Table 2 Currently recommended management for trauma-induced coagulopathy (cited from [24] with modification)

Initial assessment and management

 Extent of traumatic hemorrhage assessed

 Patient in shock with identified source of bleeding treated immediately

 Patient in shock with unidentified source of bleeding sent for further investigation

 Coagulation, hematocrit, serum lactate, base deficit assessed

 Antifibrinolytic therapy (tranexamic acid within 3 h after injury) initiated

 Patient history of anticoagulant therapy assessed

Resuscitation

 Systolic blood pressure of 80–90 mmHg achieved in absence of traumatic brain injury

 Measures to achieve normothermia implemented

 Target hemoglobin level 7–9 g/dl achieved

Surgical intervention

 Damage control surgery performed in hemodynamically unstable patient

Coagulation management

 Massive transfusion protocol with high plasma: red blood cell ratio employed

 Target fibrinogen level 1.5–2 g/l achieved

 Target platelet level achieved

 Prothrombin complex concentrate administered if indicated due to vitamin K antagonist, oral anticoagulant or evidence from viscoelastic monitoring