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© 2014 by John Wiley & Sons, Ltd. All rights reserved. Massive haemorrhage is a life-threatening emergency affecting many patient groups. 5-30% of critically ill patients with major blood loss have an accompanying coagulopathy, and this confers a poor prognosis. Successful treatment of severe bleeding is dependent upon many factors, including early identification of any at-risk patient, recognition and treatment of any accompanying coagulopathy, and the proactive delivery of red blood cells (RBC), to maintain tissue oxygenation, and blood components (FFP, platelets), to target the coagulopathy. This chapter will summarize the general haemostatic changes that occur during major blood loss and detail how this information has helped to drive recent changes to transfusion practices. It will focus on the general management of major blood loss and discuss how this may vary according to the different clinical settings.

Original publication





Book title

Haematology in Critical Care: A Practical Handbook

Publication Date



93 - 99