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Remote Damage control resuscitation

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https://www.readbyqxmd.com/read/28547532/prehospital-blood-transfusions-in-pediatric-trauma-and-nontrauma-patients-a-single-center-review-of-safety-and-outcomes
#1
Aodhnait S Fahy, Cornelius A Thiels, Stephanie F Polites, Maile Parker, Michael B Ishitani, Christopher R Moir, Kathleen Berns, James R Stubbs, Donald H Jenkins, Scott P Zietlow, Martin D Zielinski
PURPOSE: Prehospital transfusions are a novel yet increasingly accepted intervention in the adult population as part of remote damage control resuscitation, but prehospital transfusions remain controversial in children. Our purpose was to review our pediatric prehospital transfusion experience over 12 years to describe the safety of prehospital transfusion in appropriately triaged trauma and nontrauma patients. METHODS: Children (<18 years) transfused with packed red blood cells (pRBC) or plasma during transport to a single regional academic medical center between 2002 and 2014 were identified...
May 25, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28383477/the-damage-control-surgery-in-austere-environments-research-group-dcsaerg-a-dynamic-program-to-facilitate-real-time-tele-mentoring-tele-diagnosis-to-address-exsanguination-in-extreme-and-austere-environments
#2
Andrew W Kirkpatrick, Jessica McKee, Paul B McBeth, Chad G Ball, Anthony LaPorta, Timothy Broderick, Tim Leslie, David King, Heather Wright-Beatty, Jocelyn Keillor, Homer Tien
Hemorrhage is the most preventable cause of post-traumatic death. Many cases are potentially anatomically salvageable, yet remain lethal without logistics or trained personnel to deliver diagnosis or Resuscitative-surgery in austere-environments. Revolutions in technology for remote-mentoring of ultrasound and surgery may enhance capabilities to utilize the skill-sets of non-physicians. Thus, our Research-Collaborative explored remote-mentoring to empower non-physicians to address junctional and torso hemorrhage-control in Austere-environments...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28333833/leadership-and-a-casualty-response-system-for-eliminating-preventable-death
#3
Russ S Kotwal, Harold R Montgomery, Ethan A Miles, Curtis C Conklin, Michael T Hall, Stanley A McChrystal
Combat casualties who die from their injuries do so primarily in the prehospital setting. Although most of these deaths result from injuries that are nonsurvivable, some are potentially survivable. Of injuries that are potentially survivable, most are from hemorrhage. Thus, military organizations should direct efforts toward prehospital care, particularly through early hemorrhage control and remote damage control resuscitation, to eliminate preventable death on the battlefield. A systems-based approach and priority of effort for institutionalizing such care was developed and maintained by medical personnel and command-directed by nonmedical combatant leaders within the 75th Ranger Regiment, U...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28333831/deployed-skills-training-for-whole-blood-collection-by-a-special-operations-expeditionary-surgical-team
#4
Linda C Benavides, Iain M Smith, Jerome M Benavides, Douglas M Bowley, Heidi A Doughty, Jonathan B Lundy
BACKGROUND: Noncompressible hemorrhage is the leading cause of potentially preventable battlefield death. Combining casualty retrieval from the battlefield and damage control resuscitation (DCR) within the "golden hour" increases survival. However, transfusion requirements may exceed the current blood component stocks held by forward surgical teams. Warm fresh whole blood (WFWB) is an alternative. We report WFWB transfusion training developed by and delivered to a US Golden Hour Offset Surgical Treatment Team and the resulting improvement in confidence with WFWB transfusion...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28333828/prehospital-blood-transfusion-programs-capabilities-and-lessons-learned
#5
Martin D Zielinski, James R Stubbs, Kathleen S Berns, Elon Glassberg, Alan D Murdock, Eilat Shinar, Geir Arne Sunde, Steve Williams, Mark H Yazer, Scott Zietlow, Donald H Jenkins
No abstract text is available yet for this article.
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28291451/prehospital-blood-transfusion-during-aeromedical-evacuation-of-trauma-patients-in-israel-the-idf-csar-experience
#6
Jacob Chen, Avi Benov, Roy Nadler, Daniel N Darlington, Andrew P Cap, Ari M Lipsky, Elon Glassberg
BACKGROUND: Data regarding the effect of prehospital blood administration to trauma patients during short-to-moderate time evacuations is scarce. The Israel Air Force Airborne Combat Search and Rescue is the only organization that deals with aeromedical evacuation for both military and civilian casualties in Israel and the only one with the ability to give blood in the prehospital setting. METHODS: Data on packed red blood cells (PRBCs) administration in the evacuation missions from January 2003 to June 2010 were analyzed and actual transfusion practice was compared to clinical practice guidelines (CPGs)...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/27787439/damage-control-surgery-in-weightlessness-a-comparative-study-of-simulated-torso-hemorrhage-control-comparing-terrestrial-and-weightless-conditions
#7
Andrew W Kirkpatrick, Jessica Lynn McKee, Homer Tien, Anthony J LaPorta, Kit Lavell, Tim Leslie, David R King, Paul B McBeth, Susan Brien, Derek J Roberts, Reginald Franciose, Jonathan Wong, Vivian McAlistair, Danielle Bouchard, Chad G Ball
BACKGROUND: Torso bleeding remains the most preventable cause of post-traumatic death worldwide. Remote damage control resuscitation (RDCR) endeavours to rescue the most catastrophically injured, but has not focused on prehospital surgical torso hemorrhage control (HC). We examined the logistics and metrics of intraperitoneal packing in weightlessness in Parabolic flight (0g) compared to terrestrial gravity (1g) as an extreme example of surgical RDCR. METHODS: A surgical simulator was customized with high-fidelity intraperitoneal anatomy, a "blood" pump and flowmeter...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27531659/tactical-damage-control-resuscitation-in-austere-military-environments
#8
REVIEW
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...
December 2016: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27405067/tactical-study-of-care-originating-in-the-prehospital-environment-tacscope-acute-traumatic-coagulopathy-on-the-contemporary-battlefield
#9
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
https://www.readbyqxmd.com/read/27100755/-blood-failure-time-to-view-blood-as-an-organ-how-oxygen-debt-contributes-to-blood-failure-and-its-implications-for-remote-damage-control-resuscitation
#10
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
https://www.readbyqxmd.com/read/27100752/coagulation-factor-concentrate-based-therapy-for-remote-damage-control-resuscitation-rdcr-a-reasonable-alternative
#11
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
https://www.readbyqxmd.com/read/27100751/the-pragmatic-randomized-optimal-platelet-and-plasma-ratios-trial-what-does-it-mean-for-remote-damage-control-resuscitation
#12
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
https://www.readbyqxmd.com/read/26725147/augmentation-of-point-of-injury-care-reducing-battlefield-mortality-the-idf-experience
#13
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
https://www.readbyqxmd.com/read/26051813/evaluation-of-remote-ischaemic-post-conditioning-in-a-pig-model-of-cardiac-arrest-a-pilot-study
#14
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
https://www.readbyqxmd.com/read/26002268/tranexamic-acid-as-part-of-remote-damage-control-resuscitation-in-the-prehospital-setting-a-critical-appraisal-of-the-medical-literature-and-available-alternatives
#15
REVIEW
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
https://www.readbyqxmd.com/read/26002261/coagulation-function-of-stored-whole-blood-is-preserved-for-14-days-in-austere-conditions-a-rotem-feasibility-study-during-a-norwegian-antipiracy-mission-and-comparison-to-equal-ratio-reconstituted-blood
#16
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
https://www.readbyqxmd.com/read/25133598/the-traumatic-hemostasis-and-oxygenation-research-network-remote-damage-control-resuscitation-rdcr-symposium
#17
EDITORIAL
Ronald V Maier
No abstract text is available yet for this article.
May 2014: Shock
https://www.readbyqxmd.com/read/24662783/implementation-and-execution-of-civilian-remote-damage-control-resuscitation-programs
#18
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
https://www.readbyqxmd.com/read/24662780/prehospital-use-of-plasma-the-blood-bankers-perspective
#19
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
https://www.readbyqxmd.com/read/24604439/evaluation-of-contingency-telemedical-support-to-improve-casualty-care-at-a-simulated-military-intermediate-resuscitation-facility-the-em-angel-study
#20
RANDOMIZED CONTROLLED TRIAL
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
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