International Journal of Molecular Medical Science, 2025, Vol.15, No.4, 195-204 http://medscipublisher.com/index.php/ijmms 197 hemostasis before hospital treatment and in emergency situations. If used correctly in the early stage, it can greatly improve the survival rate of patients (Sambasivan and Schreiber, 2009; Meléndez-Lugo et al., 2020; Muldowney et al., 2022). 3.2 Fluid resuscitation and rational use of blood products Today's trauma recovery places more emphasis on the early and balanced infusion of blood products rather than excessive use of crystalloid fluid to restore body volume, oxygen supply and coagulation capacity. The adoption of perinatal hypotension, early transfusion of plasma, platelets and red blood cells in appropriate proportions, and the use of adjuvant drugs such as tranexamic acid are the core contents of injury control resuscitation, which can reduce the mortality probability and blood transfusion requirements of patients at risk of massive hemorrhage (Ruiz and Andresen, 2014; Ruiz and Andresen, 2014; Ntourakis and Liasis, 2020; Kim and Cho, 2024). 3.3 The role and skill requirements of nursing staff in the hemostasis process Nursing staff are crucial for the early detection and treatment of bleeding problems. They need to be proficient in hemostasis methods, blood transfusion management, and continuously monitor the conditions of shock or abnormal coagulation function. Their professional capabilities in using hemostatic drugs, maintaining normal body temperature and detecting complications directly affect the recovery of patients, which also indicates that continuous training and simulation exercises are very necessary (Neveleff et al., 2010; Phillips et al., 2017). 3.4 Coordination Strategies in the pre-hospital and emergency stages Good cooperation between the pre-hospital medical team and the hospital team can ensure smooth connection of trauma care. Pre-hospital medical staff first carry out hemostasis and resuscitation work, and at the same time inform the emergency team of key information. A unified process, rapid patient transfer, and the initiation of massive blood transfusion protocols are crucial for shortening the time for critically ill patients to receive final treatment and achieving better treatment outcomes (Tobin and Varon, 2013; Meléndez-Lugo et al., 2020). 4 Commonly Used Methods for Monitoring Coagulation Function 4.1 Routine laboratory inspection Routine laboratory tests such as prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen concentration and D-dimer are widely used to assess coagulation in trauma and intensive care scenarios. These examinations can provide useful information on specific aspects of the coagulation process and are crucial for diagnosing coagulation problems, monitoring anticoagulant therapy, and guiding blood transfusion decisions. However, these examinations usually take a relatively long time to process and may not fully reflect the complexity of the hemostasis process within the body, especially during acute bleeding (Lippi and Guidi, 2004; French fries, 2011; Swathi and Krishnamurti, 2021). 4.2 Dynamic coagulation monitoring technology Dynamic viscoelastic tests such as thromboelastography (TEG) and rotational thromboelastography (ROTEM) can evaluate the entire coagulation process from clot formation to fibrinolysis in real time and immediately. These techniques can produce results quickly (usually within 5 to 10 minutes), enabling doctors to make clinical decisions promptly in emergencies and before and after surgeries. TEG and ROTEM can assess platelet function, clot strength and fibrinolytic activity, which makes them particularly useful in guiding targeted blood product therapy and managing complex coagulation disorders (Figure 1) (Rugeri et al., 2007; French Fries, 2011; Smart et al., 2017; Swathi and Krishnamurti, 2021; Dang et al., 2022). 4.3 Comparison of monitoring methods and clinical applications Although routine laboratory tests have uniform standards and are widely used, they have problems such as long processing time and inability to comprehensively assess hemostatic function. In contrast, TEG and ROTEM can provide comprehensive and dynamic coagulation conditions, and have advantages in reducing blood loss, optimizing blood transfusion plans, and lowering the treatment costs for surgical and trauma patients. Research shows that there is a moderate to strong association between the parameters of ROTEM/TEG and the results of routine tests. However, in terms of rapid and targeted bleeding management, viscoelastic testing has more
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