Damage Control Resuscitation in Penetrating Trauma: Rules of the Game

2016 ◽  
pp. 23-27
Author(s):  
Hee Soo Jung ◽  
Ryan Schmocker ◽  
Suresh Agarwal
Keyword(s):  
Damage Control ◽  
Penetrating Trauma ◽  
Damage Control Resuscitation ◽  
Rules Of The Game

The progression of damage control resuscitation in severe penetrating trauma: a fourteen year experience in a level one trauma center

2014 ◽  
Vol 219 (4) ◽  
pp. e191
Author(s):  
Carlos Ordoñez ◽  
David Alejandro D. Mejia Toro ◽  
Marisol Badiel ◽  
MIchael W. Parra ◽  
Cristina Vernaza ◽  
...  
Keyword(s):  
Trauma Center ◽  
Damage Control ◽  
Penetrating Trauma ◽  
Damage Control Resuscitation

scholarly journals Damage control resuscitation: REBOA as the new fourth pillar

2020 ◽  
Author(s):  
Carlos Alberto Ordoñez ◽  
Michael Parra ◽  
Jose Julian Serna ◽  
Fernando Rodriguez ◽  
Alberto Garcia ◽  
...  
Keyword(s):  
Trauma Patient ◽  
Damage Control ◽  
Penetrating Trauma ◽  
Damage Control Surgery ◽  
Metabolic Decompensation ◽  
Severely Injured ◽  
Damage Control Resuscitation ◽  
New Paradigm ◽  
Permissive Hypotension ◽  
Hemostatic Resuscitation

Damage Control Resuscitation (DCR) seeks to combat metabolic decompensation of the severely injured trauma patient by battling on three major fronts: Permissive Hypotension, Hemostatic Resuscitation, and Damage Control Surgery (DCS). The aim of this article is to perform a review of the history of DCR/DCS and to propose a new paradigm that has emerged from the recent advancements in endovascular technology: The Resuscitative Balloon Occlusion of the Aorta (REBOA). Thanks to the advances in technology, a bridge has been created between Pre-hospital Management and the Control of Bleeding described in Stage I of DCS which is the inclusion and placement of a REBOA. We have been able to show that REBOA is not only a tool that aids in the control of hemorrhage, it is also a vital tool in the hemodynamic resuscitation of a severely injured blunt and/or penetrating trauma patient. That is why we propose a new paradigm “The Fourth Pillar”: Permissive Hypotension, Hemostatic Resuscitation, Damage Control Surgery and REBOA.

Damage Control Resuscitation

2019 ◽  
pp. 15-22
Author(s):  
Yu Chen ◽  
Xijing Zhang
Keyword(s):  
Damage Control ◽  
Damage Control Resuscitation

scholarly journals Preparing Austere Maritime Surgical Teams for Deployment During the COVID-19 Global Pandemic: Is It Time to Change the Training Pipeline?

2021 ◽  
Author(s):  
Diego A Vicente ◽  
Obinna Ugochukwu ◽  
Michael G Johnston ◽  
Chad Craft ◽  
Virginia Damin ◽  
...  
Keyword(s):  
Communication Skills ◽  
Damage Control ◽  
Skills Training ◽  
Subject Matter Experts ◽  
Damage Control Resuscitation ◽  
Medical Department ◽  
Global Pandemic ◽  
Life Saving ◽  
Surgical Teams ◽  
Compare And Contrast

ABSTRACT Introduction Navy Medicine's Role 2 Light Maneuver (R2LM) Emergency Resuscitative Surgical Systems (ERSS) are austere surgical teams manned, trained, and equipped to provide life-saving damage control resuscitation and surgery in any environment on land or sea. Given the restrictions related to the COVID-19 pandemic, the previously established pre-deployment training pipeline for was modified to prepare a new R2LM team augmenting a Role 1 shipboard medical department. Methods The modified curriculum created in response to COVID-19 related restriction is compared and contrasted to the established pre-deployment R2LM ERSS curriculum. Subject Matter Experts and currently deployed R2LM members critically evaluate the two curricula. Results Both curricula included the team R2LM platform training and exposure to cadaver based team trauma skills training. The modified curriculum included didactics on shipboard resuscitation, anesthesia and surgery, shipboard COVID-19 management, and prolonged field care in austere maritime environments. Conclusions We describe Navy Medicines R2LM ERSS capability and compare and contrast the standard R2LM pre-COVID-19 curriculum to the modified curriculum. Central to both curricula, the standard R2LM platform training is important for developing and honing team dynamics, communication skills and fluid leadership; important for the successful function austere surgical teams. Several opportunities for improvement in the pre-deployment training were identified for R2LM teams augmenting shipboard Role 1 medical departments.

scholarly journals Evidence for use of damage control surgery and damage control interventions in civilian trauma patients: a systematic review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Derek J. Roberts ◽  
◽  
Niklas Bobrovitz ◽  
David A. Zygun ◽  
Andrew W. Kirkpatrick ◽  
...  
Keyword(s):  
Systematic Review ◽  
Damage Control ◽  
Penetrating Trauma ◽  
Damage Control Surgery ◽  
Trauma Patients ◽  
Clinical Scenario ◽  
Cross Sectional ◽  
Iliac Vessel ◽  
Civilian Trauma ◽  
Definitive Surgery

Abstract Background Although damage control (DC) surgery is widely assumed to reduce mortality in critically injured patients, survivors often suffer substantial morbidity, suggesting that it should only be used when indicated. The purpose of this systematic review was to determine which indications for DC have evidence that they are reliable and/or valid (and therefore in which clinical situations evidence supports use of DC or that DC improves outcomes). Methods We searched 11 databases (1950–April 1, 2019) for studies that enrolled exclusively civilian trauma patients and reported data on the reliability (consistency of surgical decisions in a given clinical scenario) or content (surgeons would perform DC in that clinical scenario or the indication predicted use of DC in practice), construct (were associated with poor outcomes), or criterion (were associated with improved outcomes when DC was conducted instead of definitive surgery) validity for suggested indications for DC surgery or DC interventions. Results Among 34,979 citations identified, we included 36 cohort studies and three cross-sectional surveys in the systematic review. Of the 59 unique indications for DC identified, 10 had evidence of content validity [e.g., a major abdominal vascular injury or a packed red blood cell (PRBC) volume exceeding the critical administration threshold], nine had evidence of construct validity (e.g., unstable patients with combined abdominal vascular and pancreas gunshot injuries or an iliac vessel injury and intraoperative acidosis), and six had evidence of criterion validity (e.g., penetrating trauma patients requiring > 10 U PRBCs with an abdominal vascular and multiple abdominal visceral injuries or intraoperative hypothermia, acidosis, or coagulopathy). No studies evaluated the reliability of indications. Conclusions Few indications for DC surgery or DC interventions have evidence supporting that they are reliable and/or valid. DC should be used with respect for the uncertainty regarding its effectiveness, and only in circumstances where definitive surgery cannot be entertained.

Evaluation of military trauma system practices related to damage-control resuscitation

2012 ◽  
Vol 73 ◽  
pp. S459-S464 ◽  
Author(s):  
Keith Palm ◽  
Amy Apodaca ◽  
Debra Spencer ◽  
George Costanzo ◽  
Jeffrey Bailey ◽  
...  
Keyword(s):  
Damage Control ◽  
Trauma System ◽  
Damage Control Resuscitation ◽  
Military Trauma

Optimizing a decision support system for damage control resuscitation using mixed methods human factors analysis

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Daniela Schmulevich ◽  
Pamela Z. Cacchione ◽  
Sara Holland ◽  
Kristin Quinlan ◽  
Alyson Hinkle ◽  
...  
Keyword(s):  
Decision Support ◽  
Mixed Methods ◽  
Decision Support System ◽  
Human Factors ◽  
Support System ◽  
Damage Control ◽  
Damage Control Resuscitation ◽  
Factors Analysis ◽  
Human Factors Analysis

Damage Control Resuscitation

2017 ◽  
pp. 57-75
Author(s):  
Jacob R. Peschman ◽  
Donald H. Jenkins ◽  
John B. Holcomb ◽  
Timothy C. Nunez
Keyword(s):  
Damage Control ◽  
Damage Control Resuscitation

Restrictive fluid resuscitation in combination with damage control resuscitation

2012 ◽  
Vol 73 (3) ◽  
pp. 674-678 ◽  
Author(s):  
Marquinn D. Duke ◽  
Chrissy Guidry ◽  
Jordan Guice ◽  
Lance Stuke ◽  
Alan B. Marr ◽  
...  
Keyword(s):  
Fluid Resuscitation ◽  
Damage Control ◽  
Damage Control Resuscitation
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