Coagulation challenges after severe injury with hemorrhagic shock.

During the past 50 years, there have been huge changes in the approach to coagulopathic bleeding following the treatment of traumatic hemorrhagic shock (HS). Treatment during the 1960s consisted primarily of physiologic saline (balanced electrolyte solution [BES]) and whole blood supported with sodium bicarbonate for acidosis. Subsequent coagulopathy was assumed to be caused by lack of the labile factors (FV and FVIII) which were then replaced by fresh whole blood.

Effects of ethanol ingestion on the severity and outcome of trauma.

Review of 1,198 patients with regard to outcome and the presence or absence of detectable ethanol in the blood as determined in the emergency room demonstrated no difference in the severity of injury in those who had been drinking and those who had not. Mortality was significantly lower in those who had been drinking. There were no other significant differences in the two groups.