A rare cause of negative explora tory laparotomy in severe blunt trauma

peer reviewedWe report the case of a young man involved in a high velocity road traffic accident. He presented with multiple injuries and a shock. This shock was suspected to be caused by an intra-abdominal bleeding and an exploratory laparotomy was performed. The procedure did not identify any intra-abdominal bleeding and the source of bleeding was found lately: an intramuscular active bleeding in the dorsal and lumbar muscular compartments. This case was discussed in our local mortality and morbidity meeting

A rare cause of negative exploratory laparotomy in severe blunt trauma

peer reviewedWe report the case of a young man involved in a high velocity road traffic accident. He presented with multiple injuries and a shock. This shock was suspected to be caused by an intra-abdominal bleeding and an exploratory laparotomy was performed. The procedure did not identify any intra-abdominal bleeding and the source of bleeding was found lately: an intramuscular active bleeding in the dorsal and lumbar muscular compartments. This case was discussed in our local mortality and morbidity meetin

Pre-hospital transfusion of red blood cells in civilian trauma patients: what's next?

[No abstract available

Early identification of trauma patients in need for emergent transfusion: results of a single-center retrospective study evaluating three scoring systems.

BACKGROUND: The Trauma-Induced Coagulopathy Clinical Score (TICCS) was developed to be calculable on the site of injury to discriminate between trauma patients with or without the need for damage control resuscitation and thus transfusion. This early alert could then be translated to in-hospital parameters at patient arrival. Base excess (BE) and ultrasound (FAST) are known to be predictive parameters for emergent transfusion. We emphasize that adding these two parameters to the TICCS could improve the scoring system predictability. METHODS: A retrospective study was conducted in the University Hospital of Liege. TICCS was calculated for every patient. BE and FAST results were recorded and points were added to the TICCS according to the TICCS.BE definition (+ 3 points if BE /= 10 and 81.5% with a TICCS.BE >/= 14 required emergent transfusion. CONCLUSION: Adding BE and FAST to the original TICCS does not significantly improve the scoring system predictability. A prehospital TICCS > 10 could be used as a trigger for emergent transfusion activation. TASH could then be used at hospital arrival. Prehospital TASH calculation may be possible but should be further investigated. LEVEL OF EVIDENCE: Diagnostic test, level III