Read by QxMD icon Read

Remote Damage control resuscitation

Yann Daniel, S Habas, L Malan, J Escarment, J-S David, S Peyrefitte
BACKGROUND: Despite the early uses of tourniquets and haemostatic dressings, blood loss still accounts for the vast majority of preventable deaths on the battlefield. Over the last few years, progress has been made in the management of such injuries, especially with the use of damage control resuscitation concepts. The early application of these procedures, on the field, may constitute the best opportunity to improve survival from combat injury during remote operations. DATA SOURCES: Currently available literature relating to trauma-induced coagulopathy treatment and far-forward transfusion was identified by searches of electronic databases...
August 16, 2016: Journal of the Royal Army Medical Corps
Robert T Gerhardt, Elon Glassberg, John B Holcomb, Robert L Mabry, Martin B Schreiber, Philip C Spinella
BACKGROUND: Uncontrolled major hemorrhage and delayed evacuation remain substantial contributors to potentially survivable combat death, along with mission, environment, terrain, logistics, and hostile action. Life-saving interventions and the onset of acute traumatic coagulopathy (ATC) may also contribute. OBJECTIVE: Analyze US casualty records from the DoD Trauma Registry, using International Normalized Ratio (INR) of 1.5 for onset of ATC. METHODS: Retrospective cohort study from September 2007 to June 2011, inclusive...
September 2016: Shock
Christopher K Bjerkvig, Geir Strandenes, Håkon S Eliassen, Philip C Spinella, Theodor K Fosse, Andrew P Cap, Kevin R Ward
Hemorrhagic shock is both a local and systemic disorder. In the context of systemic effects, blood loss may lead to levels of reduced oxygen delivery (DO2 ) sufficient to cause tissue ischemia. Similar to other physiologic debts such as sleep, it is not possible to incur a significant oxygen debt and suffer no consequences for lack of timely repayment. While the linkage between oxygen debt and traditional organ failure (renal, hepatic, lung, and circulation) has been long recognized, we should consider failure in two additional linked and very dynamic organ systems, the endothelium and blood...
April 2016: Transfusion
Marc Maegele
The concept of remote damage control resuscitation (RDCR) is still in its infancy and there is significant work to be done to improve outcomes for patients with life-threatening bleeding secondary to injury. The prehospital phase of resuscitation is critical and if shock and coagulopathy can be rapidly minimized before hospital admission this will very likely reduce morbidity and mortality. The optimum transfusion strategy for these patients is still highly debated and the potential implications of the recently published pragmatic, randomize, optimal platelet, and plasma ratios trial (PROPPR) for RDCR have been reviewed...
April 2016: Transfusion
John D Yonge, Martin A Schreiber
BACKGROUND: Implications from the pragmatic, randomize, optimal platelet and plasma ratios (PROPPR) trial are critical for remote damage control resuscitation (DCR). Utilizing DCR principals in remote settings can combat early mortality from hemorrhage. Identifying the appropriate transfusion strategy is mandatory prior to adopting prehospital hemostatic resuscitation strategies. STUDY DESIGN AND METHODS: The PROPPR study was examined in relation to the following questions: 1) Why is it important to have blood products in the prehospital setting?; 2) Which products should be investigated for prehospital hemostatic resuscitation?; 3) What is the appropriate ratio of blood product transfusion?; and 4) What are the appropriate indications for hemostatic resuscitation? RESULTS: PROPPR demonstrates that early and balanced blood product transfusion ratios reduced mortality in all patients at 3 hours and death from exsanguination at 24 hours (p = 0...
April 2016: Transfusion
Benov Avi, Glassberg Elon, Erez Nissim Baruch, Shina Avi, Twig Gilad, Levi Moran, Zoarets Itay, Sagi Ram, Bader Tarif, Dagan David, Yitzhak Avraham, Kreiss Yitshak
STUDY OBJECTIVE: In 2012, the Israel Defense Forces Medical Corps (IDF-MC) set a goal of reducing mortality and eliminating preventable death on the battlefield. A force buildup plan entitled "My Brother's Keeper" was launched addressing: trauma medicine, training, change of Clinical Practice Guidelines (CPGs), injury prevention, data collection, global collaboration and more. The aim of this article is to examine how military medical care has evolved due "My Brother's Keeper" between Second Lebanon War (SLW, 2006) to Operation Protective Edge (OPE, 2014)...
May 2016: Injury
Martin Albrecht, Patrick Meybohm, Ole Broch, Karina Zitta, Marc Hein, Jan-Thorsten Gräsner, Jochen Renner, Berthold Bein, Matthias Gruenewald
BACKGROUND: Remote ischaemic post-conditioning (RIPoC) in which transient episodes of ischaemia (e.g. by inflation and deflation of a blood pressure cuff) are applied after a prolonged ischaemia/reperfusion injury, may have the potential to improve patient outcome and survival following cardiac arrest. In this study we employed a pig model of cardiac arrest and successful cardiopulmonary resuscitation to evaluate the effects of RIPoC on haemodynamics, cardiac tissue damage and neurologic deficit...
August 2015: Resuscitation
Sylvain Ausset, Elon Glassberg, Roy Nadler, Geir Sunde, Andrew P Cap, Clément Hoffmann, Soryapong Plang, Anne Sailliol
BACKGROUND: Hemorrhage remains the leading cause of preventable trauma-associated mortality. Interventions that improve prehospital hemorrhage control and resuscitation are needed. Tranexamic acid (TXA) has recently been shown to reduce mortality in trauma patients when administered upon hospital admission, and available data suggest that early dosing confers maximum benefit. Data regarding TXA implementation in prehospital trauma care and analyses of alternatives are lacking. This review examines the available evidence that would inform selection of hemostatic interventions to improve outcomes in prehospital trauma management as part of a broader strategy of "remote damage-control resuscitation" (RDCR)...
June 2015: Journal of Trauma and Acute Care Surgery
Geir Strandenes, Ivar Austlid, Torunn O Apelseth, Tor A Hervig, Jan Sommerfelt-Pettersen, Maryanne C Herzig, Andrew P Cap, Heather F Pidcoke, Einar K Kristoffersen
BACKGROUND: Formulation of a medical preparedness plan for treating severely bleeding casualties during naval deployment is a significant challenge because of territory covered during most missions. The aim of this study was to evaluate the concept of "walking blood bank" as a supportable plan for supplying safe blood and blood products. METHODS: In 2013, the Royal Norwegian Navy conducted antipiracy operations from a frigate, beginning in the Gulf of Aden and ending in the Indian Ocean...
June 2015: Journal of Trauma and Acute Care Surgery
Ronald V Maier
No abstract text is available yet for this article.
May 2014: Shock
Donald Jenkins, James Stubbs, Steve Williams, Kathleen Berns, Martin Zielinski, Geir Strandenes, Scott Zietlow
Remote damage control resuscitation is a recently defined term used to describe techniques and strategies to provide hemostatic resuscitation to injured patients in the prehospital setting. In the civilian setting, unlike the typical military setting, patients who require treatment for hemorrhage come in all ages with all types of comorbidities and have bleeding that may be non-trauma related. Thus, in the austere setting, addressing the needs of the patient is no less challenging than in the military environment, albeit the caregivers are typically not putting their lives at risk to provide such care...
May 2014: Shock
Tor Hervig, Heidi Doughty, Paul Ness, John F Badloe, Olle Berseus, Elon Glassberg, Hans E Heier
At the 2013 Traumatic Hemostasis and Oxygenation Research Network's Remote Damage Control Resuscitation symposium, a panel of senior blood bankers with both civilian and military background was invited to discuss their willingness and ability to supply prehospital plasma for resuscitation of massively bleeding casualties and to comment on the optimal preparations for such situations. Available evidence indicates that prehospital use of plasma may improve remote damage control resuscitation, although level I evidence is lacking...
May 2014: Shock
Robert Gerhardt, Jonathon Berry, Robert L Mabry, Lawrence Flournoy, Robert G Arnold, Christopher Hults, John B Robinson, Robert A Thaxton, Ramon Cestero, Jason D Heiner, Alexandra R Koller, Kevin M Cox, Jay N Patterson, Warren R Dalton, Anne L McKeague, Gary Gilbert, Carl Manemeit, Bruce D Adams
OBJECTIVE: We sought to determine whether Contingency Telemedical Support (CTS) improves the success rate and efficiency of primary care providers performing critical actions during simulated combat trauma resuscitation. Critical actions included advanced airway, chest decompression, extremity hemorrhage control, hypothermia prevention, antibiotics and analgesics, and hypotensive resuscitation, among others. BACKGROUND: Recent studies report improved survival associated with skilled triage and treatment in the out-of-hospital/preoperative phase of combat casualty care...
2014: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Christian Medby
Crystalloids and colloids are used in prehospital fluid resuscitation to replace blood loss and preserve tissue perfusion until definite surgical control of bleeding can be achieved. However, large volumes of fluids will increase bleeding by elevating blood pressure, dislodging blood clots, and diluting coagulation factors and platelets. Hypotensive fluid resuscitation strategies are used to avoid worsening of uncontrolled bleeding. This is largely supported by animal studies. Most clinical evidence suggests that restricting fluid therapy is associated with improved outcome...
May 2014: Shock
Donald H Jenkins, Joseph F Rappold, John F Badloe, Olle Berséus, Lorne Blackbourne, Karim H Brohi, Frank K Butler, Andrew P Cap, Mitchell Jay Cohen, Ross Davenport, Marc DePasquale, Heidi Doughty, Elon Glassberg, Tor Hervig, Timothy J Hooper, Rosemary Kozar, Marc Maegele, Ernest E Moore, Alan Murdock, Paul M Ness, Shibani Pati, Todd Rasmussen, Anne Sailliol, Martin A Schreiber, Geir Arne Sunde, Leo M G van de Watering, Kevin R Ward, Richard B Weiskopf, Nathan J White, Geir Strandenes, Philip C Spinella
The Trauma Hemostasis and Oxygenation Research Network held its third annual Remote Damage Control Resuscitation Symposium in June 2013 in Bergen, Norway. The Trauma Hemostasis and Oxygenation Research Network is a multidisciplinary group of investigators with a common interest in improving outcomes and safety in patients with severe traumatic injury. The network's mission is to reduce the risk of morbidity and mortality from traumatic hemorrhagic shock, in the prehospital phase of resuscitation through research, education, and training...
May 2014: Shock
Geir Strandenes, Marc De Pasquale, Andrew P Cap, Tor A Hervig, Einar K Kristoffersen, Matthew Hickey, Christopher Cordova, Olle Berseus, Håkon S Eliassen, Logan Fisher, Steve Williams, Philip C Spinella
Military experience and recent in vitro laboratory data provide a biological rationale for whole-blood use in the treatment of exsanguinating hemorrhage and have renewed interest in the reintroduction of fresh whole blood and cold-stored whole blood to patient care in austere environments. There is scant evidence to support, in a field environment, that a whole blood-based resuscitation strategy is superior to a crystalloid/colloid approach even when augmented by a limited number of red blood cell (RBC) and plasma units...
May 2014: Shock
Philip C Spinella, Allan Doctor
The philosophy of damage control resuscitation (DCR) and remote damage control resuscitation (RDCR) can be summarized by stating that the goal is to prevent death from hemorrhagic shock by "staying out of trouble instead of getting out of trouble." In other words, it is preferred to arrest the progression of shock, rather than also having to reverse this condition after significant tissue damage and organ injury cascades are established. Moreover, to prevent death from exsanguination, a balanced approach to the treatment of both shock and coagulopathy is required...
May 2014: Shock
Timothy James Hooper, Marc De Pasquale, Geir Strandenes, Geir Sunde, Kevin R Ward
The environmental and logistical constraints of the prehospital setting make it a challenging place for the treatment of trauma patients. This is perhaps more pronounced in the management of battlefield casualties before extraction to definitive care. In seeking solutions, interest has been renewed in implementing damage control resuscitation principles in the prehospital setting, a concept termed remote damage control resuscitation. These developments, while improving conflict survival rates, are not exclusive to the military environment, with similar situations existing in the civilian setting...
May 2014: Shock
Philip C Spinella, Geir Strandenes
This year, the Trauma Hemostasis and Oxygenation Research Network had its third annual conference from June 17 to 19 at the Solstrand Hotel, near Bergen, Norway. It was sponsored and organized by the Norwegian Naval Special Operation Commando together with the Norwegian Air Ambulance Foundation. The Trauma Hemostasis and Oxygenation Research Network is composed of more than 150 members from 16 countries who all have a common interest in the prevention and treatment of traumatic hemorrhagic shock. The network is multidisciplinary to include members from both the military and civilian medical community representing areas of surgery, critical care, emergency medicine, transfusion medicine, anesthesiology, hematology, and basic science...
May 2014: Shock
Gary W Muniz, David A Wampler, Craig A Manifold, Greg Z Grudic, Jane Mulligan, Steven Moulton, Robert T Gerhardt, Victor A Convertino
BACKGROUND: This study aimed to test the hypothesis that the addition of a real-time decision-assist machine learning algorithm by emergency medical system personnel could shorten the time needed to identify an unstable patient during a hemorrhage profile as compared with vital sign information alone. METHODS: Fifty emergency medical team-paramedics from a large, urban fire department participated as subjects. Subjects viewed a monitor screen on two occasions as follows: (1) display of standard vital signs alone and (2) with the addition of an index (Compensatory Reserve Index) associated with estimated central blood volume status...
August 2013: Journal of Trauma and Acute Care Surgery
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"