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Trauma hemostasis and oxygenation research position paper on remote damage control resuscitation: definitions,
Donald H Jenkins1, Joseph F Rappold, John F Badloe
1*Department of Surgery, Mayo Clinic, Rochester, Minnesota; †Department of Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania; ‡Transfusion Medicine, Blood Banking (American Society of Clinical Pathology), Netherlands Military Blood Bank; §Department of Transfusion Medicine, Örebro University Hospital, Örebro, Sweden; ∥Commander, US Army Institute of Surgical Research, San Antonio, Texas; ¶Trauma Sciences, Barts and the London School of Medicine, and Trauma & Vascular Surgery at the Royal London Hospital, London, UK; **Committee on Tactical Combat Casualty Care, Joint Trauma System, Joint Base San Antonio, Texas; ††Coagulation and Blood Research, US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas; ‡‡Department of Surgery University of California-San Francisco, San Francisco, California; §§Centre for Trauma Sciences, Blizard Institute, Bart's & the London School of Medicine, Queen Mary University of London, London, UK; ∥∥Deployment Medicine International, Gig Harbor, Washington; ¶¶Transfusion Medicine NHS Blood and Transplant, Birmingham, UK; ***The Trauma & Combat Medicine Branch, Surgeon General's HQ, Israel Defense Forces, Ramat Gan; and †††Department of Military Medicine, Hebrew University, Jerusalem, Israel; ‡‡‡Blood Bank, Haukeland University Hospital, and Department of Clinical Science, University of Bergen, Norway; §§§UK Defence Medical Services, Anaesthetic Department, Frenchay Hospital, Bristol UK; ∥∥∥Department of Surgery, Memorial Hermann Hospital, University of Texas Medical School at Houston, Houston, Texas; ¶¶¶Department for Traumatology, Orthopedic Surgery and Sportsmedicine Cologne-Merheim Medical Center, Cologne, Germany; ****Vice Chairman for Research, Department of Surgery, University of Colorado Denver, Colorado; ††††Surgeon General for Trauma, Air Force Medical Operations Agency, Lackland AFB, Texas; and Division of Trauma and General Surgery, Unive
Abstract:
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. The concept of remote damage control resuscitation is in its infancy, and there is a significant amount of work that needs to be done to improve outcomes for patients with life-threatening bleeding secondary to injury. The prehospital phase of resuscitation is critical in these patients. If shock and coagulopathy can be rapidly identified and minimized before hospital admission, this will very likely reduce morbidity and mortality. This position statement begins to standardize the terms used, provides an acceptable range of therapeutic options, and identifies the major knowledge gaps in the field.
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