title: The lost art of whole blood transfusion in austere environments.
abstract: The optimal resuscitation fluid for uncontrolled bleeding and hemorrhagic shock in both pre- and in-hospital settings has been an ongoing controversy for decades. Hemorrhage continues to be a major cause of death in both the civilian and military trauma population, and survival depends on adequacy of hemorrhage control and resuscitation between onset of bleeding and arrival at a medical treatment facility. The terms far-forward and austere are defined, respectively, as the environment where professional health care providers normally do not operate and a setting in which basic equipment and capabilities necessary for resuscitation are often not available. The relative austerity of a treatment setting may be a function of timing rather than just location, as life-saving interventions must be performed quickly before hemorrhagic shock becomes irreversible. Fresh whole blood transfusions in the field may be a feasible life-saving procedure when facing significant hemorrhage.
authors.affiliation: 1Norwegian Naval Special Operations Commando, Bergen, Norway; 2Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway; 3Department of Anesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway; 4Medical Operations Royal Caribbean Cruises Ltd., Miami, FL; and 5U.S. Army Institute of Surgical Research, Joint Base San Antonio-Fort Sam Houston, TX.
authors.forename: Geir
authors.initials: G
authors.lastname: Strandenes
authors.forename: Tor A
authors.initials: TA
authors.lastname: Hervig
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Bjerkvig
authors.forename: Steve
authors.initials: S
authors.lastname: Williams
authors.forename: Håkon S
authors.initials: HS
authors.lastname: Eliassen
authors.forename: Theodor K
authors.initials: TK
authors.lastname: Fosse
authors.forename: Hans
authors.initials: H
authors.lastname: Torvanger
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Cap
mesh_terms: D001803:Blood Transfusion / Q000379:methods* / Q000639:trends; D004777:Environment; D006470:Hemorrhage / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D012151:Resuscitation / Q000379:methods* / Q000639:trends; D012771:Shock, Hemorrhagic / Q000175:diagnosis / Q000628:therapy