TRAUMA CARE IN EMERGENCY ENVIRONMENTS: ASSESSING OUTCOMES OF DIFFERENT RESUSCITATION STRATEGIES IN TRAUMATIC HEMORRHAGIC SHOCK

Background: Traumatic hemorrhagic shock is among the most frequent causes of early death following severe trauma. Optimization of resuscitation strategy is crucial to maximizing outcomes. Traditional large-volume crystalloid infusion has been more and more challenged by balanced blood product resuscitation and permissive hypotension methods. Objectives: To compare clinical outcomes of different resuscitation strategies—aggressive crystalloid infusion, balanced blood component therapy, and permissive hypotension—in patients who come with traumatic hemorrhagic shock. Methods: Comparative observational study was conducted in emergency departments of tertiary trauma centers. Patients were divided into three groups according to the resuscitation strategy received. Outcomes like mortality, need for transfusion, development of coagulopathy, and length of stay were compared. Results: Balanced blood component resuscitation had improved survival and fewer complications than crystalloid aggressive resuscitation. Permissive hypotension was useful in selected penetrating trauma but had to be selectively chosen. Conclusion: Early balanced resuscitation practices improve outcomes in traumatic hemorrhagic shock, warranting their adoption into trauma protocols. Future research should further refine patient selection for permissive hypotension to maximize benefits. Keywords: Trauma care; Hemorrhagic shock; Resuscitation techniques; Emergency treatment; Balanced transfusion; Permissive hypotension; Crystalloids; Clinical outcome