Trauma resuscitation should focus on early goal-directed therapy with use of viscoelastic hemostatic assays while initially applying a ratio 1:1:1 driven transfusion therapy (with red blood cells, plasma and platelets) in order to sustain normal hemostasis and control further bleeding. Mortality from major trauma continues to be a worldwide problem, and massive hemorrhage remains a major cause in 40% of potentially preventable trauma deaths. Development of trauma-induced coagulopathy challenges 25–35% of the patients further increasing trauma mortality.

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