Prolonged Field Care Working Group Fluid Therapy Recommendations.

Area of Science:

• Emergency Medicine
• Trauma Surgery
• Military Medicine

Background:

• Hemorrhagic shock poses a significant threat in prolonged field care (PFC) settings.
• Current resuscitation strategies require optimization for Special Operations Forces (SOF) medical personnel.
• The need for comprehensive fluid management in both hemorrhagic and non-hemorrhagic conditions during PFC is critical.

Purpose of the Study:

• To establish fresh whole blood (FWB) as the primary resuscitation fluid for hemorrhagic shock in PFC.
• To advocate for FWB transfusion capability as a core competency for SOF Medics.
• To outline the necessity of addressing non-hemorrhagic fluid resuscitation and maintenance requirements within PFC.

Main Methods:

• The Prolonged Field Care Working Group convened to review and establish best practices.
• Expert consensus was reached regarding the use of FWB in hemorrhagic shock.
• Guidelines were developed to encompass broader fluid management strategies for PFC.

Main Results:

• The Working Group reached a consensus recommending fresh whole blood (FWB) as the fluid of choice for hemorrhagic shock.
• There is a strong recommendation for SOF Medics to possess FWB transfusion skills.
• The importance of addressing fluid requirements in non-hemorrhagic conditions during PFC was highlighted.

Conclusions:

• Fresh whole blood (FWB) transfusion should be a fundamental skill for SOF Medics managing patients in hemorrhagic shock.
• PFC protocols must integrate comprehensive fluid management for both hemorrhagic and non-hemorrhagic conditions.
• Standardizing FWB use enhances combat casualty care capabilities in austere environments.