An updated guideline on the management of significant bleeding and coagulopathy following major trauma has been released by the pan-European, multidisciplinary Task Force for Advanced Bleeding Care in Trauma. The document, published in the journal Critical Care, includes recommendations intended to guide the management of patients during the early phase of hospital care following traumatic injury. It should be noted, however, that some of the recommendations and principles discussed in the document may also apply to the pre-hospital setting. Specific examples include the use of tourniquets and the first administration of tranexamic acid (TXA) at the site of injury. While these recommendations provide guidance for the diagnosis and treatment of major bleeding and coagulopathy, emerging evidence supports the author group’s belief that the greatest outcome improvement can be achieved through education and the establishment of and adherence to local clinical management algorithms.

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