SUPPLEMENTAL DIGITAL CONTENT 1. Plots of patient timelines including hemorrhage control procedures through 24 hours after emergency department (ED) arrival, renal impairment as defined by the RIFLE categorization through 28 days, and blood volume administered through 2 hours after ED arrival. Patients randomized to standard resuscitation are listed on the left side of the plot with time extending from the center of the plot at time 0 when the study kit was opened until 28 days on the far left of the plot. Patients randomized to controlled resuscitation are listed on the right side of the plot with time extending from the center at time 0 until 28 days on the far right of the plot. The patients for each group are sorted by survival time (lowest to highest), then estimated intensive care unit (ICU) time (highest to lowest), and then by hospital length of stay (highest to lowest). Blood volume through 2 hours and cause of death (COD) are presented in the margins outside the plot area. The plots shows that survival bias may explain much of the difference in hemorrhage control procedures, renal impairment, and early blood administration between the treatment groups.
EX TBI/RSP
EX UNK
EX EX/TBI
EX TBI EX/RSP
TBI EX EX TBI SEP EX
J J
W
W W
EX EX EX EX EX TBI TBI RSP
W 0
15m 15m
1h 1h
2 2
6 6
24h 24h
3d 3d
28d 28d
CODBlood volume Blood volumeCOD
through 2h through 2h
Log time since kit opened Log time since kit opened
Standard Resuscitation Controlled Resuscitation
Timeline Death
Kit open thru ED arrival ED/ICU/OR/hospital
Renal Impairment (RIFLE) Risk
Injury Failure
Hemorrhage Control Procedures within 2 hours of ED arrival 2−24 hours after ED arrival
Cause of Death (COD) EX
RSP SEP TBI UNK
Exsanguination/hemorrhagic shock
Respiratory/pulmonary contusion/tension pneumo Sepsis
Traumatic brain injury Unknown (died in field)
Other Events W
J
Withdrew consent
Taken into police custody (jail)
*Patients sorted by death time (low to high), then estimated ICU time (high to low), then hospital length of stay (high to low).
