assessment:
1. Injury mechanism
2. Base deficit
3. Blood lactate
4. Arterial oxygen
5. Central venous oxygen saturation ?

Look for documented and realistic estimates of blood loss, external and internal

Assessment of internal bleeding:
1. chest - radiographs
2. stomach - nasogastric tube
3. bowel - bloody stool
4. pelvis - fracture
5. abdomen - imaging or DPL

Transfusion without timely surgery may worsen the outcome