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Hemostasis or haemostasis is a process which causes bleeding to stop, meaning to keep blood within a damaged blood vessel. It is the first stage of wound healing. This involves blood changing from a liquid to a gel. Intact blood vessels are central to moderating blood's tendency to clot. The endothelial cells of intact vessels prevent blood clotting with a heparin-like molecule and thrombomodulin and prevent platelet aggregation with nitric oxide and prostacyclin. When endothelial injury occurs, the endothelial cells stop secretion of coagulation and aggregation inhibitors and instead secrete von Willebrand factor which initiate the maintenance of hemostasis after injury. Hemostasis has three major steps: 1) vasoconstriction, 2) temporary blockage of a break by a platelet plug, and 3) blood coagulation, or formation of a fibrin clot. These processes seal the hole until tissues are repaired.
Types of Hemostasis:
Hemostasis can be achieved in various other ways if the body cannot do it naturally (or needs help) during surgery or medical treatment. When the body is under shock and stress, hemostasis is harder to achieve. Though natural hemostasis is most desired, having other means of achieving this is vital for survival in many emergency settings. Without the ability to stimulate hemostasis the risk of hemorrhaging is great. During surgical procedures the types of hemostasis listed below can be used to control bleeding while avoiding and reducing the risk of tissue destruction. Hemostasis can be achieved by chemical agent as well as mechanical or physical agents. Which hemostasis type used is determined based on the situation.
Hemostasis in emergency medicine:
Debates still continue to rise on the subject of hemostasis and how to handle situations with large injuries. If an individual did acquire a large injury resulting in extreme blood loss, then a hemostatic agent alone would not be very effective. Medical professionals continue to debate on what the best ways to assist a patient in a chronic state are; however, it is universally accepted that hemostatic agents are the primary tool for smaller bleeding injuries
Some main types of hemostasis used in emergency medicine include:
Chemical/topical: This is a topical agent often used in surgery settings to stop bleeding. Microfibriller collagen is the most popular choice among surgeons because it attracts the patients natural platelets and starts the blood clotting process when it comes in contact with the platelets. This topical agent requires normal hemostatic pathway to be properly functional.
Direct pressure or pressure dressing: This type of hemostasis approach is most commonly used in situations where proper medical attention is not available. Putting pressure and/or dressing to a bleeding wound only slows the process of blood loss, allowing for more time to get to an emergency medical setting. Soldiers use this skill during combat when someone has been injured because this process allows for blood loss to be decreased, giving the system time to start coagulation.
Sutures and ties: Sutures are often used to close an open wound, allowing for the injured area to stay free of pathogens and other unwanted debris to enter the site; however, it is also essential to the process of hemostasis. Sutures and ties allow for skin to be joined back together allowing for platelets to start the process of hemostasis at a quicker pace. Using sutures results in a quicker recovery period because the surface area of the wound has been decreased.
Physical agents: Gelatin sponges have been indicated as great hemostatic devices. Once applied to a bleeding area, a gelatin sponge quickly stops or reduces the amount of bleeding present. These physical agents are mostly used in surgical settings as well as after surgery treatments. These sponges absorb blood, allow for coagulation to occur faster, and give off chemical responses that decrease the time it takes for the hemostasis pathway to start.
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Related conferences:
1) International Society on Thrombosis and Haemostasis (ISTH)
2) XXV ISTH Congress (with 61st Annual SSC Meeting) -- will be held in Toronto
3) 62nd Annual SSC Meeting -- will be held in Montpellier
4) XXVI ISTH Congress (with 63rd Annual SSC Meeting) -- will be held in Berlin
5) XXVII ISTH Congress (with 65th Annual SSC Meeting) -- will be held in Melbourne
6)2014 ASH Annual Meeting -- will be held in San Francisco
7) Thrombosis and Hemostasis Summit of North America (THSNA) held its 2nd comprehensive scientific meeting dedicated to thrombosis and hemostasis
Symposiums and Workshops:
• 7th Symposium on Hemostasis was held at the Carolina Inn, Chapel Hill
• 2015HTRS scientific symposium
Related societies:
• American Society of Hematology (ASH)
• International Society on Thrombosis and Haemostasis (ISTH)
• American Heart Association (AHA)
• Hemostasis and thrombosis research society
This page will be updated regularly.
This page was last updated on November 5, 2024
