title: Advances in damage control resuscitation and surgery: implications on the organization of future military field forces.
abstract: Medical support to deployed field forces is increasingly becoming a shared responsibility among allied nations. National military medical planners face several key challenges, including fiscal restraints, raised expectations of standards of care in the field and a shortage of appropriately trained specialists. Even so, medical services are now in high demand, and the availability of medical support may become the limiting factor that determines how and where combat units can deploy. The influence of medical factors on operational decisions is therefore leading to an increasing requirement for multinational medical solutions. Nations must agree on the common standards that govern the care of the wounded. These standards will always need to take into account increased public expectations regarding the quality of care. The purpose of this article is to both review North Atlantic Treaty Organization (NATO) policies that govern multinational medical missions and to discuss how recent scientific advances in prehospital battlefield care, damage control resuscitation and damage control surgery may inform how countries within NATO choose to organize and deploy their field forces in the future.
authors.affiliation: The Canadian Forces Health Services, the 1 Canadian Field Hospital, Petawawa, Ont., the Trauma Services and the Department of Surgery, Sunnybrook Medical Centre, Toronto, Ont.
authors.forename: Homer
authors.initials: H
authors.lastname: Tien
authors.affiliation: The 1 Canadian Field Hospital, Petawawa, Ont. and the Trauma Program, McGill University Health Centre, Montréal, Que.
authors.forename: Andrew
authors.initials: A
authors.lastname: Beckett
authors.affiliation: The 1 Canadian Field Hospital, Petawawa, Ont.
authors.forename: Naisan
authors.initials: N
authors.lastname: Garraway
authors.affiliation: The 1 Canadian Field Hospital, Petawawa, Ont. and McGill University, Montréal, Que.
authors.forename: Max
authors.initials: M
authors.lastname: Talbot
authors.affiliation: The 1 Canadian Field Hospital, Petawawa, Ont. and the Sunnybrook Health Sciences Centre, Toronto, Ont.
authors.forename: Dylan
authors.initials: D
authors.lastname: Pannell
authors.affiliation: The Sunnybrook Health Sciences Centre, Toronto, Ont.
authors.forename: Thamer
authors.initials: T
authors.lastname: Alabbasi
mesh_terms: D002170:Canada; D006801:Humans; D008493:Medical Missions / Q000458:organization & administration*; D008887:Military Medicine / Q000458:organization & administration*; D008889:Military Personnel; D017410:Practice Guidelines as Topic; D012151:Resuscitation / Q000592:standards*; D014947:Wounds and Injuries / Q000601:surgery / Q000628:therapy*