Damage Control Resuscitation in Combat Trauma: Role 1 and Role 2
Battlefield hemorrhage rarely follows the timelines assumed by standard trauma protocols. This lecture reframes Damage Control Resuscitation for Role 1 and Role 2, where evacuation may be delayed, blood products are limited, and every decision must preserve the patient’s path to definitive hemorrhage control.
The session connects trauma-induced coagulopathy, hypothermia, acidosis, and hypocalcemia with practical actions: identifying patients who require DCR, prioritizing whole blood and balanced component therapy, using tranexamic acid and calcium, preventing heat loss, defining resuscitation targets, and deciding when airway intervention helps—or harms.
A severe penetrating-trauma case anchors the discussion: cardiac arrest at Role 1, massive transfusion at Role 2, and a 17-liter resuscitation that depended heavily on warm fresh donor blood. The closing discussion explores vasopressors in hemorrhagic shock, intubation before prolonged evacuation, and renal protection after extensive soft-tissue injury—where clear algorithms give way to difficult clinical judgment.
The session connects trauma-induced coagulopathy, hypothermia, acidosis, and hypocalcemia with practical actions: identifying patients who require DCR, prioritizing whole blood and balanced component therapy, using tranexamic acid and calcium, preventing heat loss, defining resuscitation targets, and deciding when airway intervention helps—or harms.
A severe penetrating-trauma case anchors the discussion: cardiac arrest at Role 1, massive transfusion at Role 2, and a 17-liter resuscitation that depended heavily on warm fresh donor blood. The closing discussion explores vasopressors in hemorrhagic shock, intubation before prolonged evacuation, and renal protection after extensive soft-tissue injury—where clear algorithms give way to difficult clinical judgment.