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How Do You Manage Excessive Bleeding in the OR?

You know the importance of preoperatively assessing risk for bleeding in your patients. However, what do you do when such bleeding occurs, despite measures to prevent it?

Good physiology and good surgery go a long way toward achieving hemostatic stability in patients. Well-resuscitated patients with a low risk for bleeding and good anesthesia support are factors in determining whether bleeding will occur. Sometimes, however, there is no predicting when such events will arise. If bleeding or clotting complications should arise, what are some of the measures you have at your disposal?

  1. Use tamponade for acute bleeding
  2. Consider application of topical hemostatic agents
  3. Employ systemic therapies, including fresh frozen plasma, cryoprecipitate, or platelets
  4. Consider new therapies, such as antifibrinolytics or recombinant factor VIIa
With an arsenal of agents to choose from, you and your OR team can strive for hemostatic stability in your patients.


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