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Blood far forward: Time to get moving!

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  • 1From the Coagulation Blood Research Program (A.P.C., H.F.P.), US Army Institute of Surgical Research, Fort Sam Houston, Houston, Texas; Deployment Medicine International (M.D.P.), Gig Harbor, Washington; Department of Surgery (J.F.R.), Temple University School of Medicine, Philadelphia, Pennsylvania; The Trauma & Combat Medicine Branch (E.G.), Surgeon General's HW, Israel Defense Forces, Ramat Gan, Israel; Norwegian Naval Special Operations Commando (H.S.E., G.S.), Bergen, Norway; Department of Anaesthesia Intensive Care (C.K.B., T.K.F.), Haukeland University Hospital, Bergen, Norway; US Army Special Operations Command (S.K.), Fort Bragg, North Carolina; Advanced Tactical & Emergency Medicine (P.T.), United Kingdom; Department of Anesthesiology (R.S.), Division of Trauma Anesthesiology, Medical Director of Perfusion Cell Salvage Services, R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland; Ranger Regiment (E.M., A.F.), Fort Benning, Georgia; Department of Emergency Medicine (K.R.W.), University of Michigan, Michigan Center for Integrative Research in Critical Care, Ann Arbor, Michigan; Department of Pediatrics (P.C.S.), Division of Pediatric Critical Care, Washington University in St. Louis, St. Louis, Missouri; Department of Immunology Transfusion Medicine (G.S.), Haukeland University Hospital, Bergen, Norway.

The Journal of Trauma and Acute Care Surgery
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PubMed
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Combat casualty care has advanced, but hemorrhage control and prehospital resuscitation require improvement. Whole-blood transfusions offer a current method for far-forward resuscitation, supporting ongoing research.

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Area of Science:

  • Military medicine
  • Trauma surgery
  • Emergency medical services

Background:

  • Combat casualty care has evolved significantly over the past decade, particularly following the conflicts in Iraq and Afghanistan.
  • Current planning often prioritizes technological solutions over historical perspective in addressing medical challenges.
  • Progress in treating combat wounded is evident, yet significant gaps remain.

Purpose of the Study:

  • To appraise the evolution of combat casualty care in a historical context.
  • To identify areas for improvement in hemorrhage control and prehospital resuscitation.
  • To suggest strategies for enhancing far-forward resuscitation using existing and novel approaches.

Main Methods:

  • Historical review of medical practices in combat casualty care.
  • Analysis of recent advancements and persistent challenges in treating combat wounded.
  • Evaluation of current technologies and methods for prehospital resuscitation.

Main Results:

  • Undeniable progress has been made in treating combat casualties.
  • Effective hemorrhage control and prehospital resuscitation for coagulopathy and shock remain critical areas needing further development.
  • Existing technologies and methods, including whole-blood transfusion, can enhance far-forward resuscitation.

Conclusions:

  • Continued efforts are necessary to refine combat casualty care protocols.
  • Whole-blood transfusion represents a viable strategy for immediate resuscitation in far-forward settings.
  • Integrating historical lessons with ongoing research is crucial for future advancements in trauma care.