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 March 31, 2015 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 March 31, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Tuesday, March 31, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Soda, Salt and Sugar: The Next Generation of Taxes

Soda, Salt and Sugar: The Next Generation of Taxes

Washington Post (Mar. 30, 2015) — Denisa Livingston, a health advocate for the Dinι Community Advocacy Alliance, and the Post&apos;s Abby Phillip discuss efforts around the country to make unhealthy food choices hurt your wallet as much as your waistline. Video provided by Washington Post
Powered by NewsLook.com
UnitedHealth Buys Catamaran

UnitedHealth Buys Catamaran

Reuters - Business Video Online (Mar. 30, 2015) — The $12.8 billion merger will combine the U.S.&apos; third and fourth largest pharmacy benefit managers. Analysts say smaller PBMs could also merge. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
S. Leone in New Anti-Ebola Lockdown

S. Leone in New Anti-Ebola Lockdown

AFP (Mar. 28, 2015) — Sierra Leone imposed a three-day nationwide lockdown Friday for the second time in six months in a bid to prevent a resurgence of the deadly Ebola virus. Duration: 01:17 Video provided by AFP
Powered by NewsLook.com
These Popular Antibiotics Can Cause Permanent Nerve Damage

These Popular Antibiotics Can Cause Permanent Nerve Damage

Newsy (Mar. 27, 2015) — A popular class of antibiotic can leave patients in severe pain and even result in permanent nerve damage. 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