Major traumatic hemorrhage is potentially preventable with rapid hemorrhage control and improved resuscitation techniques.

The time from injury to hospital, resuscitation, diagnosis, and definitive bleeding control should be as expeditiously as possible.

Adult trauma patient with major bleeding requiring early blood transfusion, ≥ 4 units of any blood components within two hours from injury, constituted only of 2.1% of the trauma population admitted to hospital in this study.

The use of a transfusion-based definition of major bleeding within a short time frame from injury is in line with recent studies showing a median time to hemorrhagic death less than three hours.

The major bleeding definition from this Delphi process by Wong et al. also included all types of blood components to reflect a balanced approach to resuscitation.

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