HEMORRHAGE CONTROL
DESIGNATION OF CONDITION
Any wound that creates circulatory shock due to blood loss may need application of tourniquet. Symptoms include pallor, AMS, hypotension, weak pulses, cool clammy skin or physical signs of severe uncontrollable hemorrhage, amputation or near amputation.
ALL PROVIDERS
1. Apply direct pressure to the injury
a. If this is effective dress the wound and elevate extremity
b. If this is ineffective proceed with protocol
2. If wound is amenable to tourniquet placement:
a. Apply tourniquet above the wound. Avoid joints.
b. If first tourniquet does not control hemorrhage apply second tourniquet above first
c. Do not release tourniquet until definitive care is at bedside
3. If wound is not amenable to tourniquet placement
a. Apply hemostatic dressing into wound and apply direct pressure directly to bleeding source
4. Hemodialysis access sites may result in life threatening hemorrhage. Direct digital pressure with hemostatic dressing should be used first followed by tourniquet in the setting of life-threatening hemorrhage when other means of hemorrhage control have been unsuccessful
5. Treat pain according to pain protocol. Tourniquets are rapidly very painful.
6. If significant non-compressible hemorrhage continues consider TXA administration within three hours of start of hemorrhage)
Adult Initial Bolus (16 years and older).
Mix 2 grams vial in 250 ml. of fluid.
Administer 2 grams (250 ml.) IV/IO over 10 minutes.
Note: TXA is indicated in postpartum patients with clinically significant non-compressible
postpartum hemorrhage. In postpartum hemorrhage the dose is 1 gram in 250 ml. given over 10 minutes. If bleeding continues at 15 minutes repeat the 1 gram dose over 10 minutes.
6. OXYTOCIN should be given in postpartum hemorrhage. All field delivery patients should receive 10 U IM after delivery regardless of if the placenta has delivered. If hemorrhage occurs mix 20 U in a one-liter bag and administer wide open with a large drip.
DESIGNATION OF CONDITION
Any wound that creates circulatory shock due to blood loss may need application of tourniquet. Symptoms include pallor, AMS, hypotension, weak pulses, cool clammy skin or physical signs of severe uncontrollable hemorrhage, amputation or near amputation.
ALL PROVIDERS
1. Apply direct pressure to the injury
a. If this is effective dress the wound and elevate extremity
b. If this is ineffective proceed with protocol
2. If wound is amenable to tourniquet placement:
a. Apply tourniquet above the wound. Avoid joints.
b. If first tourniquet does not control hemorrhage apply second tourniquet above first
c. Do not release tourniquet until definitive care is at bedside
3. If wound is not amenable to tourniquet placement
a. Apply hemostatic dressing into wound and apply direct pressure directly to bleeding source
4. Hemodialysis access sites may result in life threatening hemorrhage. Direct digital pressure with hemostatic dressing should be used first followed by tourniquet in the setting of life-threatening hemorrhage when other means of hemorrhage control have been unsuccessful
5. Treat pain according to pain protocol. Tourniquets are rapidly very painful.
6. If significant non-compressible hemorrhage continues consider TXA administration within three hours of start of hemorrhage)
Adult Initial Bolus (16 years and older).
Mix 2 grams vial in 250 ml. of fluid.
Administer 2 grams (250 ml.) IV/IO over 10 minutes.
Note: TXA is indicated in postpartum patients with clinically significant non-compressible
postpartum hemorrhage. In postpartum hemorrhage the dose is 1 gram in 250 ml. given over 10 minutes. If bleeding continues at 15 minutes repeat the 1 gram dose over 10 minutes.
6. OXYTOCIN should be given in postpartum hemorrhage. All field delivery patients should receive 10 U IM after delivery regardless of if the placenta has delivered. If hemorrhage occurs mix 20 U in a one-liter bag and administer wide open with a large drip.