Featured Research

from universities, journals, and other organizations

Shift in resuscitation practices in military combat hospitals under review

Date:
July 16, 2014
Source:
The JAMA Network Journals
Summary:
Widespread military adoption of damage control resuscitation policies has shifted resuscitation practices at combat hospitals during conflicts. One of the most important advancements in combat trauma care has been the adoption of DCR, with the basic principles of early, balanced administration of blood products, aggressive correction of coagulopathy (when blood will not clot) and the minimization of crystalloid fluids (intravenous fluids). Adoption of DCR has been credited with improvements in survival among severely injured patients.

Widespread military adoption of damage control resuscitation (DCR) policies has shifted resuscitation practices at combat hospitals during conflicts.

Related Articles


Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) are the first prolonged conflicts the United States has been involved in since the Vietnam War. Medical and surgical advances have often emerged from the battlefields. One of the most important advancements in combat trauma care has been the adoption of DCR, with the basic principles of early, balanced administration of blood products, aggressive correction of coagulopathy (when blood will not clot) and the minimization of crystalloid fluids (intravenous fluids). Adoption of DCR has been credited with improvements in survival among severely injured patients.

Authors analyzed injury patterns, early care and resuscitation among soldiers who died in the hospital before and after implementation of DCR policies. They reviewed data from the Joint Theater Trauma Registry (2002-2011) for combat hospitals. In-hospital deaths were divided into pre-DCR (before 2006) and DCR (2006-2011).

Results: Of 57,179 soldiers admitted to a forward combat hospital, 2,565 (4.5 percent) subsequently died at the hospital. The majority of patients (74 percent) were severely injured and 80 percent died within 24 hours of admission. DCR policies was associated with a decrease in average 24-hour crystalloid infusion volume and increased use of fresh frozen plasma. The average ratio of packed red blood cells to fresh frozen plasma changed from 2.6:1 during the pre-DCR period to 1.4:1 during the DCR period. There was a shift in injury patterns with more severe head trauma cases in the DCR group.

"Patients who died in a hospital during the DCR period were more likely to be severely injured and have a severe brain injury, consistent with a decrease in deaths among potentially salvageable patients," researchers noted.

Commentary: Let's Close Performance Improvement Loop on Adverse Outcomes In a related commentary, John B. Holcomb, M.D., of the University of Texas Health Science Center at Houston, writes: "The War on Terrorism will not be over for a long time. Command attention at all levels on combat casualty care must remain a laser focus or our casualties will not have the best possible outcome."


Story Source:

The above story is based on materials provided by The JAMA Network Journals. Note: Materials may be edited for content and length.


Journal References:

  1. Nicholas R. Langan, Matthew Eckert, Matthew J. Martin. Changing Patterns of In-Hospital Deaths Following Implementation of Damage Control Resuscitation Practices in US Forward Military Treatment Facilities. JAMA Surgery, 2014; DOI: 10.1001/jamasurg.2014.940
  2. John B. Holcomb. Resuscitation Is Better for Combat Casualty Outcomes. JAMA Surgery, 2014; DOI: 10.1001/jamasurg.2014.961

Cite This Page:

The JAMA Network Journals. "Shift in resuscitation practices in military combat hospitals under review." ScienceDaily. ScienceDaily, 16 July 2014. <www.sciencedaily.com/releases/2014/07/140716165826.htm>.
The JAMA Network Journals. (2014, July 16). Shift in resuscitation practices in military combat hospitals under review. ScienceDaily. Retrieved November 25, 2014 from www.sciencedaily.com/releases/2014/07/140716165826.htm
The JAMA Network Journals. "Shift in resuscitation practices in military combat hospitals under review." ScienceDaily. www.sciencedaily.com/releases/2014/07/140716165826.htm (accessed November 25, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Tuesday, November 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

From Popcorn To Vending Snacks: FDA Ups Calorie Count Rules

From Popcorn To Vending Snacks: FDA Ups Calorie Count Rules

Newsy (Nov. 25, 2014) The US FDA is announcing new calorie rules on Tuesday that will require everywhere from theaters to vending machines to include calorie counts. Video provided by Newsy
Powered by NewsLook.com
Daily Serving Of Yogurt Could Reduce Risk Of Type 2 Diabetes

Daily Serving Of Yogurt Could Reduce Risk Of Type 2 Diabetes

Newsy (Nov. 25, 2014) Need another reason to eat yogurt every day? Researchers now say it could reduce a person's risk of developing type 2 diabetes. Video provided by Newsy
Powered by NewsLook.com
Madagascar Working to Contain Plague Outbreak

Madagascar Working to Contain Plague Outbreak

AFP (Nov. 24, 2014) Madagascar said Monday it is trying to contain an outbreak of plague -- similar to the Black Death that swept Medieval Europe -- that has killed 40 people and is spreading to the capital Antananarivo. Duration: 00:42 Video provided by AFP
Powered by NewsLook.com
Are Female Bosses More Likely To Be Depressed?

Are Female Bosses More Likely To Be Depressed?

Newsy (Nov. 24, 2014) A new study links greater authority with increased depressive symptoms among women in the workplace. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins