U.S. Army Medical Department journal
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Many combat-related deaths occur in the prehospital environment before the casualty reaches a medical treatment facility. The tenets of Tactical Combat Casualty Care (TCCC) were published in 1996 and integrated throughout the 75th Ranger Regiment in 1999. In order to validate and refine TCCC protocols and procedures, a prehospital trauma registry was developed and maintained. The application of TCCC, in conjunction with validation and refinement of TCCC through feedback from a prehospital trauma registry, has translated to an increase in survivability on the battlefield.
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Uncontrolled hemorrhage remains the leading cause of potentially preventable death in combat casualties. In the current conflict, nearly two-thirds of these deaths occurred as a result of torso injuries with noncompressible hemorrhage and one-third from extremity injuries with compressible bleeding. ⋯ To provide combat medics with the best means of treating hemorrhages, it is essential to understand the mechanism of action, efficacy strength, and possible adverse effects of each available hemostatic agent. In this article, we review the risks and benefits of the agents/dressings that have been used on the battlefield, the process that led to the selection of the new agents, and the present deficiencies that must be addressed in the development of new products.