{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T21:03:13Z","timestamp":1794258193910,"version":"4.9.0"},"reference-count":27,"publisher":"Cambridge University Press (CUP)","issue":"6","license":[{"start":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T00:00:00Z","timestamp":1696204800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Prehosp. Disaster med."],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1049023X23006428_as1\">\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Uncontrolled trauma-related hemorrhage remains the primary preventable cause of death among those with critical injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1049023X23006428_as2\">\n                    <jats:title>Study Objective:<\/jats:title>\n                    <jats:p>The purpose of this investigation was to evaluate the types of trauma associated with critical injury and trauma-related hemorrhage, and to determine the time to definitive care among patients treated at major trauma centers who were predicted to require massive transfusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1049023X23006428_as3\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A secondary analysis was performed of the Pragmatic, Randomized, Optimal Platelet and Plasma Ratios (PROPPR) trial data (N = 680). All patients included were predicted to require massive transfusion and admitted to one of 12 North American trauma centers. Descriptive statistics were used to characterize patients, including demographics, type and mechanism of injury, source of bleeding, and receipt of prehospital interventions. Patient time to definitive care was determined using the time from activation of emergency services to responder arrival on scene, and time from scene departure to emergency department (ED) arrival. Each interval was calculated and then summed for a total time to definitive care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1049023X23006428_as4\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Patients were primarily white (63.8%), male (80.3%), with a median age of 34 (IQR 24-51) years. Roughly one-half of patients experienced blunt (49.0%) versus penetrating (48.2%) injury. The most common types of blunt trauma were motor vehicle injuries (83.5%), followed by falls (9.3%), other (3.6%), assaults (1.8%), and incidents due to machinery (1.8%). The most common types of penetrating injuries were gunshot wounds (72.3%), stabbings (24.1%), other (2.1%), and impalements (1.5%). One-third of patients (34.5%) required some prehospital intervention, including intubation (77.4%), chest or needle decompression (18.8%), tourniquet (18.4%), and cardiopulmonary resuscitation (CPR; 5.6%). Sources of bleeding included the abdomen (44.3%), chest (20.4%), limb\/extremity (18.2%), pelvis (11.4%), and other (5.7%). Patients waited for a median of six (IQR4-10) minutes for emergency responders to arrive at the scene of injury and traveled a median of 27 (IQR 19-42) minutes to an ED. Time to definitive care was a median of 57 (IQR 44-77) minutes, with a range of 12-232 minutes. Twenty-four-hour mortality was 15% (n = 100) with 81 patients dying due to exsanguination or hemorrhage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1049023X23006428_as5\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Patients who experience critical injury may experience lengthy times to receipt of definitive care and may benefit from bystander action for hemorrhage control to improve patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1049023x23006428","type":"journal-article","created":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T06:06:23Z","timestamp":1696226783000},"page":"780-783","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":47,"title":["Epidemiology of Trauma-Related Hemorrhage and Time to Definitive Care Across North America: Making the Case for Bleeding Control Education"],"prefix":"10.1017","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8710-1944","authenticated-orcid":false,"given":"Allison R.","family":"Jones","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Miller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2023,10,2]]},"reference":[{"key":"S1049023X23006428_ref9","unstructured":"9. American Heart Association. CPR Facts & Stats 2018. https:\/\/cpr.heart.org\/en\/resources\/cpr-facts-and-stats. Accessed April 12, 2023."},{"key":"S1049023X23006428_ref12","doi-asserted-by":"publisher","DOI":"10.17226\/23511"},{"key":"S1049023X23006428_ref25","doi-asserted-by":"publisher","DOI":"10.1111\/phn.12638"},{"key":"S1049023X23006428_ref10","unstructured":"10. Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) Trial. National Heart, Lung, and Blood Institute Web site. https:\/\/biolincc.nhlbi.nih.gov\/studies\/proppr\/. Accessed May 10, 2023."},{"key":"S1049023X23006428_ref1","unstructured":"1. World Health Organization. Injuries and Violence 2021. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/injuries-and-violence. Accessed November 18, 2021."},{"key":"S1049023X23006428_ref14","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002999"},{"key":"S1049023X23006428_ref19","volume-title":"Stop the Bleed: 2018 Progress Report","year":"2018"},{"key":"S1049023X23006428_ref5","first-page":"32","article-title":"Improving survival from active shooter events: The Hartford Consensus","volume":"100","author":"Jacobs","year":"2015","journal-title":"Bull Am Coll Surg."},{"key":"S1049023X23006428_ref22","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2018.1099"},{"key":"S1049023X23006428_ref11","unstructured":"11. StataCorp. Stata Statistical Software: Release 17. 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Accessed January 25, 2023."},{"key":"S1049023X23006428_ref13","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002833"},{"key":"S1049023X23006428_ref17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2200798"},{"key":"S1049023X23006428_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jen.2019.10.020"},{"key":"S1049023X23006428_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2020.02.036"},{"key":"S1049023X23006428_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(20)30140-7"},{"key":"S1049023X23006428_ref2","doi-asserted-by":"publisher","DOI":"10.1111\/trf.15161"},{"key":"S1049023X23006428_ref6","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16162870"},{"key":"S1049023X23006428_ref3","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7014e1"},{"key":"S1049023X23006428_ref15","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usx016"},{"key":"S1049023X23006428_ref20","unstructured":"20. American Heart Association. Basic Life Support (BLS) 2023. https:\/\/cpr.heart.org\/en\/cpr-courses-and-kits\/healthcare-professional\/basic-life-support-bls-training. Accessed April 12, 2023."},{"key":"S1049023X23006428_ref23","doi-asserted-by":"publisher","DOI":"10.1177\/2165079920930730"},{"key":"S1049023X23006428_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2018.09.025"},{"key":"S1049023X23006428_ref26","doi-asserted-by":"publisher","DOI":"10.1097\/JTN.0000000000000651"}],"container-title":["Prehospital and Disaster Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1049023X23006428","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T08:45:42Z","timestamp":1701333942000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1049023X23006428\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,2]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["S1049023X23006428"],"URL":"https:\/\/doi.org\/10.1017\/s1049023x23006428","relation":{},"ISSN":["1049-023X","1945-1938"],"issn-type":[{"value":"1049-023X","type":"print"},{"value":"1945-1938","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,2]]},"assertion":[{"value":"\u00a9 The Author(s), 2023. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}