An upshot of war - damage control resuscitation.
Management of battlefield casualties in Iraq and Afghanistan has seen considerable development in damage control resuscitation, which aims to address the risk of haemorrhage, initially due to mechanical damage; and thereafter due to the development of life-threatening coagulopathy. Damage control resuscitation combines a variety of techniques, such as the use of the combat application tourniquet and novel haemostatics, through to ground-breaking developments in transfusion protocols. These practical aspects of the doctrine are combined with an ethos which sees consultant-led care implemented from as close to the point of wounding as is possible. Meticulous trauma audit is included in this process and has allowed for rapid translation of knowledge into practice. The main elements of this doctrine are described.
Byers
Rachel
R
Military of Defence Hospital Unit Northallerton, Friarage Hospital, Northallerton, North Yorkshire DL6 1JG, UK. rachbye@yahoo.com
D000004:Abbreviations as Topic; D000138:Acidosis / Q000209:etiology / Q000517:prevention & control; D055826:Afghan Campaign 2001-; D001778:Blood Coagulation Disorders / Q000209:etiology / Q000517:prevention & control; D004635:Emergency Medicine / Q000379:methods; D016529:Emergency Nursing; D004638:Emergency Treatment / Q000379:methods* / Q000451:nursing; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D007035:Hypothermia / Q000209:etiology / Q000517:prevention & control; D054542:Iraq War, 2003-2011; D008887:Military Medicine / Q000379:methods*; D024802:Nurse's Role; D012151:Resuscitation / Q000379:methods*; D014111:Tourniquets; D014194:Traumatology / Q000379:methods; D014857:Warfare; D014947:Wounds and Injuries / Q000150:complications / Q000628:therapy*
D006490:Hemostatics