title: [Advanced methods of prehospital bleeding management based on the experience and standards of tactical medicine].
abstract: Hemostatic agents are currently used in the form of special granules or soaked gauze. Their use is particularly advantageous in difficult body location (e.g. on neck, armpit or groin), where other methods of bleeding control are impossible to use or fail. In a tactical environment tranexamic acid received first class recommendation for use in case of severe bleeding in the US Army. Its application should be considered in case of traumatic amputation, penetrating chest and abdominal trauma or hemorrhagic shock. The aim of the implementation of hypotensive resuscitation is to maintain perfusion of vital organs in patient with hypovolemia, without excessive fluid infusion. Modern method of bleeding control in combat condition are compression clamps. The purpose of these devices is to compress blood vessel by external pressure pads, especially in difficult to access arteries and large veins in the pelvis or in the distal abdominal aorta.
authors.affiliation: Medical University of Łódź, Poland: Chair of Anesthesiology and Intensive Care, Department of Rescue Medicine and Disaster Medicine.
authors.forename: Przemysław
authors.initials: P
authors.lastname: Kluj
authors.affiliation: London North West Healthcare NHS Trust: Northwick Park Hospital, Anaesthetics Department.
authors.forename: Dawid
authors.initials: D
authors.lastname: Aleksandrowicz
authors.affiliation: Medical University of Łódź, Poland: Department of Anesthesiology and Intensive Care, II Chair of Eye Diseases.
authors.forename: Waldemar
authors.initials: W
authors.lastname: Machała
authors.affiliation: Medical University of Łódź, Poland: Chair of Anesthesiology and Intensive Care, Department of Rescue Medicine and Disaster Medicine.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Gaszyński
mesh_terms: D000007:Abdominal Injuries / Q000150:complications / Q000628:therapy; D000673:Amputation, Traumatic / Q000150:complications / Q000628:therapy; D000933:Antifibrinolytic Agents / Q000008:administration & dosage*; D004632:Emergency Medical Services / Q000379:methods* / Q000458:organization & administration; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000517:prevention & control*; D008887:Military Medicine / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D012151:Resuscitation / Q000379:methods*; D013898:Thoracic Injuries / Q000150:complications / Q000628:therapy; D014148:Tranexamic Acid / Q000008:administration & dosage*; D014481:United States; D014950:Wounds, Penetrating / Q000150:complications / Q000628:therapy
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
keywords: TCCC; combat ready clamps; hemostatic agent; hypotensive resuscitation; tranexamic acid