Implementation and execution of civilian remote damage control resuscitation programs

Donald Jenkins, James Stubbs, Steve Williams, Kathleen Berns, Martin Zielinski, Geir Strandenes, Scott Zietlow

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Remote damage control resuscitation is a recently defined term used to describe techniques and strategies to provide hemostatic resuscitation to injured patients in the prehospital setting. In the civilian setting, unlike the typical military setting, patients who require treatment for hemorrhage come in all ages with all types of comorbidities and have bleeding that may be non-trauma related. Thus, in the austere setting, addressing the needs of the patient is no less challenging than in the military environment, albeit the caregivers are typically not putting their lives at risk to provide such care. Two organizations have pioneered remote damage control resuscitation in the civilian environment: Mayo Clinic and Royal Caribbean Cruises Ltd. The limitations in rural Minnesota and shipboard are daunting. Patients who have hemorrhage requiring transfusion are often hundreds of miles from hospitals able to provide damage control resuscitation. This article details the development and implementation of novel programs specifically designed to address the varied needs of patients in such circumstances. The Mayo Clinic program essentially takes a standard-of-care treatment algorithm, by which the patient would be treated in the emergency department or trauma bay, and projects that forward into the rural environment with specially trained prehospital personnel and special resources. Royal Caribbean Cruises Ltd has adapted a traditional military field practice of transfusing warm fresh whole blood, adding significant safety measures not yet reported on the battlefield (see within this Supplement the article entitled "Emergency Whole Blood Use in the Field: A Simplified Protocol for Collection and Transfusion"). The details of development, implementation, and preliminary results of these two civilian programs are described herein.

Original languageEnglish (US)
Pages (from-to)84-89
Number of pages6
JournalShock
Volume41
Issue numberSUPPL. 1
DOIs
StatePublished - 2014

Fingerprint

Resuscitation
Hemorrhage
Hemostatics
Standard of Care
Caregivers
Hospital Emergency Service
Comorbidity
Emergencies
Safety
Wounds and Injuries
Therapeutics

Keywords

  • helicopter
  • prehospital
  • shipboard
  • Shock
  • trauma
  • TXA
  • whole blood

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Emergency Medicine
  • Medicine(all)

Cite this

Jenkins, D., Stubbs, J., Williams, S., Berns, K., Zielinski, M., Strandenes, G., & Zietlow, S. (2014). Implementation and execution of civilian remote damage control resuscitation programs. Shock, 41(SUPPL. 1), 84-89. https://doi.org/10.1097/SHK.0000000000000133

Implementation and execution of civilian remote damage control resuscitation programs. / Jenkins, Donald; Stubbs, James; Williams, Steve; Berns, Kathleen; Zielinski, Martin; Strandenes, Geir; Zietlow, Scott.

In: Shock, Vol. 41, No. SUPPL. 1, 2014, p. 84-89.

Research output: Contribution to journalArticle

Jenkins, D, Stubbs, J, Williams, S, Berns, K, Zielinski, M, Strandenes, G & Zietlow, S 2014, 'Implementation and execution of civilian remote damage control resuscitation programs', Shock, vol. 41, no. SUPPL. 1, pp. 84-89. https://doi.org/10.1097/SHK.0000000000000133
Jenkins D, Stubbs J, Williams S, Berns K, Zielinski M, Strandenes G et al. Implementation and execution of civilian remote damage control resuscitation programs. Shock. 2014;41(SUPPL. 1):84-89. https://doi.org/10.1097/SHK.0000000000000133
Jenkins, Donald ; Stubbs, James ; Williams, Steve ; Berns, Kathleen ; Zielinski, Martin ; Strandenes, Geir ; Zietlow, Scott. / Implementation and execution of civilian remote damage control resuscitation programs. In: Shock. 2014 ; Vol. 41, No. SUPPL. 1. pp. 84-89.
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