An upshot of war – Damage control resuscitation

Byers, Capt Rachel

doi:10.1016/j.ienj.2010.01.002

Cited by 14 publications

(16 citation statements)

References 38 publications

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“…Research should focus on the transferability of trauma care innovations 89,90 and implementation of clinical improvements, such as cumulative blood loss recording, training and reminders for staff. 23,91,92 Weighted sampling is an underused methodology that reduces data entry burden and could be extrapolated to research, audit and monitor other morbidities.…”

Section: Resultsmentioning

confidence: 99%

Reporting errors, incidence and risk factors for postpartum haemorrhage and progression to severe PPH: a prospective observational study

Briley

Seed

Tydeman

et al. 2014

BJOG

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ObjectiveTo quantify reporting errors, measure incidence of postpartum haemorrhage (PPH) and define risk factors for PPH (≥500 ml) and progression to severe PPH (≥1500 ml).DesignProspective observational study.SettingTwo UK maternity services.PopulationWomen giving birth between 1 August 2008 and 31 July 2009 (n = 10 213).MethodsWeighted sampling with sequential adjustment by multivariate analysis.Main outcome measuresIncidence and risk factors for PPH and progression to severe PPH.ResultsErrors in transcribing blood volume were frequent (14%) with evidence of threshold preference and avoidance. The incidences of PPH ≥500, ≥1500 and ≥2500 ml were 33.7% (95% CI 31.2–36.2), 3.9% (95% CI 3.3–4.6) and 0.8% (95% CI 0.6–1.0). New independent risk factors predicting PPH ≥ 500 ml included Black African ethnicity (adjusted odds ratio [aOR] 1.77, 95% CI 1.31–2.39) and assisted conception (aOR 2.93, 95% CI 1.30–6.59). Modelling demonstrated how prepregnancy- and pregnancy-acquired factors may be mediated through intrapartum events, including caesarean section, elective (aOR 24.4, 95% CI 5.53–108.00) or emergency (aOR 40.5, 95% CI 16.30–101.00), and retained placenta (aOR 21.3, 95% CI 8.31–54.7). New risk factors were identified for progression to severe PPH, including index of multiple deprivation (education, skills and training) (aOR 1.75, 95% CI 1.11–2.74), multiparity without caesarean section (aOR 1.65, 95% CI 1.20–2.28) and administration of steroids for fetal reasons (aOR 2.00, 95% CI 1.24–3.22).ConclusionsSequential, interacting, traditional and new risk factors explain the highest rates of PPH and severe PPH reported to date.

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Section: Resultsmentioning

confidence: 99%

Reporting errors, incidence and risk factors for postpartum haemorrhage and progression to severe PPH: a prospective observational study

Briley

Seed

Tydeman

et al. 2014

BJOG

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“…This study highlights the number of personnel medically repatriated from Afghanistan who are classified as primary care casualties, amounting to 20% of all AEs during 2009-10, but little is known about them compared to the well published data on battle casualties [3][4][5]. This 20% constitutes a sizeable hole in military medical research and puts potentially undue pressure on the medical evacuation air bridge.…”

Section: Discussionmentioning

confidence: 95%

Op HERRICK Primary Care Casualties: The Forgotten Many

Nelson¹,

Wall²,

Driver³

et al. 2012

J R Army Med Corps

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A significant number of aeromedical evacuations from Afghanistan are for primary care casualties. The DPTS can be used to provide a basic overview of the care pathway of repatriated personnel. Little contact with the medical services would appear to occur for these types of casualties. There is a significant gap in military medical research looking at primary care casualties repatriated from operations.

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“…In such patients, administration of fresh frozen plasma and cryoprecipitate, in addition to transfusion of crystalloid fluids and erythrocyte suspension, has been reported to decrease risk of mortality. [11][12][13] For the reversal of hyperthermia, core rewarming should be performed in the operating room and the ICU, and the blood and the intravenous fluids should be rewarmed. The third step of DCS includes definitive surgery for all associated organ injuries following metabolic normalization.…”

Section: Discussionmentioning

confidence: 99%

Where should the damage control surgery be performed – at the nearest health center or at a fully equipped hospital?

Uğur

Akküçük

Koca

et al. 2015

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Transport of casualties from a combat area to a fully equipped hospital where all techniques of damage control surgery (DCS) can be performed requires a great deal of time. Therefore, prior to transport, prompt control of hemorrhage and contamination should be achieved, and resuscitative procedures should be performed at the nearest health center. The aim of the present study was to investigate the effect of the location at which DCS was performed on rates of mortality.

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An upshot of war – Damage control resuscitation

Cited by 14 publications

References 38 publications

Reporting errors, incidence and risk factors for postpartum haemorrhage and progression to severe PPH: a prospective observational study

Reporting errors, incidence and risk factors for postpartum haemorrhage and progression to severe PPH: a prospective observational study

Op HERRICK Primary Care Casualties: The Forgotten Many

Where should the damage control surgery be performed – at the nearest health center or at a fully equipped hospital?

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