Journal of the Royal Army Medical Corps
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With the development of British Army doctrine it is necessary to review the concepts underlying medical support to the modern battlefield. In particular, the provision of timely and balanced resuscitation to the high intensity battle is an issue requiring an understanding of both the tactical and the clinical demands. The wholesale application of civilian techniques and approaches to trauma management is not possible given the austerity of the battlefield clinical environment. ⋯ Specifically, the introduction of a triad approach to trauma management is offered. The triad comprises readily available Battlefield Advanced Trauma Life Support (BATLS) skills, Surgical Resuscitation deployed forward and the provision of Field Intensive Care. Such an approach would marry together the clinically ideal with the tactically.
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Hypertonic saline solutions have properties that may be advantageous for resuscitation. In both animal and human studies rapid improvements in cardiovascular status occur when hypertonic saline is administered to hypovolaemic subjects and the possible side effects of hypertonic solutions have not been shown to be of clinical importance. Hypertonic saline certainly has a potential role in resuscitation of hypovolaemic casulaties in the modern military setting.