Andrew D Fisher, Ethan A Miles, Andrew P Cap, Geir Strandenes, Shawn F Kane
Author Information
Andrew D Fisher: 75th Ranger Regiment, 6420 Dawson Loop, Fort Benning, GA 31905.
Ethan A Miles: 75th Ranger Regiment, 6420 Dawson Loop, Fort Benning, GA 31905.
Andrew P Cap: Institute of Surgical Research, 3698 Chambers Pass, Fort Sam Houston, TX 78234-7767.
Geir Strandenes: Norwegian Naval Special Operations Commando, Bergen, Norway. Dept. of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.
Shawn F Kane: U.S. Army Special Operations Command, 2929 Desert Storm Drive, Fort Bragg, NC 28310.
Recently the Committee on Tactical Combat Casualty Care changed the guidelines on fluid use in hemorrhagic shock. The current strategy for treating hemorrhagic shock is based on early use of components: Packed Red Blood Cells (PRBCs), Fresh Frozen Plasma (FFP) and platelets in a 1:1:1 ratio. We suggest that lack of components to mimic whole blood functionality favors the use of Fresh Whole Blood in managing hemorrhagic shock on the battlefield. We present a safe and practical approach for its use at the point of injury in the combat environment called Tactical Damage Control Resuscitation. We describe pre-deployment preparation, assessment of hemorrhagic shock, and collection and transfusion of fresh whole blood at the point of injury. By approaching shock with goal-directed therapy, it is possible to extend the period of survivability in combat casualties.
