Bleeding and coagulation in Trauma with Ross Davenport

In this conversation we will examine the principles of coagulopathy and novel approaches to coagulopathy within pre-hospital care. We will examine the utility of fibrinogen concentrate, the distinct features of fibrinogen concentrate with cryoprecipitate, its longevity of use compared to other blood products, how you constitute fibrinogen concentrate for use in the pre-hospital environment amongst other topics. 

 

To do this I have Ross Davenport with me, Ross is a Consultant Trauma & Vascular Surgeon at the Royal London hospital in the UK. He is also a Senior Lecturer in Trauma Sciences and has previously worked in prehospital care for both London and Essex & Herts Air Ambulance. His research has focused on trauma-induced coagulopathy, acute response to injury and the treatment of major trauma haemorrhage. His work in traumatic coagulopathy and massive transfusion, inflammation and organ dysfunction has had international renown. In the episode we examine:

·      Coagulation and the pre-hospital evidence 

·      Are we getting a handle on hypothermic induced coagulopathy 

·      What is fibrinogen concentrate and its mechanism of action?

·      How it differs from cryoprecipitate and whether we still need cryoprecipitate.

·      What the initial empirical research shows from CRYOSTAT 2 research.

·      It’s robustness within pre-hospital environments and how you reconstitute it for pre-hospital use. 

·      Current trials with Fibrinogen concentrate and early indications of effectiveness. 

·      ROTEM/thromboelastometry markers of effectiveness 

·      When to give it in the patient journey? 

Please enjoy this episode.