The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition, 2023

Front

1 of 3 · Front

📘 GuidelineCh 6 · Emergency, Trauma, Acute Care & Surgical Critical Care

The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition, 2023

In one breath

The sixth European guideline on major bleeding and coagulopathy after trauma: early repeated haemostasis monitoring, tranexamic acid as soon as possible and within 3 hours (1 g over 10 minutes, then 1 g over 8 hours), and rapid haemorrhage control.

EditionSixth Edition, 2023

Issued byMultidisciplinary European Task Force (ESAIC, ESICM, European Shock Society, ESTES, EuSEM and NATA)

Place of issueEurope / International

PublishedCritical Care · 2023;27(1):80

⏳ Pending verification

FACE COLOURS Front — the summary · Back 1 — what it covers + key recommendations · Back 2 — evidence, changes + source

Back 1

2 of 3 · Back 1

Back colours mark the reading sections — the chapter colour is the band and chip.

§1 · What it covers

This guideline covers bleeding trauma patients, including adults requiring damage-control resuscitation and surgery.

Applies to: Bleeding trauma patients, including adults requiring damage-control resuscitation and surgery.

§2 · Key recommendations

Early and repeated hemostasis monitoring using conventional tests and/or point-of-care/viscoelastic methods (Grade 1C).
Give TXA as soon as possible to a bleeding or significantly at-risk trauma patient, preferably en route and within 3 hours: 1 g over 10 minutes followed by 1 g over 8 hours (Grade 1A).
do not await viscoelastic results (Grade 1B).
The full guideline also addresses restricted fluids/permissive hypotension, fibrinogen, platelets, calcium, temperature, and rapid hemorrhage control.

FACE COLOURS Front — the summary · Back 1 — what it covers + key recommendations · Back 2 — evidence, changes + source

Back 2

3 of 3 · Back 2

Back colours mark the reading sections — the chapter colour is the band and chip.

§3 · Evidence & grading

GRADE system; recommendations use strong/weak plus evidence quality (for example 1A, 1B, 1C). The authors used systematic searches, risk-of-bias assessment, and expert consensus.

§4 · What changed in this edition

Not yet established — pending verification.

§5 · Source & working link

Rossaint R, et al. The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition. Crit Care. 2023;27(1):80. doi:10.1186/s13054-023-04327-7 · PMID 36859355.

Publisher — the record's original_url, carried verbatim ↗DOI — 10.1186/s13054-023-04327-7 ↗PubMed — PMID 36859355 ↗

Link check 2026-11-11: the publisher (Springer) URL, DOI and PubMed record (PMID 36859355) all fetched live — title, journal, volume and article number match the record.

Source: Tamer-supplied guideline index, intake 2026-11-10 (record #106, Domain 10) · Card built 2026-11-11 (Wave D) from the record itself; the §5.2 verification pass (UpToDate + Medscape → Perplexity → Tamer decision) has not yet run on this card. ⚑ Conflict flag on the source record — documented cross-society disagreement (intake DOCX Table 2): Trauma resuscitation — European major-bleeding guideline 2023 vs JTS update 2023. The record's notes state the concrete point: the European TXA regimen (1 g + 1 g over 8 hours) differs from the 2023-updated JTS preference for a 2-g bolus; both preserve the time-critical principle. Unresolved — pending the verification pass (UpToDate + Medscape → Perplexity → Tamer decision).

FACE COLOURS Front — the summary · Back 1 — what it covers + key recommendations · Back 2 — evidence, changes + source

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