Latest News

Guide explains nonsurgical management of major hemorrhage


 

FROM THE CANADIAN MEDICAL ASSOCIATION JOURNAL

‘Optimal recommendations’

Commenting on the document, Bourke Tillmann, MD, PhD, trauma team leader at Sunnybrook Health Sciences Centre and the Ross Tilley Burn Center in Toronto, said: “Overall, I think it is a good overview of MHPs as an approach to major hemorrhage.”

The review also is timely, since Ontario released its MHP guidelines in 2021, he added. “I would have liked to see more about the treatment aspects than just an overview of an MHP. But if you are the person overseeing the emergency department or running the blood bank, these protocols are incredibly useful and incredibly important.”

“This report is a nice and thoughtful overview of best practices in many areas, especially trauma, and makes recommendations that are optimal, although they are not necessarily practical in all centers,” Eric L. Legome, MD, professor and chair of emergency medicine at Mount Sinai West and Mount Sinai Morningside, New York, said in an interview.

“If you’re in a small rural hospital with one lab technician, trying to do all of these things, it will not be possible. These are optimal recommendations that people can use to the best of their ability, but they are not standard of care, because some places will not be able to provide this level of care,” he added. “This paper provides practical, reasonable advice that should be looked at as you are trying to implement transfusion policies and processes, with the understanding that it is not necessarily applicable or practical for very small hospitals in very rural centers that might not have access to these types of products and tools, but it’s a reasonable and nicely written paper.”

No outside funding for the guideline was reported. Dr. Callum has received research funding from Canadian Blood Services and Octapharma. She sits on the nominating committee with the Association for the Advancement of Blood & Biotherapies and on the data safety monitoring boards for the Tranexamic Acid for Subdural Hematoma trial and the Fibrinogen Replacement in Trauma trial. Dr. Tillmann and Dr. Legome reported no relevant financial relationships.

A version of this article originally appeared on Medscape.com.

Pages

Recommended Reading

Damar Hamlin’s cardiac arrest: Key lessons
MDedge Emergency Medicine
A patient named ‘Settle’ decides to sue instead
MDedge Emergency Medicine
What is the psychological cost of performing CPR?
MDedge Emergency Medicine
A new (old) drug joins the COVID fray, and guess what? It works
MDedge Emergency Medicine
Three wild technologies about to change health care
MDedge Emergency Medicine
A doctor intervenes in a fiery car crash
MDedge Emergency Medicine
Doc never met patient who died from insect bite, but negligence suit moves forward; more
MDedge Emergency Medicine
A doctor must go to extremes to save a choking victim
MDedge Emergency Medicine
Pulmonary embolism workup needed for any sudden onset of exertional dyspnea
MDedge Emergency Medicine
COVID vs. flu: Which is deadlier?
MDedge Emergency Medicine