Review Of Trauma Care In The Prehospital Setting: Hemorrhage Control And Assessment Tools

Abstract

Trauma remains a significant global health challenge, with uncontrolled hemorrhage being a leading cause of preventable death. Paramedics play a pivotal role in the prehospital management of traumatic hemorrhage, and their ability to rapidly assess, control bleeding, and initiate evidence-based interventions directly influences patient outcomes. This review examines the epidemiology of trauma, the pathophysiology of hemorrhage, and the critical importance of paramedic-delivered hemorrhage control and assessment in the prehospital setting. Key interventions, including direct pressure, tourniquets, hemostatic agents, and pelvic binders, are discussed, along with their indications, effectiveness, and potential complications. The review also explores the use of trauma scoring systems and emerging technologies for hemorrhage severity assessment, highlighting the role of paramedics in triage and early identification of patients at risk for shock. The impact of prehospital hemorrhage control on patient-level outcomes, such as survival rates and disability reduction, as well as system-level outcomes, including cost-effectiveness and regional trauma system performance, is examined. Challenges and barriers to effective hemorrhage control in different settings are identified, emphasizing the need for ongoing training, interprofessional collaboration, and resource allocation. The review underscores the importance of comprehensive, simulation-based education for paramedics in hemorrhage control techniques and trauma assessment, as well as the role of continuing education and recertification in maintaining skills proficiency. By improving paramedic-delivered prehospital hemorrhage control and assessment, healthcare systems can reduce preventable trauma deaths, optimize patient outcomes, and strengthen the overall trauma care continuum.