Trotsky was killed with an icepick to the skull. It was actually an ice axe.
I recently read a short play, which begins the moment after the hammer strikes and becomes embedded into Trotsky's head, that proceeds to detail the thoughts and sensations, moment by moment, he had as he remained conscious and confronted his assassins in order to question them.
Trotsky had to seek treatment at the hospital. He was operated on and died the next day from exsanguination and shock. Exsanguination is an extreme loss of blood.
His last words were: "I will not survive this attack. Stalin has finally accomplished the task he attempted unsuccessfully before."
