• V Albrecht, E Stürmer, A Driessen, M Schenk, L Betsche, and M Maegele.
• 1Institute for Research in Operative Medicine, Faculty of Health; Witten/Herdecke University, Germany 2Department of Traumatology, Orthopaedic Surgery and Sports Traumatology, Cologne-Merheim Medical Center (CMMC), Cologne, Germany.
• Shock. 2015 Oct 1;44 Suppl 2:6-7.

IntroductionEarly detection of trauma haemorrhage and coagulopathy has been associated with improved outcomes. We assessed infrastructure, logistics and management of trauma haemorrhage and coagulopathy across German trauma centres.MethodsAn online-survey (20 questions) was developed and analysed using the open source survey application LimeSurvey®. It was disseminated among surgeons and anaesthetists in Germany. Hospitals of all levels were addressed.Results106 questionnaires were completed and analysed. Two thirds declared they worked in level I trauma centres. 61.3% of the respondents followed a treatment-algorithm. Over 90% used standard laboratory and coagulation tests for decision-making. 56.6% of the respondents declared they additionally used extended coagulation assays (TEG/ROTEM). PRBCs, FFP, platelet concentrates, prothrombin complex concentrates, TXA, calcium, fibrinogen and vitamin K were used by more than 85% of the respondents for the initial treatment of bleeding trauma patients. In all hospitals irrespective of care level the time between patient arrival and administration of the first blood product was less than 30 minutes. Anticoagulants (including NOACs) were identified as an increasing problem in the trauma population (>95%). 65% of the respondents necessitated reliable testing assays for risk stratification. 57.6% required interdisciplinary training programs to improve clinical skills.ConclusionThere is variation in the management of haemorrhage/ coagulopathy across German trauma centres. Though bleeding patients depend on structured procedures, more than a third of the respondents declare they do not follow a treatment algorithm. NOACs are considered as an increasing problem in trauma care.

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