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US combat resuscitation guidelines improve military survival rates

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Widespread US military adoption of damage control resuscitation (DCR) policies has shifted resuscitation practices at combat hospitals during conflicts, reports [s]RTNZ Health[/s]. It has also improved survival among severely injured patients, according to a review of data of 57, 179 soldiers admitted to forward combat centres by Dr Nicholas Langan and colleagues from the [b]Madigan Army Medical Centre, Tacoma[/b]. The basic principles of DCR are the early, balanced administration of blood products, aggressive correction of coagulopathy (when blood will not clot) and the minimisation of crystalloid fluids (intravenous fluids).

Trauma experts at the [b]University of Pittsburgh[/b] School of Medicine are launching a multi-centre trial to see if administering a blood-clotting drug to severely injured patients while they are being transported by helicopter to the hospital can improve survival rates, reports [s]Health Canal[/s]. Sponsored by the [b]US Department of Defence[/b], the trial will build on past research indicating that tranexamic acid, commonly used in cardiac surgery, can lower mortality in patients at risk of bleeding following injury. Uncontrolled bleeding is a leading cause of death following a traumatic injury because it can lead to multiple organ failure and infection.

Full RTNZ Health report
JAMA Surgery abstract:
Full Health Canal report


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