Tactical damage control resuscitation

Andrew D. Fisher, Ethan A. Miles, Andrew P. Cap, Geir Strandenes, Shawn F. Kane

Research output: Contribution to journalReview articlepeer-review

84 Scopus citations


Recently the Committee on Tactical Combat Casualty Care changed the guidelines on fluid use in hemorrhagic shock. The current strategy for treating hemorrhagic shock is based on early use of components: Packed Red Blood Cells (PRBCs), Fresh Frozen Plasma (FFP) and platelets in a 1:1:1 ratio. We suggest that lack of components to mimic whole blood functionality favors the use of Fresh Whole Blood in managing hemorrhagic shock on the battlefield. We present a safe and practical approach for its use at the point of injury in the combat environment called Tactical Damage Control Resuscitation. We describe pre-deployment preparation, assessment of hemorrhagic shock, and collection and transfusion of fresh whole blood at the point of injury. By approaching shock with goal-directed therapy, it is possible to extend the period of survivability in combat casualties.

Original languageEnglish
Pages (from-to)869-875
Number of pages7
JournalMilitary Medicine
Issue number8
StatePublished - Aug 2015
Externally publishedYes


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