Predicting the Need to Pack Early for Severe Intra-abdominal Hemorrhage

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Abstract
To determine if the decision to pack for hemorrhage could be refined. Seventy consecutive trauma patients for whom packing was used to control hemorrhage were studied. The patients had liver injuries, abdominal vascular injuries, and bleeding retroperitoneal hematomas. Preoperative variables were analyzed and survivors compared with nonsurvivors. Packing controlled hemorrhage in 37 (53%) patients. Significant differences (p Conclusion Patients who suffer severe injury, hypothermia, refractory hypotension, coagulopathy, and acidosis need early packing if they are to survive. Failure to control hemorrhage is related to severity of injury and delay in the use of pack tamponade. A specific protocol that mandates packing when parameters reach a critical limit should be considered.

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