Resuscitation and Treatment of Shock

Hemorrhage continues to be the most common cause of death among service members wounded in combat. Injuries that were previously nonsurvivable in previous wars are now routinely seen by combat surgeons in forward surgical units, the result of improvements in body armor, the universal use of field tourniquets to control extremity hemorrhage at the point of injury, and rapid air evacuation strategies. Combat orthopaedic surgeons remain a vital aspect of the forward surgical unit, tasked with assisting general surgical colleagues in the resuscitation of patients in hemorrhagic shock while also addressing traumatic amputations, open and closed long bone fractures, and mechanically unstable pelvic trauma. Future military and civilian trauma research endeavors will seek to identify how the advances made in the past 15 years will translate toward the emerging battlefield of the future, one where forward surgical units must be lighter, smaller, and more mobile to address the changing scope of military combat operations.