Tactical damage control resuscitation: definition, evolution, and proposals

Abstract

Coagulopathy and hypothermia occur in a considerable percentage of combat casualties when they were transferred to combat support hospital and result in a high mortality. To reduce the mortality of combat casualties, tactical damage control resuscitation (TDCR) needs to be implemented as early as possible, preferentially in the first aid stage and early treatment stage. The strategies for TDCR have undergone evolutions, highlighted by the transition from prediction of massive transfusion to the prediction of acute traumatic coagulopathy (ATC), by the transition from fixed ratio resuscitation with blood components to accurate resuscitation guided by laboratory examinations and concentrates-based hemostatic resuscitation, and by the evolution of the product options for resuscitation to keep up with the development of new resuscitation strategies. The advancement in TDCR urges greater efforts to enhance the research of the natural course of different combat injuries, to establish an accurate prediction system for ATC, and to enhance the training of TDCR skills.

Keywords

• military medicine
• tactical damage control resuscitation
• acute traumatic coagulopathy