Journal of the Royal Army Medical Corps
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Military trauma produces predominantly blast and fragmentation injury, commonly resulting in haemorrhagic shock. Injury patterns to limbs are such that the conventional sites for venous cannulation may be unsuitable. The EZ-IO (Vidacare, San Antonio) system is one of a number of novel products designed for intraosseous (IO) access in adults or children. ⋯ A total of 32 needles were inserted, with 97% effective function. IO needles were used to administer fluid (crystalloid, packed red cells and fresh frozen plasma) and drugs (analgesics, cardiac arrest drugs, antibiotics, drugs for both rapid sequence induction and maintenance of anaesthesia). No complication of infection was noted, but pain was observed in responsive patients with the pain of infusion exceeding that of the underlying injuries in 3 cases.
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Damage Control Resuscitation (DCR) is a novel concept that draws together a series of technical and organisational advances in combat casualty care. It is consistent with and encapsulates the established concept of damage control surgery (DCS).
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Practice Guideline
UK defence medical services guidance for the use of recombinant factor VIIa (rFVIIa) in the deployed military setting.
Use of recombinant Factor VIIa (rFVIIa) for trauma is currently an 'off label' use. There are reports of rFVIIa contributing to the successful outcome of military trauma patients. This paper sets out the current position of the UK Defence Medical Services with regard to using rFVIIa in military trauma.