Walking between the drops: Israeli defense forces' fluid resuscitation protocol

Area of Science:

• Trauma Resuscitation
• Prehospital Care
• Fluid Administration

Background:

• Current trauma resuscitation research emphasizes balancing fluid withholding and administration.
• The previous Israel Defense Forces' prehospital fluid protocol faced implementation challenges in field settings.

Purpose of the Study:

• To describe a process improvement initiative for a revised trauma resuscitation protocol.
• To balance scientific recommendations with practical field implementation in fluid administration.

Main Methods:

• Review of existing research on prehospital fluid administration.
• Development of a unified, easily implementable protocol for diverse medical personnel.
• Consideration of both short and lengthy evacuation scenarios.

Main Results:

• The revised protocol is designed for broad applicability across various caregiver levels.
• The protocol is suitable for both short and extended evacuation times.
• A simplified approach aims to improve the likelihood of survival.

Conclusions:

• Easily implemented guidelines without unnecessary complexity can improve survival in trauma care.
• The current protocol guides providers toward a key decision point for fluid administration.
• Achieving perfectly balanced fluid resuscitation remains challenging due to limited shock assessment tools and conflicting data.