Hypovolaemia from uncontrolled bleeding

Question 1

treatment

Answer 1

• Compress external bleeding.
• Apply a tourniquet if there is severe bleeding from a limb that is not controlled by direct pressure.
• Do not remove penetrating objects from the head or truncal area.
• Cover sucking chest wounds with a dressing.
• Begin transport without delay, providing most treatments en route.
• Keep the patient warm.
• Gain IV access.
• Administer tranexamic acid IV provided the patient cannot be enrolled in the PATCH study:
  a) 1 g of tranexamic acid IV for an adult.
  b) See the paediatric drug dose tables for a child.
• Administer IV fluid if the patient has severe shock:
  a) Arrange for blood to be administered if there is an established protocol for this in the area, or
  b) Administer 500 ml of 0.9% sodium chloride for an adult or 10 ml/kg of 0.9% sodium chloride for a child.
  c) Administer further fluid if the patient remains severely shocked.
• Re-evaluate the need for a tourniquet after bleeding is controlled. Consider releasing the tourniquet if there is a focal bleeding point that can be controlled with direct pressure and transport time to hospital is over 30 minutes.