Transfusion for trauma: civilian lessons from the battlefield?

Moor, P.; Rew, David A.; Midwinter, Mark J.; Doughty, Heidi

doi:10.1111/j.1365-2044.2008.05829.x

Cited by 18 publications

(15 citation statements)

References 32 publications

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“…Many lessons can be drawn from observations and experiences from combat casualties in contemporary conflict zones. It is difficult to perform randomized-controlled trials in these environments but the study and observations from the management of these casualties have helped inform and develop ideas from civilian trauma studies [90]. The development of DCR and the sequencing with DCS have incorporated the principles of haemostatic resuscitation.…”

Section: Discussionmentioning

confidence: 99%

Resuscitation and coagulation in the severely injured trauma patient

Midwinter

Woolley

2011

Phil. Trans. R. Soc. B

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Developments in the resuscitation of the severely injured trauma patient in the last decade have been through the increased understanding of the early pathophysiological consequences of injury together with some observations and experiences of recent casualties of conflict. In particular, the recognition of early derangements of haemostasis with hypocoagulopathy being associated with increased mortality and morbidity and the prime importance of tissue hypoperfusion as a central driver to this process in this population of patients has led to new resuscitation strategies. These strategies have focused on haemostatic resuscitation and the development of the ideas of damage control resuscitation and damage control surgery continuum. This in turn has led to a requirement to be able to more closely monitor the physiological status, of major trauma patients, including their coagulation status, and react in an anticipatory fashion.

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Section: Discussionmentioning

confidence: 99%

Resuscitation and coagulation in the severely injured trauma patient

Midwinter

Woolley

2011

Phil. Trans. R. Soc. B

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“…DCR and DCS need to occur concurrently from the outset. Many of these lessons have been already been (re-)learnt on the battlefield and have potential consequences for improvements in civilian trauma management [30] The earlier this surgery takes place the better. Any approach that minimizes any pre-theatre delay is important.…”

Section: Discussionmentioning

confidence: 99%

Damage Control Surgery in the Era of Damage Control Resuscitation

Midwinter

2009

J R Army Med Corps

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“…25,26 Aggressive treatment of the 'lethal triad' of hypothermia, acidosis and coagulopathy using haemostatic techniques, early damage control surgical intervention and massive transfusion has led to survival rates in military settings of over 86% compared to 40-60% in comparable trauma in civilian settings. 10 Adoption of these transfusion practices in civilian high-income trauma care 23 has been relatively slow. Applying military transfusion protocols to the civilian context has been complex as practices need to be adapted to the severity of the trauma and cannot rely on a uniform response to haemostatic resuscitation.…”

Section: Key Technologies: Intraosseous Needles Tourniquet and Bloodmentioning

confidence: 99%

Lessons learned from the casualties of war: battlefield medicine and its implication for global trauma care

et al. 2015

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SummaryAccording to the Global Burden of Disease, trauma is now responsible for five million deaths each year. High-income countries have made great strides in reducing traumarelated mortality figures but low-middle-income countries have been left behind with high trauma-related fatality rates, primarily in the younger population. Much of the progress high-income countries have made in managing trauma rests on advances developed in their armed forces. This analysis looks at the recent advances in high-income military trauma systems and the potential transferability of those developments to the civilian health systems particularly in lowmiddle-income countries. It also evaluates some potential lifesaving trauma management techniques, proven effective in the military, and the barriers preventing these from being implemented in civilian settings.

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Transfusion for trauma: civilian lessons from the battlefield?

Cited by 18 publications

References 32 publications

Resuscitation and coagulation in the severely injured trauma patient

Resuscitation and coagulation in the severely injured trauma patient

Damage Control Surgery in the Era of Damage Control Resuscitation

Lessons learned from the casualties of war: battlefield medicine and its implication for global trauma care

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